A federal appeals court has upheld an Oklahoma law prohibiting minors from accessing gender-affirming care, reinforcing a growing trend of legal support for such bans across the country.
The decision, released Wednesday by the Tenth Circuit Court of Appeals, reinforces Senate Bill 613, which stops Oklahomans under 18 from receiving hormone therapy, puberty blocking medications or surgical gender-affirming care. Under the law, health care providers who violate the ban can face felony charges.
Shortly after the ban became law, a group of five families and a medical provider specializing in adolescent medicine, supported by Lambda Legal and the ACLU of Oklahoma, filed suit against the state. The plaintiffs argued the ban violated their rights under the Equal Protection Clause of the Fourteenth Amendment.
An Oklahoma district court denied a preliminary injunction in October 2023 but the plaintiffs appealed their case.
The appeals court's unanimous decision found "no evidence" the Oklahoma law discriminates against transgender minors. To make a ruling, the court relied heavily on the U.S. Supreme Court's ruling in United States v. Skrmetti, which upheld a similar ban in Tennessee in June.
Attorney General Gentner Drummond praised the decision and said it will protect Oklahoma children from "so-called 'gender transition' procedures."
"I am grateful the battle is now won," Drummond said in a statement on Thursday. "Thanks to this critical victory, our children will no longer be subjected to the lifelong consequences of these damaging procedures."
A 2025 study from JAMA Pediatrics found that less than 0.1% of teens with private insurance in the U.S. are transgender and receive gender-related medicines.
In a joint statement, the organizations that filed the lawsuit said they are considering their next steps.
"Yesterday's ruling is a devastating outcome for transgender youth and their families across Oklahoma and another tragic result of the Supreme Court's errant and harmful ruling in Skrmetti," the statement said. "Oklahoma's ban is openly discriminatory and provably harmful to the transgender youth of this state, putting political dogma above parents, their children, and their family doctors."
Oklahoma is one of 27 other states that have enacted laws or policies limiting youth access to gender-affirming care since 2021.
Virtually all major U.S. medical associations support youth access to gender-affirming care, including the American Medical Association, American Academy of Pediatrics and the American Psychological Association, among others. The groups cite evidence demonstrating that medically necessary gender-affirming care improves mental health outcomes for transgender youth, including by reducing suicidal ideation.
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