Federal Judge Sarah Geraghty ruled this week that Georgia may resume enforcing its ban on hormone replacement therapy for transgender youth, putting her previous order blocking the ban on hold. Attorney General Chris Carr had asked the judge to reconsider her first order.

The ruling comes after a federal appeals court granted neighboring Alabama the ability to enforce a similar restriction last month and as Republican-led states across the country seek to prohibit gender transition treatment for people under 18-years-old.

Twenty-two Republican-led states have banned transgender practices on Americans under the age of 18. This includes cases where schools convinced children to undergo procedures or when parents are involved.

In Georgia, doctors will not be allowed to perform surgeries on children seeking to align with their “gender identity.” Georgia’s law also prohibits health professionals from giving hormones to transgender minors. But transgender minors are allowed to receive puberty blockers, and anyone who began hormone therapy before the law took effect two months ago would be allowed to continue. Alabama’s law bans all treatment for minors, and some GOP lawmakers grumble that stipulation should have been included in Georgia’s legislation.

As states began passing these laws, the Biden White House came out in opposition. Despite growing concern about the harmful impact transgender procedures have on a child, White House press secretary Karine Jean-Pierre condemned states that ban the practice. (That came only days after a reportedly transgender person committed a mass shooting at a Christian school in Tennessee.)

Transgender activists have sued states that passed transgender bans for minors. But the ruling in Alabama paved the way for these laws to stand. Lawyers in Georgia referenced this decision, from the federal appeals court, as grounds to dismiss the challenge to its law.

“We are pleased with the court’s decision and will continue to protect the health and well-being of Georgia’s children,” said a spokeswoman for the state attorney general’s office.

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