The first families left as soon as they could, emptying homes and pulling out of school after Tennessee banned gender-transition care for their children. Others chose to remain, cutting back on vacations and Christmas spending to make it to doctor appointments out of state.

Even some who have stayed say they have not ruled out the possibility of leaving Tennessee in the future.

This is why the stakes for families feel impossibly high as the Supreme Court hears arguments on Wednesday in a challenge to the Tennessee law. They fear a ruling in favor of the ban, which passed last year, could further jeopardize care for their children at a moment when the incoming Trump administration has pledged to impose restrictions on life for transgender people.

“You have to go into this whole different way of being when you’re constantly having to say, ‘I didn’t choose this, there are no good options,’” said Kristen Chapman, who left Tennessee with her teenage daughter soon after the law passed. “It’s like a natural disaster happens in your family, because it changes how you are and where you feel OK.”

Parents from five other families, and three of the children, agreed to be interviewed only if they would not be named, citing concerns about retribution and continuing harassment.