Editor’s note: This article has been updated.

A federal judge on Tuesday struck down an Arkansas law that would have prevented doctors from providing gender-affirming care to transgender youth or referring them to any other health care worker. The state is “permanently enjoined” from enforcing the law, U.S. District Judge James Moody Jr. wrote in his decision. 

The decision marks the end of the first full trial for such a ban. LGBTQ+ legal experts and advocates believe that the decision in Arkansas, which has blocked the first gender-affirming care ban to become law, will set precedent for other lawsuits in states restricting gender-affirming care. 

The law, which never took effect due to a preliminary injunction granted last year, is now blocked. The bill’s history was fraught even before it was passed into law. Republican Gov. Asa Hutchinson vetoed the ban in 2021, calling it extreme, but had his protests overruled by state lawmakers. Holly Dickson, executive director of the ACLU of Arkansas, said the law is “one of the most dangerous” that the group has ever challenged — adding that debate over the law has sent a harmful message to trans youth and LGBTQ+ people in the state that they are not welcome. 

Four families of transgender youth and two doctors sued Arkansas over its ban, on the grounds that it violated the 14th Amendment’s equal protection and due process clauses by discriminating on the basis of sex and transgender status, as well as the right to freedom of speech in the First Amendment, since the ban would restrict doctors’ ability to communicate with patients. They had to prevail in only one of these claims to have the law invalidated and to block its enforcement across the state. 

U.S. District Judge James Moody Jr. awarded all of those claims and found that Arkansas’ law is unconstitutional. Arkansas can appeal the decision, although the U.S. Court of Appeals for the 8th Circuit previously upheld the preliminary injunction that kept the care ban from being enforced — and then declined the state’s appeal to reconsider that decision last month. 

Other states that want to restrict transgender health care have been watching this trial closely. Twenty states sided with Arkansas as the state defended its gender-affirming care ban. Those states asked the Eighth Circuit to reconsider its support of the initial injunction that blocked the law from taking effect. The court declined to do so. 

Of those states who joined a friend-of-the-court brief in support of Arkansas in October last year, at least 13 went on this year to pass restrictions on gender-affirming care for minors: Georgia, Idaho, Indiana, Kentucky, Mississippi, Missouri, Montana, Oklahoma, South Dakota, Tennessee, Texas, Utah, and West Virginia. 

Lawsuits against these state bans, led by national advocacy groups in order to block their enforcement, have been launched across multiple states. Gender-affirming care bans in several states have already been temporarily blocked by judges — with the latest taking place in Indiana, where a federal judge last week halted a ban on hormone therapy and puberty blockers from taking effect on July 1. 

“I’m so grateful the judge heard my experience of how this health care has changed my life for the better and saw the dangerous impact this law could have on my life and that of countless other transgender people,” Dylan Brandt, a 17-year-old transgender student from Arkansas and plaintiff in the lawsuit, said in a statement. “Transgender kids across the country are having their own futures threatened by laws like this one, and it’s up to all of us to speak out, fight back, and give them hope.”