A law in Tennessee barring doctors from offering treatments like puberty blockers and gender-affirming surgeries to transgender minors can now take effect immediately following a ruling by a US appeals court on Saturday.

The US Court of Appeals for the Sixth Circuit concluded that advocacy groups, which had contested Tennessee’s law, could not demonstrate success in asserting that the law breached the US Constitution. In a 2-1 decision, the appeals court overturned a previous ruling by a lower court that had prevented Tennessee from implementing the law during its legal challenge.

Judge Jeffrey Sutton stated, “Life-tenured federal judges should be wary of removing a vexing and novel topic of medical debate from the ebbs and flows of democracy by construing a largely unamendable federal constitution to occupy the field.”

The law specifically prohibits any medical procedure that enables a minor to identify with a gender other than the one they were assigned at birth. This law in Tennessee forms part of a broader effort by Republican lawmakers to introduce new restrictions on healthcare for transgender youths. Lawmakers have justified the measure to prevent minors from “enduring permanent damage,” while those against the actions argue that the gender-affirming care can be “lifesaving.”