The American Civil Liberties Union and likeminded groups have filed a lawsuit to overturn a new state law that bans the provision of hormone blockers and cross-sex hormones, as well as sex-change surgeries, to Oklahoma children younger than 18.

The lawsuit also seeks to overturn a state law that prevents a state-funded hospital from performing those activities on children.

“For some adolescent patients with gender dysphoria, puberty-delaying treatment and hormone therapy are medically indicated,” the lawsuit declares.

The office of Oklahoma Attorney General Gentner Drummond offered only a brief response.

“We are aware a complaint has been filed,” said Leslie Berger, press secretary for Drummond. “We will review it and will defend the laws of the State of Oklahoma.”

Senate Bill 613, which was signed into law only days ago, states, “A health care provider shall not knowingly provide gender transition procedures to any child.”

The legislation defines “gender transition procedures” to include surgical procedures that alter or remove physical or anatomical characteristics or features that are typical for the individual’s biological sex, or the provision of puberty-blocking drugs and cross-sex hormones.

Penalties for violation include felony charges, license revocation, and civil actions, which can be filed by a parent or guardian.

Lawmakers passed SB 613 amidst growing concern about the long-term psychological and mental-health impacts of gender-transition efforts on children.

The ACLU lawsuit lists 14 plaintiffs. Nearly all are pseudonymous children or family members of children who are alleged to have gender dysphoria and desire to receive puberty blockers, cross-sex hormones, or various surgeries, such as mastectomies, to make their bodies appear more like that of the opposite sex.

The other plaintiff is Shauna Lawlis, a doctor with the OU Health Center who worked in the Adolescent Medicine Roy G. Biv Program at Oklahoma Children’s Hospital, which focused on the gender-transition of children.

After state lawmakers voted to prevent OU Health Center from performing gender-transformation efforts on children during a special session last year, the lawsuit said Lawlis began working one day a week at Diversity Family Health to continue engaging in those activities.

While some medical officials wholeheartedly endorse transgender affirmation measures, including hormone treatments and surgery, many parents have reported being pressured by doctors to authorize those procedures.

A video recording of one official associated with a Vanderbilt University clinic that provided transgender services to youth bluntly referred to them as a “big money maker” for the hospital.

Notably, one patient review left on the OU Health site states, “My mother came with me to my appointment. When she tried to talk to Dr. Lawlis, Dr. Lawlis made her leave the room. My mother was just trying to communicate issues I’d been having and how I was having issues with things. Since I turned 18, Dr. Lawlis hasn’t been very nice to my mom’s and I don’t like it. They are huge advocate(s) for me and she acts like they aren’t.”

In addition to Lawlis, the other plaintiffs include a 12-year-old girl who identifies as a male, a 15-year-old male who identifies as a female, a 17-year-old female who identifies as a male, a 16-year-old male who identifies as female, and a 14-year-old female who identifies as male.

The 12-year-old plaintiff was prescribed Lupron as a puberty blocker, and the lawsuit claims the youth is “afraid to lose access to Lupron and horrified at the prospect of going through female puberty.”

However, the ethics of prescribing Lupron as a puberty blocker are hotly debated. The side effects of Lupron, which has also been administered for prostate cancer and pelvic pain, can be significant and have prompted patient lawsuits. As of 2018, a news station in Georgia reported that Lupron users had filed nearly 24,000 reports of adverse reactions with the U.S. Food and Drug Administration (FDA) and that the agency had determined more than half were serious cases.

The 15-year-old plaintiff began taking puberty-blocking medication at age 13 and started taking estrogen at age 14.

The 16-year-old suffered family trauma as a child sufficient to result in being placed in Oklahoma’s foster-care system before being adopted. After identifying as transgender, the youth was provided estrogen and spironolactone.

The 14-year-old plaintiff began seeking treatment around 2021, at about age 12, that resulted in receiving period blockers and eventually puberty-blockers.

The lawsuit claims those treatments generated positive outcomes but provides few measurable results. Instead, the lawsuit touts subjective evidence, such as saying a child plaintiff is now “able to leave the house without fear of being misgendered” or that a child is “relieved that he has not undergone puberty as a girl.”

The lawsuit argues that the law illegally discriminates against transgender-identifying youth because they cannot receive cross-sex hormones but female patients in Oklahoma can still be prescribed testosterone when dealing with polycystic ovarian syndrome, which is caused by hormone imbalance, and cross-sex hormones may be prescribed to patients experiencing precocious puberty, which can also be a result of a hormone disorder.

The long-term effects of puberty blockers remain in dispute. A ruling in Great Britain, in a case regarding whether youth aged 16 or younger can truly give informed consent to take puberty blockers, noted that one expert testified puberty blockers can have long-term physical consequences on bone density, fertility, and brain development. That ruling also noted that an information sheet provided to patients plainly stated, “We do not fully know how hormone blockers will affect bone strength, the development of your sexual organs, body shape, or your final adult height. There could be other long-term effects of hormone blockers in early puberty that we don’t yet know about.”

However, the ACLU lawsuit dismisses concerns about the side-effects of cross-sex hormones or the mental-health impacts of mastectomies, even as it describes normal development as a mortal threat, stating, “Bodily changes from puberty to stature, facial appearance, genital growth, voice, and breast development can be more difficult or even impossible to counteract.”

The lawsuit claims provision of puberty-blockers, cross-sex hormones, or sex-change surgeries to transgender individuals reduces suicidality among those individuals.

But that is also a hotly debated topic.

During Senate debate on SB 613, state Sen. David Bullard, R-Durant, noted that Johns Hopkins University had provided sex-reassignment surgeries for years and then researched the long-term outcomes of patients.

“Here’s what they found: Seven to 10 years after the surgeries, they were 20 times more likely to commit suicide,” Bullard said. “Not 20 percent. Hear me. Twenty times. That is an astounding number that we cannot deny.”

Although a study published in the American Journal of Psychiatry originally indicated that hormone treatment and surgery reduce mental-health challenges for transgender individuals, when that study was criticized officials re-examined the data and ultimately had to retract that conclusion.

Several critics of that study wrote about the retraction, noting that the “reanalysis demonstrated that neither ‘gender-affirming hormone treatment’ nor ‘gender-affirming surgery’ reduced the need of transgender-identifying people for mental health services. We appreciate the editors, the study authors, and other letter writers for carefully scrutinizing the study and publishing these findings. However, our team believes that many of the pro-transition studies we have read fare no better. Fad medicine is bad medicine, and gender-anxious people deserve better.”

The ACLU lawsuit claims that gender identity “is durable and cannot be altered voluntarily or changed through medical intervention,” but that medical treatment can alter an individual’s sex at birth to match their gender.

Claims that an individual’s self-perceived gender identity remains unchanging are also disputed by experts.

In 2017, James M. Cantor, the director of the Toronto Sexuality Centre and Associate Professor of Psychiatry at the University of Toronto, wrote that he had reviewed “every study that ever followed up transgender kids to see how they felt in adulthood,” saying there were 12 such studies at that time.

Cantor said the 12 studies “all came to the very same conclusion: The majority of kids cease to feel transgender when they get older.”