Kansas Judge Blocks State Law Banning Gender-Transition Care for Minors

On May 15, 2026, Douglas County District Judge Carl Folsom issued a temporary injunction blocking Kansas from enforcing SB 63, the state's ban on gender-affirming medical care for transgender people under 18 [1]. The ruling found the law likely violates the Kansas Constitution's Bill of Rights, which Judge Folsom said protects "the fundamental right of personal autonomy, including the right of parents to make medical decisions for their children" [1][2].

The decision arrives nearly a year after the U.S. Supreme Court closed the federal courthouse door on these challenges. It marks Kansas as a test case for whether state constitutions can provide protections that the federal Constitution, as interpreted by the current Court, does not.

The Law and Its Path to Enactment

Kansas SB 63 prohibits medical providers from prescribing puberty-blocking medications, cross-sex hormones, or performing surgical procedures to treat gender dysphoria in patients under 18 [3]. The law permits these same treatments for cisgender youth — puberty blockers for precocious puberty, for example — creating what challengers call a sex-based classification [4].

Governor Laura Kelly vetoed the bill in January 2025, stating that "it is not the job of politicians to stand between a parent and a child who needs medical care of any kind" [1]. The legislature overrode her veto, and SB 63 took effect on February 20, 2025 [3].

The law includes provisions for civil liability, allowing lawsuits against providers who offer gender-affirming care up to 10 years after patients turn 18, and subjects providers to potential license revocation [5]. A predecessor bill, SB 233, had also included restrictions on state employees supporting "social transitioning" — defined as changing pronouns or manner of dress — but that earlier version failed when the legislature could not override Kelly's veto in 2024 [5][6].

The Legal Theory: State Constitution as Shield

Judge Folsom's ruling rests on the Kansas Constitution rather than the 14th Amendment — a strategic distinction that became necessary after the Supreme Court's June 2025 decision in United States v. Skrmetti [7].

In Skrmetti, the Court ruled 6-3 that Tennessee's ban on gender-affirming care for minors did not violate the federal Equal Protection Clause, holding that the law classified patients by age and medical purpose rather than by sex, and thus warranted only rational basis review — the lowest level of judicial scrutiny [7][8]. That ruling effectively foreclosed federal equal protection challenges to similar state bans.

Judge Folsom took a different path. Rather than equal protection alone, he grounded his analysis in the Kansas Constitution's broader protections of personal autonomy and parental rights [2]. Because the law infringes on what he found to be a fundamental right, Folsom applied strict scrutiny — requiring the state to demonstrate a compelling government interest pursued through narrowly tailored means [1][2]. He found the state failed both tests.

This approach mirrors the strategy that succeeded in Montana, where a state court blocked that state's ban based on its constitution's explicit privacy protections [9]. It also builds on the Kansas Supreme Court's 2019 recognition of bodily autonomy rights in the abortion context, which established that the Kansas Bill of Rights provides independent protections beyond federal constitutional minimums [10].

Kansas Attorney General Kris Kobach accused Folsom of inventing "a new constitutional right out of whole cloth" and announced an immediate appeal [1].

How Many Patients Are Affected

According to data compiled from Kansas hospital billing records, 93 juveniles received gender-affirming treatment at Kansas facilities between 2019 and 2023, with total billing of approximately $301,097 [11]. Stormont Vail in Topeka treated 18 patients with hormones or puberty blockers, the University of Kansas Hospital treated 17 patients (eight surgical, nine hormonal), and Saint Luke's South Surgery Center in Overland Park treated seven surgical patients [11].

The ACLU has cited an estimate of approximately 7,300 transgender adolescents living in Kansas [4], though only a fraction of those would be actively receiving medical treatment at any given time. The immediate clinical impact of the ban, which took effect in February 2025 before the injunction, forced active patients to either discontinue treatment or seek care out of state.

The Scramble for Alternatives

Reporting from KCUR in December 2025 documented families leaving Kansas entirely after the ban took effect [12]. Some relocated to Colorado, where gender-affirming care for minors remains legal and accessible. Others explored out-of-state travel for ongoing care — a prospect that requires appointments every three to six months, with costs including transportation, lodging, and out-of-network insurance complications [12][13].

The Trans Youth Emergency Project, which provides travel grants of $500 renewable four times per year, has distributed more than $600,000 to 1,200 families nationally since 2023 [14]. But for low-income families without the resources to relocate or travel regularly, the ban represented a hard cutoff from established medical relationships.

The injunction, if upheld, would allow Kansas providers to resume treating minors — though uncertainty about the appeal may deter some clinicians from doing so.

The National Landscape: 27 States and Counting

Source: KFF Policy Tracker

Data as of May 17, 2026CSV

The rapid spread of state bans has been one of the most significant developments in health policy since 2022. From a single ban in 2021 (Arkansas), the number grew to 22 states by end of 2023 and 27 by 2025 [9]. The Skrmetti decision removed the primary legal obstacle, and 25 of those bans currently remain in force [9].

Only Montana and Arkansas have bans that are currently blocked by court order — Montana's on state constitutional grounds, and Arkansas's was initially blocked before the Eighth Circuit reversed in August 2025, citing the Supreme Court's rational basis framework [9][15]. Kansas now joins as the third state where a court has intervened, though on a temporary basis pending further litigation.

Comparing Legal Theories Across States

The Kansas ruling represents a distinct legal theory from those tried elsewhere:

• Alabama and Tennessee (federal challenges): Argued sex-based classification under the 14th Amendment's Equal Protection Clause. Failed after Skrmetti established rational basis review [7][8].
• Montana (state challenge): Succeeded based on the Montana Constitution's explicit right to privacy. The ban remains blocked [9].
• Kansas (state challenge): Relies on personal autonomy and parental rights under the Kansas Bill of Rights, applying strict scrutiny. Pending appeal [1][2].

