A North Dakota judge ruled that he will not immediately block the state's ban on gender transition treatment for minors.
District Judge Jackson Lofgren on Monday denied a temporary restraining order requested by the plaintiffs. The three families and a pediatrician who are suing also sought a preliminary injunction to temporarily block the law from being enforced as their case proceeds, but a hearing for that request is not until January.
"We're disappointed in this ruling, but we are confident that when all the evidence has been presented, the court will ultimately find that ending the health care ban permanently is the only just, equitable, and constitutional resolution," said Gender Justice's Brittany Stewart, the lead attorney for the plaintiffs.
In his ruling, Lofgren cited the plaintiffs' "nearly five-month delay" in filing their complaint, as well as their argument based "upon inclusion in a protected class not previously recognized by the North Dakota Supreme Court or a new application of state constitutional principles."
The plaintiffs argued that North Dakota's new restrictions on puberty blockers, hormones and surgery for children violate the constitutional rights of transgender youth in the state.
House Bill 1254, which took effect in April, makes it a felony for a healthcare provider to perform gender transition surgery on a minor. The law also makes it a misdemeanor punishable by up to 360 days in jail and $3,000 in fines to prescribe or give hormone treatments or puberty blockers to a child.
Proponents of the law say it protects children from what they describe as irreversible effects of treatments and surgeries. Opponents, meanwhile, argue that the restrictions will harm transgender youth, who are at a greater risk of depression, self-harm and suicide, and claim that these surgeries were not being performed in North Dakota.
The legislation includes a grandfather clause for children who were receiving treatments before Republican Gov. Doug Burgum signed it into law. But Stewart argues that providers view the clause as too vague and thus, are not risking the penalties. The families who are suing have been traveling out of state so their children can receive gender transition treatment.
North Dakota is among roughly two dozen states with Republican-led legislatures that have passed similar laws restricting gender transition treatment for children, leading to legal challenges.
Judges have put on hold the enforcement of similar bans in Arkansas, Georgia, Indiana and Montana as cases play out. A court in Florida has allowed the state to enforce a ban generally, with an exception for those who challenged the ban. Judges initially paused enforcement in Alabama, Kentucky and Tennessee, but federal appeals courts have allowed those bans to move forward.
The Associated Press contributed to this report.