In a significant victory for transgender rights, transgender youth in Montana regained access to gender-affirming care on Tuesday after a state court declared Senate Bill 99 unconstitutional. The bill, passed in 2023, sought to ban puberty blockers, hormone treatments, and surgical procedures for minors experiencing gender dysphoria.
Montana Fourth Judicial District Court Judge Jason Marks, in a detailed 59-page ruling, determined that the law was rooted in political and ideological motivations rather than a genuine state interest in protecting minors. Marks concluded that the law effectively aimed to block transgender expression rather than address any medically acknowledged risks.
A Politically Driven Law
SB 99 not only prohibited critical medical care for transgender minors but also threatened disciplinary actions against healthcare providers who violated its terms, including suspension of their medical licenses for at least a year. The families of two transgender teenagers, alongside two healthcare providers, challenged the law, arguing it violated their constitutional rights to privacy and equal protection.
Judge Marks issued a preliminary injunction in September 2023, preventing the law from taking effect. The Montana Supreme Court upheld this injunction in December 2024, citing likely violations of the state’s right to privacy. In the final ruling, Marks noted that the state’s defense of the law fell short, particularly its assertion that gender-affirming treatments posed a health risk.
Medical Consensus Supports Care
The state attempted to justify the law by claiming a need to protect minors from “experimental” treatments. However, Marks pointed out that major medical organizations, including those in the United States, recognize gender-affirming care as appropriate for adolescents with gender dysphoria. The judge dismissed the state’s reliance on detransition narratives, noting that both sides agreed that regret rates among those receiving such care were relatively low.
“It is illogical for the Montana Legislature to pass laws regulating medical treatment that would hurt a majority where it might help a minority,” Marks wrote, emphasizing that almost every medical procedure carries a risk of regret. He highlighted the inconsistency of banning treatments for trans youth while allowing comparable medical decisions for other minors.
Marks also rejected the state’s argument that constitutional protections don’t extend to minors when a compelling interest exists. The judge found no evidence that the law would enhance protection for minors and warned that accepting such logic could lead to absurd outcomes, such as banning flu shots to protect the few who might have allergic reactions.
Relief and Celebration
The ruling was met with relief from plaintiffs and advocates alike. Phoebe Cross, a 17-year-old transgender boy involved in the lawsuit, expressed gratitude for the decision:
“I will never understand why my representatives worked so hard to strip me of my rights and the rights of other transgender kids. It’s great that the courts, including the Montana Supreme Court, have seen this law for what it was-discriminatory-and today have thrown it out for good.”
Malita Picasso, a staff attorney with the American Civil Liberties Union, also praised the decision:
“The court recognizes SB 99 for what it truly is, an effort by the state to legislate transgender Montanans out of existence,” Picasso said.
The Bottom Line
For transgender youth and their families, the ruling restores not only access to essential healthcare but also a sense of justice. As courts continue to challenge discriminatory laws, trans communities and their allies remain hopeful that more states will uphold fundamental rights, protecting trans youth from harmful legislation.