The Kansas approach is particularly significant because it frames the issue primarily as one of parental rights rather than transgender rights per se — a framing that may prove more durable in conservative-leaning state courts.

What the Clinical Evidence Shows

The medical evidence underlying these policy debates remains contested, though the volume of research has grown substantially.

Source: OpenAlex

Data as of Jan 1, 2026CSV

Research publications on adolescent gender dysphoria peaked at 1,687 papers in 2024 before declining in 2025-2026, reflecting both the maturation of the field and possible chilling effects from the political environment [16].

Major U.S. medical associations — including the American Medical Association, the American Academy of Pediatrics, and the American Psychological Association — support access to gender-affirming care for appropriately assessed adolescents [4]. Their position holds that puberty blockers and hormone therapy, when administered under clinical protocols, reduce gender dysphoria and improve mental health outcomes.

However, several international reviews have reached more cautious conclusions. The UK's Cass Review, published in April 2024, found the evidence base for psychological benefit from hormones was "weak" and recommended "an extremely cautious clinical approach" with a "strong clinical rationale" required before providing hormones to anyone under 18 [17]. The Review led NHS England to adopt a policy preventing prescribing of puberty-suppressing hormones to patients under 18 outside of research settings [17][18].

Sweden and Finland have similarly restricted access, moving toward psychotherapy-first approaches and limiting medical interventions to research protocols or cases of severe, persistent dysphoria [17].

Critics of these international reviews argue they applied overly rigid evidence standards that discount observational data and patient-reported outcomes. A 2025 critique published in the Journal of Sex & Marital Therapy challenged the Cass Review's methodology, arguing it dismissed relevant evidence [19]. The Yale Law School's Integrity Project published a detailed rebuttal of the Review's conclusions [20].

Detransition: What the Data Actually Shows

Source: JAMA Pediatrics / Systematic Reviews

Data as of Oct 1, 2024CSV

The question of detransition — patients who discontinue or reverse gender-affirming treatment — has become politically central despite limited high-quality data. A 2024 systematic review found overall discontinuation rates of approximately 3.3%, with rates specifically due to identity change at approximately 2.4% [21]. A separate study published in JAMA Pediatrics surveyed 220 youth who accessed puberty blockers or hormones and found that 4% (nine patients) expressed regret [21][22].

These figures are disputed. The Society for Evidence-Based Gender Medicine (SEGM) argues that accurate detransition rates remain unknown due to inadequate follow-up — a point the Cass Review itself emphasized, noting that its audit could not identify all patients who detransitioned because adult gender clinics refused to share data [17][23].

A 2024 survey of nearly 4,000 LGBTQ+ youth found that 16.8% of those who started medical treatment reported stopping at some point — but 80% of those who stopped still identified as transgender, and 37% wished they hadn't stopped, suggesting external barriers rather than regret drove most discontinuation [22].

The claim that "1 in 5" people who transition as minors later detransition — cited by ban proponents — does not match the peer-reviewed literature, which consistently reports lower figures. However, advocates for bans argue that short follow-up periods in existing studies undercount detransition, which the Cass Review noted has an average time-to-occurrence of seven years [17].

Financial and Organizational Stakes

The litigation has drawn significant institutional support on both sides. The ACLU and ACLU of Kansas are lead counsel for the plaintiffs in Loe v. Kansas [4]. On the medical side, amicus support from the AMA, AAP, and APA reflects these organizations' formal policy positions supporting access to gender-affirming care [4].

On the other side, Kansas Attorney General Kobach's office is defending the law with support from organizations including the Alliance Defending Freedom, which has been involved in defending similar bans across multiple states [7]. SEGM and the American College of Pediatricians (a smaller organization distinct from the American Academy of Pediatrics) have provided expert support for ban proponents [23].

The pharmaceutical stakes are relatively modest compared to other healthcare litigation. The total billing for gender-affirming care for Kansas minors between 2019 and 2023 was approximately $301,000 — a negligible amount for major pharmaceutical companies [11]. The larger financial interests involve legal advocacy organizations on both sides, which use these cases for fundraising and membership drives.

What Comes Next

The immediate question is whether the Kansas Court of Appeals will stay Judge Folsom's injunction pending appeal. If the injunction holds, Kansas providers can resume treating transgender minors — though some may hesitate given the legal uncertainty.

The broader question is whether state constitutional claims can succeed where federal ones have failed. If the Kansas Supreme Court ultimately upholds Folsom's analysis, it would establish that at least some state constitutions provide protections the federal Constitution does not — creating a patchwork where a transgender teenager's access to medical care depends entirely on which state they live in.

For the families involved, the stakes are immediate. The plaintiffs — identified only as Ryan Roe, age 16, and Lily Loe, age 13 — are currently without the medical care their doctors had prescribed [4]. Whether they regain access, and how quickly, depends on appeals courts that may take months or years to rule.

The Access Divide

If the ban ultimately survives, Kansas families would face the same calculus confronting families in 26 other states: relocate, travel regularly for out-of-state care, or go without. The nearest states where care remains legal and accessible include Colorado and Illinois — each several hours from most Kansas population centers [12][13].

The cost burden falls disproportionately on lower-income families. Those with means can relocate (as some already have to Colorado) or absorb $2,000-4,000 per year in travel costs for quarterly appointments [12]. Those without means face a choice between discontinuing care and financial hardship — a dynamic that raises its own constitutional questions about equal access under the law.