Bloomberg Law
Aug. 21, 2023, 1:31 PM

Transgender Care Ban for Minors Blocked in Georgia Federal Court

Mary Anne Pazanowski
Mary Anne Pazanowski
Legal Reporter

Georgia health officials can’t enforce a new law that precludes parents and their transgender children from seeking and obtaining medically necessary gender-affirming care, a federal court in the state said Sunday.

The law, SB 140, likely singles out transgender minors for a denial of care in violation of their 14th Amendment equal protection rights, the US District Court for the Northern District of Georgia said. The court issued a preliminary injunction that prevents the officials from enforcing the law while the case continues.

There are now 21 states that ban hormone therapy to treat gender dysphoria in minors, according to the Movement Advancement Project. Several federal trial courts have blocked them from enforcing these laws, but the US Court of Appeals for the Sixth Circuit has allowed Kentucky and Tennessee’s bans to take effect.

Georgia’s SB 140 is subject to heightened scrutiny under the equal protection clause, Judge Sarah E. Geraghty said. It unlawfully draws distinctions based on the sex assigned to a person at birth, and it treats people differently based on their gender nonconformity, she said.

The officials didn’t show that their interests were strong enough to survive this level of analysis, Geraghty said. Although protecting children is generally an important interest, there was no proof SB 140 served it, she said.

Every medical treatment—including hormone therapy—carries both risks and benefits, and a doctor’s decision about a particular course of treatment depends on balancing them, Geraghty said. Additionally, there was ample evidence of the therapy’s benefits, and little evidence supporting the officials’ claim that people who’ve undergone hormone therapy have regretted it later in life, she said.

In short, Georgia didn’t show a close “means-end fit” between the law and the state’s interests, the court said. Therefore, it’s substantially likely the plaintiffs will win on the merits, Garaghty said.

Absent an injunction, the plaintiffs will suffer immediate and irreparable harm as a result of the law, which took effect July 1, Geraghty said. The law bars most surgeries and hormone replacement therapy, but allows doctors to prescribe puberty-blocking drugs and permits minors who were receiving hormone therapy as of July 1 to continue.

The plaintiffs sued the state June 29.

The Human Rights Campaign Foundation, O’Melveny & Myers LLP, the American Civil Liberties Union Foundation of Georgia, and the Southern Poverty Law Center represent the plaintiffs. Consovoy McCarthy PLLC and the Georgia Attorney General’s Office represent the state officials.

The case is Koe v. Noggle, N.D. Ga., No. 23-cv-2904, 8/20/23.

To contact the reporter on this story: Mary Anne Pazanowski in Washington at

To contact the editors responsible for this story: Rob Tricchinelli at; Maya Earls at; Drew Singer at

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