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Judge blocks Ark. anti-trans youth health care law from taking effect

Hormones, transgender surgeries prohibited under measure

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A federal judge has blocked an Arkansas law from taking effect that would have criminalized providing transition-related care to youth, including hormones and gender reassignment surgery.

U.S. District Judge James Moody Jr., an Obama appointee, enjoined the law from taking effect on Wednesday after hearing oral arguments in a lawsuit by the American Civil Liberties Union. The law was set to go into effect July 28.

Holly Dickson, executive director of the ACLU of Arkansas, said in a statement the decision “sends a clear message to states across the country that gender-affirming care is life-saving care, and we won’t let politicians in Arkansas — or anywhere else — take it away.”

“Today’s victory is a testament to the trans youth of Arkansas and their allies, who never gave up the fight to protect access to gender-affirming care and who will continue to defend the right of all trans people to be their authentic selves, free from discrimination,” Dickson said. “We won’t rest until this cruel and unconstitutional law is struck down for good.”

The Arkansas law would have banned doctors from providing gender reassignment surgery, hormones or puberty blockers to any person under age 18. Doctors who provide the treatment in violation of the ban could be sued for damages or professionally sanctioned. The measure contained no grandfather clause for minors who were already undergoing treatment.

The law is but one of several measures enacted against transgender youth amid a wave of bills advanced by state legislatures this year, many of which are geared toward school sports or health care.

It’s also the second law to be enjoined from taking effect. Another court has blocked a Tennessee law from going into effect that would have required public accommodations to post signs if they allow transgender people to use the restroom consistent with their gender identity.

The Arkansas Legislature enacted the law, known as House Bill 1570, in March by overriding the veto of Gov. Asa Hutchinson. (Hutchison, however, had already signed into law this year two measures seen as anti-transgender, one barring transgender youth from sports, another allowing medical providers to opt out of offering procedures over religious objections.) The Arkansas law was set to go into effect on July 28.

Sam Brinton, vice president of advocacy and government affairs for The Trevor Project, said in a statement the ruling was “a huge victory for transgender and nonbinary youth in Arkansas.”

“Thank you to our friends at the ACLU and to all the brave families and doctors involved in this case,” Brinton said. “Gender-affirming medical care is associated with positive mental health outcomes and reduced suicide risk. All trans youth deserve access to this best-practice care regardless of where they live.”

The American Civil Liberties Union filed a lawsuit in May against the law on behalf of four transgender youth and their families as well as two doctors, contending it violates equal protection and due process under the Fourteenth Amendment and the freedom of speech under the First Amendment.

Arkansas Attorney General Lisa Rutledge pledged in a statement in the aftermath of the ruling to appeal the decision, making dubious claims the law was “evidence-based.”

“This evidence-based law was created because we cannot allow children as young as 9 years old to receive experimental procedures that have irreversible, physical consequences,” Rutledge said. “I will aggressively defend Arkansas’ law, which strongly limits permanent, life-altering sex changes to adolescents. I will not sit idly by while radical groups such as the ACLU use our children as pawns for their own social agenda. As the Attorney General of Arkansas, I will be appealing today’s decision.”

The Biden administration has also weighed in on this litigation, filing last month a Statement of Interest before the court assessing the Arkansas law violates equal protection and due process under the Fourteenth Amendment.

Tony Perkins, president of the anti-LGBTQ Family Research Council, said in a statement his organization is “disappointed but not surprised” by the judge’s ruling.

“The legal challenge to this law is being mounted by a political movement that advocates for using off-label drugs and experimental procedures on minors,” Perkins said. “Yet a growing number of individuals are coming forward to share their stories of being permanently disfigured and/or sterilized from procedures such as puberty-blocking drugs, cross-sex hormones and irreversible surgeries. The truth about the dangers of these life altering procedures cannot be ignored.”

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National

United Methodist Church removes 40-year ban on gay clergy

Delegates also voted for other LGBTQ-inclusive measures

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Underground Railroad, Black History Month, gay news, Washington Blade
Mount Zion United Methodist Church is the oldest African-American church in Washington. (Washington Blade photo by Michael Key)

The United Methodist Church on Wednesday removed a ban on gay clergy that was in place for more than 40 years, voting to also allow LGBTQ weddings and end prohibitions on the use of United Methodist funds to “promote acceptance of homosexuality.” 

Overturning the policy forbidding the church from ordaining “self-avowed practicing homosexuals” effectively formalized a practice that had caused an estimated quarter of U.S. congregations to leave the church.

