Federal Trial Over Arkansas Ban On Gender-Affirming Care Underway

By Tess Vrbin, Arkansas Advocate

October 17, 2022

The federal trial challenging Arkansas’ ban on gender-affirming medical care for transgender minors began with testimony from a psychiatrist who said he has treated thousands of patients with gender dysphoria over the past three decades.

Dr. Dan Karasik, based in San Francisco, said he has seen firsthand that people of all ages with gender dysphoria, or distress due to the incongruence of gender identity and biological sex, experience a “dramatic relief” of anxiety, depression, suicidal ideation and other mental health struggles after receiving gender-affirming care.

Act 626 of 2021, or the Save Adolescents From Experimentation (SAFE) Act, was the first of its kind in the U.S. The law banned physicians from providing “gender transition” treatments like puberty blockers and sex reassignment surgeries to minors. Several transgender minors, their families and two doctors filed suit against the law shortly after it was passed, and the American Civil Liberties Union is representing them.

Not all transgender individuals seek surgeries to change their biological sex, Karasik said.

The defense, including Attorney General Leslie Rutledge, has stated that minors who transition may “outgrow” their stated gender identity or come to regret transitioning. Karasik said he has not seen this from any of his patients over about 30 years. He also said he has seen patients’ mental health struggles return if their treatments stopped for any reason, including loss of health insurance.

The defense has also claimed minors identify as transgender due to “social contagion” based on their friendships and media consumption. Karasik said this is a misunderstanding.

“As they grow to have an awareness of being transgender or having gender dysphoria, they seek out peers that might share their experiences and seek out media to gain more information and social support,” Karasik said.

U.S. District Judge James Moody is hearing the case in a bench trial and is expected to rule this week or next week. Moody placed an injunction on Act 626 in July 2021 that was upheld in August by a three-judge panel of the 8th U.S. Circuit Court of Appeals.

Similar laws restricting access to gender-affirming care in three other states — Alabama, Arizona and Texas — also are on hold after judges blocked enforcement.

A Kaiser Family Foundation analysis of the legal landscape published in June noted that in addition to the four that have adopted similar bans on gender-affirming care for youth, 15 others were considering 25 pieces of legislation with similar aims.

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