In a decisive pair of rulings, the Eighth and Tenth Circuit Courts of Appeals affirmed that states can lawfully prohibit medical sex change procedures for minors—despite claims from activists that such bans violate parental rights. The Eighth Circuit’s 8-2 decision reversed a previous injunction against Arkansas’ law, while the Tenth Circuit upheld Oklahoma’s ban just days earlier.

Both decisions leaned heavily on the Supreme Court’s recent ruling in United States v. Skrmetti, which found that Tennessee’s similar law did not violate the Equal Protection Clause. However, the appeals courts went even further, addressing arguments the high court did not directly touch—namely, whether parents have an inherent constitutional right to bypass such laws.

The Eighth Circuit flatly rejected that idea, writing: “Given the two parallel currents in this Nation’s history and tradition—first, states can prohibit medical treatments for adults and children, and second, parents cannot automatically exempt their children from regulations—this court does not find a deeply rooted right of parents to exempt their children from regulations reasonably prohibiting gender transition procedures.”

Likewise, the Tenth Circuit concluded that “our Nation does not have a deeply rooted history of affirmative access to medical treatment the government reasonably prohibited, regardless of the parent-child relationship.”

Arkansas Attorney General Tim Griffin celebrated the decision, saying he was “pleased that children in Arkansas will be protected from experimental procedures.”

The cases mark a significant turning point in the legal fight over so-called “gender-affirming care” for minors. Activists have long framed the issue as one of parental authority, but these rulings undercut that argument by affirming the government’s power to regulate—and even ban—medical treatments it deems unsafe or unnecessary for children.

The broader political battle shows no signs of slowing. Blue states continue to shield such procedures, with some enacting laws to protect doctors and families from out-of-state lawsuits. Red states, meanwhile, have moved swiftly to pass bans, citing both moral objections and the growing number of detransitioners who say they were pushed into irreversible treatments without fully understanding the consequences.

Critics of the bans argue that they interfere with “medical decision-making” between families and doctors. Supporters counter that the state has a compelling interest in protecting minors from irreversible harm—especially when many of these treatments involve sterilization, lifelong medical dependence, or procedures not backed by long-term clinical data.

The rulings may also influence pending challenges in other states, as courts increasingly follow the Supreme Court’s reasoning in Skrmetti. If that trend holds, attempts to strike down these laws on constitutional grounds could face steep odds.

For now, Arkansas and Oklahoma join a growing list of states where such procedures are off-limits to anyone under 18—and the legal groundwork laid this month could ensure those bans remain firmly in place.