In an 8-2 decision on Tuesday, the 8th U.S. Circuit Court of Appeals overturned a lower court ruling and upheld Arkansas’ law prohibiting minors from accessing sex-rejecting procedures. In its decision, the 8th Circuit’s majority cited the Supreme Court’s landmark ruling in United States v. Skrmetti, which determined that Tennessee's law regulating pediatric gender medicine does not discriminate based on “sex” or “transgender status.” The 8th Circuit similarly determined that Arkansas’ law does not violate the equal protection rights of trans-identified minors. The 8th Circuit also weighed in on whether Arkansas’ ban violated the due process rights of parents by infringing on their ability to direct medical care for their children. U.S. Circuit Judge Duane Benton, however, dismissed the due process argument, arguing that there’s a lack of historical support and precedent for the argument that parents have a right to access medical interventions for their children that a state legislature has banned.
Last week, a three-judge panel for the 10th Circuit unanimously ruled that Oklahoma’s law prohibiting minors from accessing sex-rejecting procedures is constitutional. The ruling, which also draws heavily on the Skrmetti decision, maintains that Oklahoma’s law is not driven by discriminatory animus and does not violate the Constitution. In the ruling, Circuit Judge Joel M. Carson notes that the respective laws in Tennessee and Oklahoma are “virtually indistinguishable.” “Here, like in Skrmetti, both groups include transgender minors, so there exists a ‘lack of identity’ between transgender status and the medical diagnosis excluded under SB 613. And like Tennessee’s SB1, under SB 613, a minor’s ability to receive medical treatment under SB 613 does not turn on the minor’s transgender status—it turns on the minor’s medical diagnosis” Carson wrote on behalf of himself and Circuit Judges Harris L. Hartz and Gregory A. Phillips.
In National Review Ethics and Public Policy Center fellow, Rachel Morrison, provides a helpful primer on the Federal Trade Commission’s recent announcement that it is seeking information from the public regarding “potential deceptive and unfair practices” related to “affirming care.” In particular, the FTC wants to understand the extent to which consumers “have been exposed to false or unsupported claims” or were not informed about “material risks associated with GAC,” which Morrison notes would violate Sections 5 and 12 of the FTC Act. Morrison goes on to outline the type of information that the FTC is looking for and unpacks four broad questions FTC is posing to the public to gather more detailed information from consumers. Comments are due Friday, September 26, 2025, by 11:59 p.m. and can be submitted publicly at regulations.gov or confidentially to ElectronicFilings@ftc.gov.
Journalist Ben Ryan provides an overview of new follow up data from the cross-sex hormone portion of the NIH-funded Trans Youth Care Study. The data is set to be presented at the American Academy of Child and Adolescent Psychiatry conference in October. As Ryan notes, the data is from the same study that science writer Jesse Singal took to task for a controversial 2023 paper that overstated the clinical significance of mental health improvements and failed to report findings for a number of pre-registered outcome variables like gender dysphoria, trauma symptoms, self-injury, suicidality, body esteem and quality of life. The follow up data provides an update on internalizing and externalizing symptoms among 277 participants who were between 12-20 years of age when first starting cross-sex hormones. The data suggests that roughly 25% of the sample had low symptoms at baseline and low symptoms four years later, 56% had high internalizing symptoms at baseline which showed some improvement over the course of the study, while 18% were persistently high in both internalizing and externalizing symptoms before and after treatment. Significantly, though, the study has no comparison group, and any changes in psychological improvement are confounded by variables that the study did not control for, like psychotherapy and the use of psychiatric medication.
In the New York Times, Dr. Kinnon R. MacKinnon–a trans-identified assistant professor who studies transgender care at York University in Toronto–writes about their research on “detransition” and its implications for policy. Unlike some researchers who maintain that detransition is rare, Dr. MacKinnon’s views are more nuanced and thoughtful, recognizing that different subpopulations have different outcomes. Although MacKinnon believes that blanket bans on sex-rejecting interventions are not supported by the research, MacKinnon acknowledges the reality that some transitioners are deeply dissatisfied with the consequences of medicalization. Indeed, among the detransition subtypes to emerge from MacKinnon’s research, the most common subtype (33% of participants) felt “let down by treatments, sometimes terribly so.” MacKinnon goes on to add that this subpopulation “detransitioned because of an identity change, mental health-related factors and dissatisfaction with treatment. They were much more likely to express strong regret with the decision to transition.” Revealingly, this subgroup was 90% female, more likely to start treatment at a young age, and to begin medical transition shortly after realizing their new identity.
Lisa Selin Davis writes a thoughtful rebuttal to Dr. MacKinnon’s opinion essay on detransition, arriving at radically different conclusions about the implications of MacKinnon’s research. As Davis notes, if the largest cohort in MacKinnon’s study experienced significant regret, “one might expect greater caution regarding the scale and rapid pace of gender-affirming surgeries.” Davis goes on to add that “If only 29% detransitioned for external reasons, and the majority reported worsening mental health and regret, why wouldn’t policymakers consider banning treatments that led to those results?” Davis goes on to muse about how the medical community can take stock of the issue and move forward to prevent “harmful outcomes in the future.”
Last Thursday, Massachusetts Gov. Maura Healey signed an updated “shield law” which reinforces protections for reproductive care, and protections for patients and physicians who seek or render sex-rejecting procedures. “It strengthens access to care. It bans discrimination. It protects the privacy and safety of those seeking reproductive care, gender-affirming care,” Gov. Healey told reporters. The law prohibits cooperation with out-of-state and federal investigations related to protected healthcare activities in the state, strengthens patient and consumer privacy, and prevents courts from citing “abuse, neglect or maltreatment” claims against parents who support their children undergoing sex-rejecting interventions.
According to The New York Times, at least a dozen trans-identified men and women serving in the Airforce who applied, and were cleared for, early retirement have had their approvals rescinded. Now these servicemembers, all of whom have 15-18 years of experience in the military, must choose between a “voluntary separation package” or an "involuntary separation." According to the Times, the benefits associated with early retirement packages are comparable to those received for medical retirement and standard retirement packages, however, it's unclear what exactly “voluntary packages” would entail.
Joseph Figliolia
Policy Analyst
News
