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Trans rights activists march past the state capitol on Feb. 14, 2023, in Nashville, Tenn.John Amis/The Associated Press

A Tennessee law prohibiting doctors from providing medical care such as puberty-blockers and gender affirming surgery for transgender minors can go into effect immediately, a U.S. appeals court ruled Saturday.

The U.S. Court of Appeals for the Sixth Circuit said advocacy groups that had challenged Tennessee’s law could not show they were likely to prevail on their claims it violated the U.S. Constitution. The panel of three judges voted 2-1 to reverse a lower court’s decision that had blocked Tennessee from enforcing the law while it was being challenged.

“Life-tenured federal judges should be wary of removing a vexing and novel topic of medical debate from the ebbs and flows of democracy by construing a largely unamendable federal constitution to occupy the field,” Judge Jeffrey Sutton wrote for the appeals court.

Neither the advocacy groups that challenged the law nor the state’s attorney general could be reached Saturday morning.

Tennessee’s law is part of a growing series of efforts by Republican lawmakers to impose new restrictions on medical care for transgender youths. Lawmakers said the measure was necessary to protect minors from being permanently harmed. Medical associations have said gender-affirming care can be life-saving.

It bans any medical procedure performed for the purpose of enabling a minor to identify with a gender other than the one they were assigned at birth.

Federal judges have blocked five laws similar to Tennessee’s from taking effect. Those judges found the laws violated the Constitution’s guarantee of equal protection under the law.

The appeals court’s decision Saturday said that absent a clear showing that Tennessee’s law violated the Constitution, choices about medical care and protecting minors are best settled by state legislatures.

Judge Helen White said she believed Tennessee’s law “is likely unconstitutional” as a type of sex discrimination.

Sutton wrote that the appeals court will try to reach a final decision about Tennessee’s law by Sept. 30. “These initial views, we must acknowledge, are just that: initial,” he wrote. “We may be wrong.”

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