On August 12, 2025, the U.S. Court of Appeals for the 8th Circuit upheld Arkansas’s 2021 Save Adolescents From Experimentation (SAFE) Act, overturning a lower court block and allowing the state to enforce a ban on gender-affirming medical care for transgender minors.
Passed over the veto of then‑Governor Asa Hutchinson, the SAFE Act prohibits puberty blockers, hormone therapy, and related referrals for anyone under 18. It also forbids insurance coverage and public funding for such treatments.
In an 8–2 split decision, the appellate court concluded the law does not discriminate based on sex or transgender status, citing the U.S. Supreme Court’s June 2025 ruling in United States v. Skrmetti, which upheld Tennessee’s similar ban.
The court also addressed parental rights, asserting that the Constitution does not guarantee the right to obtain medical treatments that the state deems inappropriate. Judge Duane Benton, writing for the majority, noted there is “no such right in this Nation’s history and tradition.” In dissent, Judge Jane Kelly criticized the decision, pointing to a “startling lack of evidence” linking the ban to genuine child protection goals.
For the ACLU of Arkansas and the families at the heart of the case, the decision is deeply painful. ACLU Executive Director Holly Dickson called the ruling “a tragically unjust result for transgender Arkansans, their doctors, and their families,” stressing that “this is a dangerous law that harms children” and denies them a fundamental right to necessary care.
Legal analysts warn this development may have ripple effects beyond Arkansas. With 25 Republican‑led states now enforcing similar bans, the ruling offers judicial momentum to other jurisdictions seeking to restrict gender‑affirming care for minors.
The conflict underscores a growing national divide: while several states champion “shield” laws that protect access to gender‑affirming care, Arkansas and others chart a contrary path. The SAFE Act now returns to a district court where it was previously found unconstitutional, a legal battle far from over.
For transgender youth and their families, the ruling’s consequences transcend courtroom arguments. They worry about denied healthcare, disrupted transitions, and the emotional toll of living under laws that challenge their identity. Meanwhile, health experts and major medical associations, including the World Professional Association for Transgender Health and the American Academy of Pediatrics, continue to affirm gender‑affirming care as evidence‑based and crucial to many minors’ well‑being.
This is not just legal news; it’s a human story of resilience, resistance, and the enduring struggle for trans-affirming healthcare. As the ruling reverberates through other courts and statehouses, its impact will be measured not only in legal precedent but also in the lived experiences of the young people at its center.