The New York Times notes additional votes “affirming L.G.B.T.Q. inclusion in the church are expected before the meeting adjourns on Friday.” Wednesday’s measures were passed overwhelmingly and without debate. Delegates met in Charlotte, N.C.

According to the church’s General Council on Finance and Administration, there were 5,424,175 members in the U.S. in 2022 with an estimated global membership approaching 10 million.

The Times notes that other matters of business last week included a “regionalization” plan, which gave autonomy to different regions such that they can establish their own rules on matters including issues of sexuality — about which international factions are likelier to have more conservative views.

Rev. Kipp Nelson of St. Johns’s on the Lake Methodist Church in Miami shared a statement praising the new developments:

“It is a glorious day in the United Methodist Church. As a worldwide denomination, we have now publicly proclaimed the boundless love of God and finally slung open the doors of our church so that all people, no matter their identities or orientations, may pursue the calling of their hearts.

“Truly, all are loved and belong here among us. I am honored to serve as a pastor in the United Methodist Church for such a time as this, for our future is bright and filled with hope. Praise be, praise be.”

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Federal Government

Republican state AGs challenge Biden administration’s revised Title IX policies

New rules protect LGBTQ students from discrimination

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U.S. Secretary of Education Miguel Cardona (Screen capture: AP/YouTube)

Four Republicans state attorneys general have sued the Biden-Harris administration over the U.S. Department of Education’s new Title IX policies that were finalized April 19 and carry anti-discrimination protections for LGBTQ students in public schools.

The lawsuit filed on Tuesday, which is led by the attorneys general of Kentucky and Tennessee, follows a pair of legal challenges from nine Republican states on Monday — all contesting the administration’s interpretation that sex-based discrimination under the statute also covers that which is based on the victim’s sexual orientation or gender identity.

The administration also rolled back Trump-era rules governing how schools must respond to allegations of sexual harassment and sexual assault, which were widely perceived as biased in favor of the interests of those who are accused.

“The U.S. Department of Education has no authority to let boys into girls’ locker rooms,” Tennessee Attorney General Jonathan Skrmetti said in a statement. “In the decades since its adoption, Title IX has been universally understood to protect the privacy and safety of women in private spaces like locker rooms and bathrooms.”

“Florida is suing the Biden administration over its unlawful Title IX changes,” Florida Gov. Ron DeSantis wrote on social media. “Biden is abusing his constitutional authority to push an ideological agenda that harms women and girls and conflicts with the truth.”

After announcing the finalization of the department’s new rules, Education Secretary Miguel Cardona told reporters, “These regulations make it crystal clear that everyone can access schools that are safe, welcoming and that respect their rights.”

The new rule does not provide guidance on whether schools must allow transgender students to play on sports teams corresponding with their gender identity to comply with Title IX, a question that is addressed in a separate rule proposed by the agency in April.

LGBTQ and civil rights advocacy groups praised the changes. Lambda Legal issued a statement arguing the new rule “protects LGBTQ+ students from discrimination and other abuse,” adding that it “appropriately underscores that Title IX’s civil rights protections clearly cover LGBTQ+ students, as well as survivors and pregnant and parenting students across race and gender identity.”

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Federal Government

4th Circuit rules gender identity is a protected characteristic

Ruling a response to N.C., W.Va. legal challenges

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Lewis F. Powell Jr. Courthouse in Richmond, Va. (Photo courtesy of the U.S. Courts/GSA)

BY ERIN REED | The 4th U.S. Circuit Court of Appeals ruled Monday that transgender people are a protected class and that Medicaid bans on trans care are unconstitutional.

Furthermore, the court ruled that discriminating based on a diagnosis of gender dysphoria is discrimination based on gender identity and sex. The ruling is in response to lower court challenges against state laws and policies in North Carolina and West Virginia that prevent trans people on state plans or Medicaid from obtaining coverage for gender-affirming care; those lower courts found such exclusions unconstitutional.

In issuing the final ruling, the 4th Circuit declared that trans exclusions were “obviously discriminatory” and were “in violation of the equal protection clause” of the Constitution, upholding lower court rulings that barred the discriminatory exclusions.

The 4th Circuit ruling focused on two cases in states within its jurisdiction: North Carolina and West Virginia. In North Carolina, trans state employees who rely on the State Health Plan were unable to use it to obtain gender-affirming care for gender dysphoria diagnoses.

In West Virginia, a similar exclusion applied to those on the state’s Medicaid plan for surgeries related to a diagnosis of gender dysphoria. Both exclusions were overturned by lower courts, and both states appealed to the 4th Circuit.

