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The conservative-majority U.S. Supreme Court on Monday let a Republican-backed law in Idaho that criminalizes gender-affirming care for transgender minors broadly take effect after a federal judge blocked it as unconstitutional.
The court granted Republican Idaho Attorney General Raúl Labrador's request to narrow a preliminary injunction issued by U.S. District Judge Lynn Winmill, who ruled that the law violated the U.S. Constitution's 14th Amendment guarantees of due process and equal protection under the law, while the state pursues an appeal.
The Supreme Court's order allows the state to enforce the ban against everyone except the plaintiffs who challenged it.
Five of the court's six conservative justices concurred with the decision to grant Labrador's request. Its three liberal justices dissented. Conservative Chief Justice John Roberts did not publicly indicate how he voted.
Acting in a lawsuit brought by two transgender girls, 15 and 16, and their parents, Winmill blocked the Idaho law, called the Vulnerable Child Protection Act, days before it was set to take effect on Jan. 1.
The law, one of numerous similar measures passed by Republican-led states in recent years, targets medications or surgical interventions for adolescents with gender dysphoria, the clinical diagnosis for the distress that can result from an incongruence between a person's gender identity and the sex they were assigned at birth.
Healthcare professionals can face up to up to 10 years in prison for providing treatments such as puberty blockers, hormones and mastectomies that are "inconsistent with the child's biological sex."
The law does not prohibit such treatments for other medical conditions such as early puberty or genetic disorders of sexual development, if it is consistent with a minor's biological sex.
"The state has a duty to protect and support all children, and that's why I'm proud to defend Idaho's law that ensures children are not subjected to these life-altering drugs and procedures," Labrador said after the Supreme Court acted.
The American Civil Liberties Union, which represented the plaintiffs, said the decision allows the state to shut down care for thousands of families in Idaho.
"While the court's ruling (on Monday) importantly does not touch upon the constitutionality of this law, it is nonetheless an awful result for transgender youth and their families across the state," the ACLU said.
Justice Ketanji Brown Jackson, in a dissent joined by fellow liberal Justice Sonia Sotomayor, said, "This court is not compelled to rise and respond every time an applicant rushes to us with an alleged emergency, and it is especially important for us to refrain from doing so in novel, highly charged and unsettled circumstances."
The plaintiffs, represented by the American Civil Liberties Union, sued in federal court claiming that the law is unconstitutional because it discriminates based on sex and transgender status. The gender-affirming care the plaintiffs are receiving has improved their mental health and enabled them to become "thriving teenagers," a court filing said.
Noting that the law bars transgender minors from medical treatments that other minors can access, Winmill blocked the law because it unlawfully discriminates based on transgender status and sex. The 14th Amendment protects "disfavored minorities" from legislative overreach, the judge wrote.
"That was true for newly freed slaves following the Civil War. It was true in the 20th Century for women, people of color, inter-racial couples and individuals seeking access to contraception. And it is no less true for transgender children and their parents in the 21st century," Winmill added.
The judge also held that the law violated the protection under the 14th Amendment's due process clause for the fundamental right of parents to access generally available medical care for their children.
In a concurring opinion, Justice Neil Gorsuch said the Supreme Court's decision on Monday should put judges on notice not to issue such broad injunctions as Winmill did in this case.
"Lower courts would be wise to take heed," Gorsuch wrote in an opinion joined by fellow conservative Justices Clarence Thomas and Samuel Alito. "Retiring the universal injunction ... will lead federal courts to become a little truer to the historic limits of their office."
After the San Francisco-based 9th U.S. Circuit Court of Appeals refused to lift the injunction, Labrador, backed by the Alliance Defending Freedom conservative legal group, asked the Supreme Court to intervene.
Additional reporting by John Kruzel in Washington
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