ACLU files suit against Kentucky law banning gender-affirming care for trans minors

People gather for a rally organized by LGBTQ youth and adults in opposition to Senate Bill 150 and also to celebrate Trans Day of Visibility in Lexington, Ky., Friday, March 31, 2022.

The ACLU of Kentucky has filed a legal challenge against Senate Bill 150, an omnibus bill seen by many opponents as one of the most severe pieces of “anti-trans” legislation in the United States.

The legal advocacy group filed the suit on behalf of seven unnamed Kentucky families, along with the National Center for Lesbian Rights and the law firm Morgan Lewis. It argues that the new law, which is only partially in effect, threatens to violate both plaintiffs’ individual protected rights and their parents’ protected rights under the Fourteenth Amendment.

Kentucky is one of several states whose General Assembly recently enacted a ban on gender-affirming care for transgender youth. In a legislative session marked by a Republican-led effort to combat “woke” ideology they say is infiltrating school classrooms and doctor’s offices, Senate Bill 150, targeting LGBTQ youth, was among the most controversial.

The lawsuit, filed in U.S. District Court for the Western District of Kentucky, takes issue with the portion of the Republican-backed Senate Bill 150 that bans gender transition health care services for youth living with gender dysphoria, including puberty blockers and cross-sex hormones such as testosterone and estrogen.

Gender dysphoria refers to the “psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity,” according to the American Psychiatric Association. Gender-affirming care to treat this type of dysphoria is any care administered by a provider to reduce an individual’s “clinically significant distress by permitting them to live in alignment with their gender identity,” the lawsuit explains.

The medical prohibitions in the new ban impacting this population are not slated to take effect until June 29. As that day nears, the ACLU will file a motion for preliminary injunction, asking a lower court to temporarily block enforcement of the law, ACLU Legal Director Corey Shapiro said Thursday in a news conference.

Currently in Kentucky, this type of health care is provided to minors only with a parent’s or guardian’s permission. Gender-affirming care, even for youth, is considered the standard of care by major medical associations, including the American Academy of Pediatrics, the American Medical Association and the American Psychological Association.

Though the lawsuit challenges SB 150’s medical prohibitions for trans youth, it notably does not seek to block the part of the law that bans gender transition surgery.

“While S.B. 150 also governs bathroom policies and sexual education in schools, Plaintiffs’ claims here relate solely to Section 4(2)(a) and (b) of S.B. 150, which bans the prescription and/or administration of puberty blockers and hormone therapy for transgender adolescents,” a footnote in the lawsuit reads.

The seven unnamed trans plaintiffs who filed with their families are between the ages of 9 and 16. Three live in Jefferson County, one lives in in the Western District of Kentucky and three live in the Eastern District.

Each plaintiff is currently receiving or will need gender-affirming medical care that will be illegal and inaccessible in Kentucky once the ban takes effect this summer, care that their parents and doctors agree is “medically necessary,” the lawsuit states.

Most of the plaintiffs socially transitioned at a young age, meaning they began wearing clothes and expressing themselves differently from their gender assigned at birth.

One of the plaintiffs, a trans girl who’s 14, “has always known she is a girl.” She was diagnosed with gender dysphoria at a young age, and now, with her parents’ consent, she’s prescribed estrogen. This treatment “significantly reduced JM Doe 4’s gender dysphoria and helped her feel more comfortable in her body,” according to the lawsuit. It has “provided (her) with a level of comfort and joy that her parents had never seen before.”

The lawsuit also claims SB 150 violates the Fourteenth Amendment’s clause protecting the rights of parents to make decisions “concerning the care, custody, and control of their children.”

The ban “violates this fundamental right by preventing parent plaintiffs from obtaining established, medically necessary care for their minor children,” the lawsuit says.

Though gender dysphoria is “highly treatable,” the lawsuit explains, “untreated gender dysphoria is associated with severe psychological and emotional harm, including anxiety, depression, and suicidality.”

The youngest plaintiff, a nine-year-old trans girl, was diagnosed with gender dysphoria when she was seven. Since then, her parents have taken her to an endocrinologist, a social worker and other health care providers to receive affirming care. She has socially transitioned, but she hasn’t gone through puberty yet and hasn’t begun taking any medication for her dysphoria. Once the law takes effect, her parents worry the ban will cause their daughter “irreparable harm by preventing her doctors from providing the medical care they may need when she begins puberty,” according to the lawsuit.

“Disrupting or denying medically needed care will inevitably cause plaintiffs and other vulnerable adolescents significant, irreparable harm,” it says.

Senate Bill 150 was sponsored by Sen. Max Wise, R-Campbellsville, who initially filed a version that narrowly dealt with ‘parental rights’ issues and transgender pronoun use by school employees. The scope of the bill drastically widened in the waning days of the legislature. Nearly all of the state legislature’s elected Democrats opposed the bill, while nearly all the Republicans supported it.

Gov. Andy Beshear vetoed the measure, but his veto was overriden by the Republican-controlled House and Senate. Hundreds gathered at the capitol to protest the legislature when it took votes on the bill.

After filing on Tuesday, the ACLU of Kentucky tweeted, “To trans youth in Kentucky: you belong here. We’ll continue to fight for your right to equal protection under the law & freedom to access the things you need to live full & authentic lives. To the commonwealth: we’ll see you in court.”

Ban Conversion Therapy Kentucky, an LGBTQ rights advocacy group, said they were working with other attorneys to file a separate lawsuit against the bill, potentially on different provisions.

“The lawsuit wisely doesn’t include the likely unconstitutional provisions concerning parental rights and student rights that likely conflict with federal education law, including FERPA and Title IX,” Rebecca Blankenship, Executive Director of Ban Conversion Therapy Kentucky, said in a statement. “The provisions, respectively, that remain unchallenged concern bathroom privacy, freedom of association, ‘Don’t Say Gay or Trans,’ and adult-on-kid harassment, issues already identified by the Kentucky Department of Education.”