Attorneys for the states had argued that the policies were not discriminatory because the exclusions for gender affirming care “apply to everyone, not just transgender people.” The majority of the court, however, struck down such a claim, pointing to several other cases where such arguments break down, such as same-sex marriage bans “applying to straight, gay, lesbian, and bisexual people equally,” even though straight people would be entirely unaffected by such bans.

Other cases cited included literacy tests, a tax on wearing kippot for Jewish people, and interracial marriage in Loving v. Virginia.

See this portion of the court analysis here:

4th Circuit rules against legal argument that trans treatment bans do not discriminate against trans people because ‘they apply to everyone.’

Of particular note in the majority opinion was a section on Geduldig v. Aiello that seemed laser-targeted toward an eventual U.S. Supreme Court decision on discriminatory policies targeting trans people. Geduldig v. Aiello, a 1974 ruling, determined that pregnancy discrimination is not inherently sex discrimination because it does not “classify on sex,” but rather, on pregnancy status.

Using similar arguments, the states claimed that gender affirming care exclusions did not classify or discriminate based on trans status or sex, but rather, on a diagnosis of gender dysphoria and treatments to alleviate that dysphoria.

The majority was unconvinced, ruling, “gender dysphoria is so intimately related to transgender status as to be virtually indistinguishable from it. The excluded treatments aim at addressing incongruity between sex assigned at birth and gender identity, the very heart of transgender status.” In doing so, the majority cited several cases, many from after Geduldig was decided.

Notably, Geduldig was cited in both the 6th and 11th Circuit decisions upholding gender affirming care bans in a handful of states.

The court also pointed to the potentially ridiculous conclusions that strict readings of what counts as proxy discrimination could lead to, such as if legislators attempted to use “XX chromosomes” and “XY chromosomes” to get around sex discrimination policies:

The 4th Circuit majority rebuts the state’s proxy discrimination argument.

Importantly, the court also rebutted recent arguments that Bostock applies only to “limited Title VII claims involving employers who fired” LGBTQ employees, and not to Title IX, which the Affordable Care Act’s anti-discrimination mandate references. The majority stated that this is not the case, and that there is “nothing in Bostock to suggest the holding was that narrow.”

Ultimately, the court ruled that the exclusions on trans care violate the Equal Protection Clause of the Constitution. The court also ruled that the West Virginia Medicaid Program violates the Medicaid Act and the anti-discrimination provisions of the Affordable Care Act.

Additionally, the court upheld the dismissal of anti-trans expert testimony for lacking relevant expertise. West Virginia and North Carolina must end trans care exclusions in line with earlier district court decisions.

The decision will likely have nationwide impacts on court cases in other districts. The case had become a major battleground for trans rights, with dozens of states filing amicus briefs in favor or against the protection of the equal process rights of trans people. Twenty-one Republican states filed an amicus brief in favor of denying trans people anti-discrimination protections in healthcare, and 17 Democratic states joined an amicus brief in support of the healthcare rights of trans individuals.

Many Republican states are defending anti-trans laws that discriminate against trans people by banning or limiting gender-affirming care. These laws could come under threat if the legal rationale used in this decision is adopted by other circuits. In the 4th Circuit’s jurisdiction, West Virginia and North Carolina already have gender-affirming care bans for trans youth in place, and South Carolina may consider a similar bill this week.

The decision could potentially be used as precedent to challenge all of those laws in the near future and to deter South Carolina’s bill from passing into law.

The decision is the latest in a web of legal battles concerning trans people. Earlier this month, the 4th Circuit also reversed a sports ban in West Virginia, ruling that Title IX protects trans student athletes. However, the Supreme Court recently narrowed a victory for trans healthcare from the 9th U.S. Circuit Court of Appeals and allowed Idaho to continue enforcing its ban on gender-affirming care for everyone except the two plaintiffs in the case.

Importantly, that decision was not about the constitutionality of gender-affirming care, but the limits of temporary injunctions in the early stages of a constitutional challenge to discriminatory state laws. It is likely that the Supreme Court will ultimately hear cases on this topic in the near future.

Celebrating the victory, Lambda Legal Counsel and Health Care Strategist Omar Gonzalez-Pagan said in a posted statement, “The court’s decision sends a clear message that gender-affirming care is critical medical care for transgender people and that denying it is harmful and unlawful … We hope this decision makes it clear to policy makers across the country that health care decisions belong to patients, their families, and their doctors, not to politicians.” 

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Erin Reed is a transgender woman (she/her pronouns) and researcher who tracks anti-LGBTQ+ legislation around the world and helps people become better advocates for their queer family, friends, colleagues, and community. Reed also is a social media consultant and public speaker.

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The preceding article was first published at Erin In The Morning and is republished with permission.

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