On August 12, 2025, the full federal Eighth Circuit Court of Appeals upheld Arkansas's 2021 law banning gender-affirming medical care for minors, including puberty blockers, hormone treatments, and surgeries. This en banc decision reversed a prior trial court ruling and former circuit precedent, following the Supreme Court's June ruling in a related Tennessee case. The court rejected claims based on the Equal Protection Clause, parental rights, and the First Amendment, emphasizing that parents do not have unlimited authority to make medical decisions for their children. Arkansas's law, the first of its kind in the nation, had been on hold since 2021 but is now allowed to be enforced. The ruling prohibits doctors from providing irreversible gender transition procedures to transgender minors and restricts referrals for such care. The decision has drawn attention amid ongoing national debates over gender-affirming care for youth. Additional related legal developments include a failed bid by transgender Medicaid beneficiaries to certify a class action forcing Idaho to cover gender-affirming care, and a California school board's vote to ban transgender athletes from girls' sports amid litigation involving former President Trump.