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Landmark trial on Arkansas trans youth medical ban wraps up


LITTLE ROCK, Ark. (AP) — The nation's first trial on a ban on gender-confirming care for children ended Thursday, as Arkansas wrapped up its case defending the prohibition with testimony from an endocrinologist opposed to such treatments for minors.

U.S. District Judge Jay Moody, who is considering whether to strike down the law after hearing nearly two weeks of testimony, didn't indicate when he would rule. Moody asked attorneys for the state and the American Civil Liberties Union to come up with a schedule for filing additional briefs in the case.

Arkansas’ law, which Moody temporarily blocked last year, would prohibit doctors from providing gender-confirming hormone treatment, puberty blockers or surgery to anyone younger than 18. It also would prohibit doctors from referring patients elsewhere for such care.

The state's final witness was Dr. Paul Hruz, a pediatric endocrinologist in St. Louis, who said the research in support of such care for minors with gender dysphoria is flawed. He said the risks were too great to administer such treatment to minors.

“There remains a question as to whether the risks outweigh the benefits and whether alternatives exist," Hruz said. “It's still an area that needs scientific investigation."

Experts say such treatments are safe if properly administered. The American Medical Association and the American Academy of Pediatrics, the Endocrine Society and the Pediatric Endocrine Society are among the multiple medical groups that have opposed Arkansas' ban in court.

Under cross-examination by an attorney from the American Civil Liberties Union, Hruz acknowledged that he has never treated a patient for gender dysphoria or diagnosed a patient with it. Hruz also was questioned about briefs he's signed onto in other court cases regarding transgender youth.

One brief — in a case regarding a school preventing a transgender teen from using the bathroom that corresponded with his gender identity — said “conditioning children into believing that a lifetime of impersonating someone of the opposite sex, achievable only through chemical and surgical interventions, is a form of child abuse."

Hruz said he “would not have chosen that wording."

Arkansas was the first state to enact a ban on gender-confirming care for children, with Republican lawmakers in 2021 overriding GOP Gov. Asa Hutchinson’s veto of the legislation. Hutchinson, who had signed other restrictions on transgender youths into law, said the prohibition went too far by cutting off the care for those currently receiving it.

The ACLU, which sued Arkansas on behalf of four families of transgender children in the state, called the law one of the most dangerous it has challenged.

“Not only does it threaten medically necessary, lifesaving care, but this and bills and resolutions like it singling out LGBTQ Arkansans send a clear, toxic message from the state legislature that all people are not welcome in Arkansas," Holly Dickson, executive director of the ACLU of Arkansas, said in a statement Thursday afternoon.

The state has argued that the prohibition is within its authority to regulate the medical profession. People opposed to such treatments for children argue they are too young to make such decisions about their futures.

“The (law) protects children from life-altering, permanent decisions that they may desire to make as an underage child but could regret as an adult; no law in Arkansas prevents someone from making these decisions as an adult," Republican Attorney General Leslie Rutledge, whose office is defending the ban, said in a statement.

A similar ban has been blocked by a federal judge in Alabama, and other states have taken steps to restrict such care. Florida medical officials last month approved a rule banning gender-confirming care for minors, at the urging of Republican Gov. Ron DeSantis.

A judge in Texas has blocked that state’s efforts to investigate gender-confirming care for minors as child abuse. Children’s hospitals around the country have faced harassment and threats of violence for providing gender-confirming care.

The Arkansas trial, which resumed Monday after a five-week recess, included testimony from one of the transgender youth challenging the state's ban. The teenager testified in October that the hormone therapy he's received has transformed his life and that the ban would force him to leave the state.

The 8th U.S. Circuit Court of Appeals last month said it wouldn't reconsider its ruling keeping the temporary order against Arkansas' ban in place.