A federal appeals court on Monday reversed an injunction against Alabama’s law banning gender-affirming care for people under 19, allowing enforcement of the ban to take effect in the state.

A three-judge panel on the 11th U.S. Circuit Court of Appeals vacated a district court judge’s temporary injunction against the law, which bans the use of puberty blockers and hormones to treat trans children. The judge had set a trial date for April 2 to determine whether the law would be permanently blocked. 

The injunction will remain in place until the court issues the official mandate, which could take days, but once the injunction is officially lifted, the ban on gender-affirming care can be enforced. This marks the second such appellate victory against gender-affirming care restrictions, which have been adopted by a growing number of conservative states. 

The judges wrote that, in reversing the injunction, states have “a compelling interest in protecting children from drugs, particularly those for which there is uncertainty regarding benefits, recent surges in use, and irreversible effects.”

Alabama Attorney General Steve Marshall said the ruling represents a “significant victory for our country, for children, and for common sense,” adding, “The Eleventh Circuit reinforced that the State has the authority to safeguard the physical and psychological wellbeing of minors.”

Many medical groups push back on the idea that bans on gender-affirming care safeguards children’s wellbeing. The American Medical Association and the American Academy of Pediatrics both oppose bans on such care and say the treatments are safe if administered properly. 

Opponents of the ban publicly condemned the ruling on Monday. 

In a joint statement, the groups representing the Alabama families challenging the state’s law issued a statement, saying their clients are “devastated by this decision,” and called the ban “a shocking example of government overreach and a jarring intrusion into private family decisions.”

“Our clients are devastated by this decision, which leaves them vulnerable to what the district court—after hearing several days of testimony from parents, doctors, and experts—found to be irreparable harm as a result of losing the medical care they have been receiving and that has enabled them to thrive,” read the statement, issued by the National Center for Lesbian Rights, GLBTQ Legal Advocates & Defenders, The Southern Poverty Law Center, and Human Rights Campaign.

“While this is a setback, we are confident that it is only a temporary one. Every federal district court that has heard the evidence presented in these cases has come to the same conclusion: these medical treatments are safe, effective, and lifesaving for some youth, and there is no legitimate reason to ban them. We believe that at the end of the day, our nation’s courts will protect these vulnerable youth and block these harmful laws, which serve no purpose other than to prevent parents from obtaining the medical care their children need,” the statement continued.

“Parents, not the government, are best situated to make these medical decisions for their children. These laws are a shocking example of government overreach and a jarring intrusion into private family decisions. This case is far from over, and we will continue to aggressively seek legal protection for these families,” the statement concluded.

The ruling follows several other similar decisions in recent weeks against bans in other states, including a federal judge in June striking down a similar law in Arkansas, which was the first state to enact a ban. Now at least 20 state have enacted similar laws restricting such care for minors. 

The Vulnerable Child Compassion and Protection Act was signed into law in 2022, making it a felony punishable by up to 10 years in prison to treat people under 19 with puberty blockers or hormones. 

– The Associated Press contributed reporting