The US Supreme Court granted an emergency request for stay led by Idaho officials, allowing the state to temporarily enforce a statewide ban on gender-affirming care for certain minors. This ban is one of the first cases related to transgender health care to reach the nation’s highest court. Labrador v. Poe is the case that challenged the law enacted in Idaho last year, which prohibits treatments such as puberty blockers and hormone therapy for transgender minors.

Under the new law, physicians who provide gender-affirming care to transgender children could face up to 10 years in prison and up to $5,000 in fines. While the law can now be enforced statewide, it cannot be applied against the two plaintiffs who challenged it. Often, emergency docket decisions do not include reasoning. However, this 34-page decision included concurrences by Justices Neil Gorsuch, Samuel Alito, Clarence Thomas, Brett Kavanaugh and Amy Coney Barrett. 

The court’s written opinion emphasized that this case poses a question about “the propriety of universal injunctive relief, a question of great significance that has needed the Court’s attention for some time.” In other words, the Ninth Circuit granted relief to the plaintiffs and additionally decided the Idaho law’s enactment was to be halted. The Supreme Court ruled this was an overstep of the lower court’s authority. The court’s three liberal justices, Ketanji Brown Jackson, Sonia Sotomayor and Elena Kagan, objected to this decision, arguing that the law should have remained entirely blocked and that it was the natural order of a case to be challenged and move through the lower courts appropriately. 

The state of Idaho and its Attorney General Raul Labrador argue that “Every day Idaho’s law remains enjoined exposes vulnerable children to risky and dangerous medical procedures and infringes Idaho’s sovereign power to enforce its democratically enacted law.” The state says that since the plaintiffs both want access to a single procedure, it is unfair that the Ninth Circuit’s injunction applies to all 20+ procedures that the Idaho law regulates as they are two minors and their parents, and the injunction covers 2 million. 

The plaintiffs, two transgender teenagers whose identities are protected, argue that the law violates the Equal Protection Clause of the Fourteenth Amendment to the US Constitution, enforceable under 42 U.S.C. § 1983, which protects individuals and groups from discrimination by the government. The brief for the teens cites that the new law does not ban cisgender boys who are forecasted to have a post-pubertal height of 5’4″ or shorter as they may be treated with testosterone for “short stature.” Idaho doctors are thus free to prescribe testosterone to cisgender boys, including to affirm cisgender boys’ gender identity with overdeveloped breast tissue. Similar differences are allowed for cisgender girls to receive estrogen for specific delayed puberty issues. Thus, counsel argues that the law has “nothing to do with protecting children and everything to do with expressing disapproval of, and stigmatizing transgender people.”

This case is part of broader state jurisprudence across the country, with more than 20 conservative states enacting similar bans targeting care for transgender youth. This spring, appeals concerning similar laws in Tennessee and Kentucky will be up for consideration by the justices.