Fate of Georgia ban on treatment for trans kids in judge’s hands

Protesters gather in March at the Georgia Capitol to oppose Senate Bill 140. The measure, which became law on July 1, prevents medical professionals from giving transgender children certain hormones or surgical treatment. A federal judge is now considering whether to put a hold on the law after parents of transgender children filed a lawsuit, saying it does not allow them to make health care decision for their children. (Arvin Temkar / arvin.temkar@ajc.com)

Credit: arvin.temkar@ajc.com

Credit: arvin.temkar@ajc.com

Protesters gather in March at the Georgia Capitol to oppose Senate Bill 140. The measure, which became law on July 1, prevents medical professionals from giving transgender children certain hormones or surgical treatment. A federal judge is now considering whether to put a hold on the law after parents of transgender children filed a lawsuit, saying it does not allow them to make health care decision for their children. (Arvin Temkar / arvin.temkar@ajc.com)

A federal judge on Friday said she needs more time before deciding whether she will halt a state law that bans certain treatments for transgender minors while a challenge to the statute makes its way through the court process.

Attorneys representing the families of transgender children told U.S. District Judge Sarah E. Geraghty that upholding Georgia’s law will have negative effects on the mental and physical health of trans minors.

Attorneys representing the state argued in the two-day hearing that more studies should be done before claiming that the benefits of allowing minors to receive hormone or surgical treatment outweigh any potential medical risks, such as blood clots, heart disease or infertility.

Geraghty, who was appointed by President Joe Biden, said she understood the high level of interest in her ruling and that she would make a decision “as soon as I possibly can.”

“I need to process the evidence we’ve heard over the past two days,” she said. “I’m going to take some additional time to make sure I get this right.”

Civil rights organizations — including the American Civil Liberties Union of Georgia, the Human Rights Campaign and the Southern Poverty Law Center — argued on behalf of the families that the law needed to be put on hold while the challenge makes its way through the court system because it takes away the rights of parents to make health care decisions for their children.

“Gender dysphoria is a real and serious medical condition that is highly treatable (under) the well-established standards of care,” said Ben Bradshaw, an attorney representing the families. Gender dysphoria — the distress that comes from feeling you’re not the gender you were assigned at birth — is a diagnosis often given to transgender people.

“The evidence confirms that these treatments lead to positive outcomes,” Bradshaw said. “They make people better and alleviate the distress. Isn’t that the point of medical care?”

The law — passed during the 2023 legislative session and signed by Gov. Brian Kemp in March — took effect July 1.

Dr. Meredithe McNamara, a professor of pediatrics who specializes in adolescent medicine and has treated children with gender dysphoria, testified that the benefits of providing care to transgender minors vastly outweighs risks associated with testosterone or estrogen treatments.

“The benefits of gender-affirming care for trans adolescents are particularly profound ... (and) can divert someone from an adolescence of distress,” she said.

Attorneys for the state said the court should deny the move to put a hold on the law because state government “has wide latitude to regulate medical procedures,” especially when the risks outweigh the benefits.

“If you’re going to administer something with risks, the benefits must be profound,” said Jeffrey M. Harris, an attorney representing the state. “And the evidence just doesn’t show that.”

Dr. Paul Hruz, a pediatric endocrinologist and professor of pediatrics at the Washington University School of Medicine, testified that the quality of the evidence provided in U.S. studies on the treatment of gender dysphoria in minors is low because of “confounding variables.”

Hruz said most transgender people are treated with both medical care, such as the hormone replacement therapy, and counseling.

“Most of these studies show association,” he said. “We can’t conclude that it’s the hormone therapy and not the psychotherapy.”

Hruz said he has never treated minors for gender dysphoria.

Several Georgia families filed a federal lawsuit against the state in June asking the courts to stop the measure from going into effect, saying it takes away the rights of parents to make health care decisions for their children. The complaint was filed a little more than a day before the law was set to take effect on July 1.

Georgia’s law, Senate Bill 140, bans health care professionals from giving hormones such as estrogen and testosterone to transgender minors. Doctors also are not allowed to perform surgeries on children seeking to align with their gender identity.

Some federal judges have stopped similar laws from taking effect in other states, including Alabama and Florida, as the cases make their way through the court process. The 6th U.S. Circuit of Appeals allowed similar laws to take effect in Kentucky and Tennessee after lower federal judges initially blocked them.

Supporters of SB 140 say it protects children from taking steps toward gender transition that are permanent. Opponents say the law goes against published medical “standards of care” and will end up hurting transgender children, who commit suicide at a higher rate than their nontransgender peers.

Medical professionals are still allowed to prescribe a hormone treatment that aims to delay puberty or stop it from progressing under the law. Children who don’t identify with their biological sex at a young age are often prescribed the puberty blockers.

SB 140 also allows minors to continue receiving hormone treatments if they began before July 1.