Federal Appeals Court upholds Oklahoma ban on gender transition care for minors

A federal appeals court has upheld Oklahoma’s ban on gender transition medical care for minors, ruling that the state’s law restricting doctors from providing hormone therapy, puberty blockers, and gender-affirming surgeries to people under 18 is constitutional.

In a decision handed down Wednesday, the U.S. Court of Appeals for the Tenth Circuit affirmed a lower court’s ruling, rejecting claims from families and doctors who argued that Senate Bill 613 violated parental rights and unfairly targeted transgender youth.

What Does SB 613 Do?

SB 613 is a state law in Oklahoma that:

1. Prohibits medical providers from giving “gender transition procedures” to anyone under 18 years old.

What Are “Gender Transition Procedures” Under This Law?

The law says these include:

1. Surgeries that change or remove body parts typical of someone’s biological sex.
2. Giving puberty blockers or “cross-sex” hormones (hormones meant to make someone develop traits typical of the opposite sex).

What’s NOT Prohibited?

SB 613 does not ban:

1. Mental health counseling or therapy for minors.
2. Medicines for treating depression, anxiety, or early/delayed puberty (as long as it’s not for gender transition).
3. Treatment for people with ambiguous genitalia (born with both male and female parts or neither).
4. Treatment for infections caused by previous gender transition procedures.
5. Emergency treatments to save someone’s life, regardless of gender transition.

Who Is Affected?

1. All minors (people under 18) in Oklahoma seeking medical gender transition (hormones or surgeries).

Who Can Still Get Treatment?

1. Adults (18 and over) are not affected by this law.
2. Kids who need puberty blockers for medical issues NOT related to gender transition (like precocious puberty) can still get them.
3. Kids born with ambiguous genitalia can get related medical treatments.

Key Reasons Behind the Bill (According to Lawmakers and the Court):

1. The Oklahoma Legislature says the law is designed to “protect kids,” reflecting concern about the long-term effects and risks of medical gender transition procedures in children, especially since medical opinions about these treatments are still evolving.
2. The court found that Oklahoma has a legitimate interest in protecting minors’ health and safety and that there isn’t a deeply rooted tradition in the U.S. of providing gender transition treatment to children.

How Did the Appeals Court Rule?

1. The court upheld the law, saying it does not unfairly target transgender minors for discrimination. It instead bans certain treatments for all minors, regardless of sex or gender identity, and is based on age and the type of medical procedure.
2. The court said that parents do not have a constitutional “fundamental right” to demand access to specific medical treatments for their children that a state has chosen to prohibit.

Timeline

October 2022

1. Governor Kevin Stitt calls for a statewide ban on gender transition surgeries and hormone therapies for minors.
2. Stitt blocks funding to Oklahoma Children’s Hospital at OU Health for gender transition services for minors by signing SB 3XX, which prohibits the use of certain funds for these procedures and sets the stage for a broader statewide ban.

February 6, 2023

1. SB 613 is introduced in the Oklahoma Senate by Sen. Julie Daniels (R-Bartlesville).

February 15, 2023

1. SB 613 passes the Oklahoma Senate with partisan support.

April 26, 2023

1. The Oklahoma House passes SB 613, sending the bill to Governor Stitt’s desk.

May 1, 2023

1. Governor Kevin Stitt signs SB 613 into law, enacting an immediate ban on gender transition surgeries and hormone therapies for those under 18.
2. The law includes criminal penalties for providers and allows civil action by parents or guardians. There is a six-month grace period for youth already receiving treatment.

May 2023

1. Multiple advocacy organizations, including the ACLU and Lambda Legal, file a lawsuit against SB 613 arguing it violates constitutional rights.

October 2023 & After

1. The district court denies a motion to block the ban, allowing SB 613 to go into effect pending appeal.

August 2025

The law remains in effect. The U.S. Court of Appeals for the Tenth Circuit affirmed a lower court’s ruling, rejecting claims from families and doctors who argued that Senate Bill 613 violated parental rights and unfairly targeted transgender youth.

Response

Oklahoma Attorney General Gentner Drummond, who led the state’s legal defense of the law, hailed the ruling. “My office mounted a vigorous defense of this commonsense law to protect children, and I am grateful the battle is now won. Thanks to this critical victory, our children will no longer be subjected to the lifelong consequences of these damaging procedures,” Drummond said in a statement.

Similar laws have been introduced or passed in other states and have faced legal challenges nationwide.

Oklahoma’s ban remains in effect following the ruling. Plaintiffs have not yet announced whether they will seek review by the U.S. Supreme Court.

The following is a joint statement from American Civil Liberties Union, the ACLU of Oklahoma, and Lambda Legal: 

“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. 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. While we and our clients consider our next steps, we want all transgender people and their families across Oklahoma to know we will never stop fighting for the future they deserve and their freedom to be themselves.”

Past Coverage

Oklahoma Attorney General's Office Puts Temporary Stay On Senate Bill Banning Gender Transition Care For Minors 

Breaking Down The State's Response To A Lawsuit Over Bill Banning Gender Affirming Care For Minors 

Gov. Stitt Bans Gender Transition Healthcare For Minors 

ACLU Files Lawsuit Claiming Oklahoma's Ban On Gender-Affirming Care For Minors Is Unconstitutional 

LGBTQ+ Community, Supporters Advocate For Gender-Affirming Care At State Capitol 

Ban Against Gender-Affirming Care For Minors Upheld By United States District Judge