Montana Court Issues Final Blow to Anti-Trans Health Care Law

A judge found that the law's premise is not scientific, but “political and ideological.”

Photo by Steven Cordes on Unsplash

A state judge in Montana has permanently struck down SB 99, a law which sought to ban gender-affirming care for Montana youth under age 18.

The court decision is a welcome reprieve for young trans Montanans, who have had the threat of forced detransition hanging over their heads since 2023. The bill would have threatened the licensure of physicians who provided trans-affirming care to this age group and prevented state funds from being used for gender-affirming surgeries, hormones, puberty blockers, and “social transitioning” measures for trans youth. It also would have allowed parents of trans kids to sue medical professionals for providing their children with the proper care.

However, the bill permitted such treatments to remain readily available for children deemed “cisgender” by doctors, and for intersex children whose parents are often coerced into consenting to irreversible, life-altering genital surgeries for their infant children.

It also defined sex in binary and immutable terms. Under the law, “females” would be “a member of the human species who, under normal development, has XX chromosomes and produces or would produce relatively large, relatively immobile gametes, or eggs.” On the other hand, “males” means a person “who, under normal development, has XY chromosomes and produces or would produce small, mobile gametes, or sperm.”

But these kinds of laws, which are being passed around the country, are highly unscientific. They try to erase the biological reality of gender and sexual diversity to further a far-right gender ideology. As the court ruling declared, “the State’s interest is actually a political and ideological one: ensuring minors in Montana are never provided treatment to address” their gender dysphoria.

“In other words, the State’s interest is actually blocking transgender expression.”

Here are the key takeaways from the May 13 ruling.

1) The court found overwhelming evidence backing the benefits of gender-affirming care for trans people.

2) The court found that the so-called “risks” of gender-affirming care for trans kids—such as cardiovascular issues or the potential for “regret”—was not exceptional or outsized compared to other medical interventions young people may receive, neither in scope nor prevalence.

3) The court found trans-affirming care was unconstitutionally held to different levels of scrutiny than other kinds of health care.

4) The court found SB 99 violates Montanans’ right to privacy, which is enshrined in their state constitution.

5) The court cited foundational cases like the Bostock decision, which ruled that trans people are protected under sex-based anti-discrimination laws and legal precedents.

6) The court found SB 99 violated plaintiffs’ right to free speech.

“I will never understand why my representatives worked so hard to strip me of my rights and the rights of other transgender kids,” said Phoebe Cross, a 17-year-old transgender boy and plaintiff in the case. “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. Just living as a trans teenager is difficult enough, the last thing me and my peers need is to have our rights taken away.”