Poe v. Labrador is the federal lawsuit challenging Idaho’s 2023 law that makes it a felony for medical professionals to provide puberty blockers, hormone therapy, or certain surgeries to minors for the purpose of gender transition. After a district court initially blocked the law statewide, the U.S. Supreme Court issued a stay on April 15, 2024, letting Idaho enforce the ban against providers generally while shielding only the two plaintiff families. The case is still pending in the Ninth Circuit, and a separate 2025 Supreme Court decision out of Tennessee has sharply narrowed the plaintiffs’ chances on the merits.
What Idaho’s Law Does
Governor Brad Little signed House Bill 71 in May 2023. Codified at Idaho Code Section 18-1506C, the statute bars medical professionals from providing three categories of treatment to minors when the purpose is to affirm a gender identity different from the child’s sex assigned at birth: puberty-blocking medication, hormone therapy (such as testosterone prescribed to someone assigned female at birth, or estrogen prescribed to someone assigned male at birth), and certain surgical procedures.
The penalty falls on the provider, not the parent or the patient. A conviction is a felony carrying up to ten years in prison.
The ban is not absolute. Treatments for genetic disorders of sex development, including conditions involving ambiguous external sex characteristics or abnormal sex chromosome structure, are excluded. The statute also permits otherwise-prohibited procedures when they are medically necessary for the child’s health, provided the purpose is not to affirm a gender identity inconsistent with the child’s biological sex. That carve-out matters because the same medication can be lawful or felonious depending on why it is prescribed.
Who Sued and Why
Two transgender adolescents and their parents filed the challenge in the U.S. District Court for the District of Idaho (Case No. 1:23-cv-269). The lead plaintiff, identified under the pseudonym Pam Poe, is a transgender teenager and Idaho native who sued through her parents, Penny and Peter Poe. The second plaintiff, Jane Doe, is also a lifelong Idaho resident and transgender teenager, suing through her parents, Joan and John Doe. The defendant is Raúl Labrador, sued in his official capacity as Idaho’s Attorney General.
The families raised two constitutional claims:
- Equal protection. HB 71 permits puberty blockers and hormone therapy for minors when the treatment aligns with their sex assigned at birth, for example to treat precocious puberty, but criminalizes the identical medications when prescribed to affirm a different gender identity. Because legality turns on the patient’s sex, the plaintiffs argued the law is a sex-based classification that must survive heightened judicial scrutiny.
- Parental due process. Parents, the families argued, have a fundamental right to make medical decisions for their children in consultation with qualified physicians, and a blanket criminal ban interferes with that right.
How the Case Moved Through the Courts
On December 26, 2023, the district court granted a preliminary injunction blocking enforcement of HB 71 statewide. The judge found the plaintiffs likely to succeed on their equal protection claim and barred the Attorney General from enforcing any provision of the law during the litigation.
Idaho appealed to the Ninth Circuit and asked for a stay of the injunction pending appeal. The Ninth Circuit denied the stay in January 2024 and then denied rehearing by the full court. Idaho took the stay request to the Supreme Court on an emergency application.
What the Supreme Court’s April 2024 Stay Did
On April 15, 2024, the Supreme Court granted a partial stay. Idaho could begin enforcing HB 71 against medical providers generally, but the district court’s protection for the two named plaintiff families stayed in place. Pam Poe and Jane Doe could continue receiving the hormone treatments at issue in the suit.
Several things the stay did not do are worth being clear about. It did not rule on whether HB 71 is constitutional. It did not end the lawsuit. And it was tied to the ongoing appeal: the stay would remain through the Ninth Circuit’s decision and any follow-up petition to the Supreme Court, dissolving automatically if the Court ultimately declined to take the case on the merits.
The Court splintered on the order. Justices Gorsuch, Thomas, and Alito concurred, writing that the district court’s statewide injunction swept further than equity allows when only two families had sued. Justices Kavanaugh and Barrett concurred separately. Justice Jackson, joined by Justice Sotomayor, dissented, arguing the state had already been turned down twice below and should carry a heavy burden to win emergency relief at the Supreme Court. Justice Kagan would have denied the application without writing.
How Skrmetti Changed the Outlook
While Poe v. Labrador sat with the Ninth Circuit, the Supreme Court took up a parallel challenge to Tennessee’s ban on gender-affirming care for minors. On June 18, 2025, the Court decided United States v. Skrmetti and held that Tennessee’s law does not violate the Equal Protection Clause.
The key move was the standard of review. Rather than applying heightened scrutiny, which would have required Tennessee to show its law was substantially related to an important government interest, the Court applied rational basis review, the most deferential standard a law can face. Under rational basis, a classification survives as long as any reasonably conceivable set of facts could justify it. The Court concluded Tennessee’s law cleared that bar, pointing to medical and scientific uncertainty around the treatments and the latitude states have to legislate when the science is unsettled.
Skrmetti did not formally decide Poe v. Labrador. But Idaho’s law is materially similar to Tennessee’s, and the equal protection theory the Idaho district court found likely to succeed is the same theory the Supreme Court rejected. A Ninth Circuit ruling that Idaho’s statute violates equal protection would be difficult to square with Skrmetti.
Not every possible claim is foreclosed. Challengers may still pursue theories Skrmetti did not reach, such as First Amendment arguments on behalf of providers or narrower as-applied challenges tied to a specific patient’s medical circumstances. The parental due process claim in Poe v. Labrador was not the basis of either Skrmetti or the Idaho district court’s injunction.
Where the Case Stands Now
The appeal remains pending in the Ninth Circuit. HB 71 is currently enforceable against medical providers throughout Idaho, with the two plaintiff families the only carve-out. The Ninth Circuit’s eventual ruling will have to be written against the backdrop of Skrmetti.
For the Poe and Doe families, the April 2024 stay preserves access to the treatments they sought when they filed. For every other Idaho provider, the criminal exposure is real: a felony carrying up to ten years in prison. The statute’s exceptions, for genetic disorders of sex development and for care that is medically necessary and not intended to affirm a gender identity inconsistent with biological sex, are the only legal daylight in the law, and whether a given course of treatment fits inside them is a question prosecutors will ultimately be in a position to second-guess. Providers weighing care in this area should be working closely with counsel before, not after, writing a prescription.