Brandt v. Rutledge, known on appeal as Brandt v. Griffin, is the federal lawsuit challenging Arkansas’s Save Adolescents From Experimentation (SAFE) Act, a 2021 law that bans certain gender transition treatments for minors. Four transgender teenagers, their parents, and two healthcare providers sued state officials, including the Attorney General and the State Medical Board, after Arkansas passed Act 626.1Justia. Brandt v. Griffin2Justia. Ark. Code Ann. § 20-9-1502 In August 2025, the Eighth Circuit reversed the permanent injunction that had blocked the law, and Arkansas can now enforce the ban.
What the SAFE Act Prohibits
Under the SAFE Act, healthcare professionals in Arkansas are generally prohibited from providing gender transition procedures to anyone under 18. The restricted procedures include:3Justia. Ark. Code Ann. § 20-9-15012Justia. Ark. Code Ann. § 20-9-1502
- Prescribing puberty-blocking medications
- Providing cross-sex hormone therapy
- Performing genital or nongenital gender reassignment surgeries
- Making medical referrals to other professionals for these treatments
Doctors who violate the law face discipline from licensing boards, which treat these actions as unprofessional conduct.4Justia. Ark. Code Ann. § 20-9-1504 The Act also bars public funds from supporting these services and restricts their availability in government facilities and through government-employed providers.5Justia. Ark. Code Ann. § 20-9-1503
What the Plaintiffs Argued
The plaintiffs raised three main constitutional claims. First, they argued the law violates the Fourteenth Amendment’s Equal Protection Clause by discriminating based on sex and transgender status. The state responded that the law classifies only by age and by specific medical procedures.1Justia. Brandt v. Griffin
Second, parents argued the law interferes with their fundamental right to direct their children’s medical care.6Legal Information Institute. Troxel v. Granville Third, the provider plaintiffs raised a First Amendment challenge to the ban on medical referrals.1Justia. Brandt v. Griffin
What the Eighth Circuit Decided
The appellate court ruled that the SAFE Act does not discriminate based on sex or transgender status, and that it is supported by a rational basis for protecting minors. The court held that states have wide discretion to legislate in areas of scientific or medical uncertainty, even where a trial court had credited evidence that the treatments are grounded in research and improve mental health. On the referral question, the court found that the state may regulate professional conduct, including referrals for prohibited procedures, even when regulation touches on some professional speech. With the injunction reversed, the ban is enforceable.1Justia. Brandt v. Griffin
How the Supreme Court’s Skrmetti Ruling Shaped the Outcome
The Eighth Circuit decided Brandt against the backdrop of United States v. Skrmetti. In June 2025, the Supreme Court held that state laws regulating medical treatments for minors do not violate equal protection when they are based on medical use and age. That ruling set the framework for how federal courts now treat challenges to bans like Arkansas’s, and it defined the limits of state authority over healthcare for transgender youth.7Congress.gov. Supreme Court Rules on State Bans – Section: United States v. Skrmetti