A Montana judge has blocked the enforcement of a ban on gender transition medical care for minors, citing multiple violations of the state constitution. The law was set to go into effect on Oct. 1.

District Court Judge Jason Marks ruled in favor of transgender youth, healthcare providers, and activists who argued that the ban on gender transition care is unconstitutional and would harm the mental and physical health of youth.

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Marks's ruling places a preliminary injunction on the ban until a full trial can be held on the issue, according to the Associated Press. The judge said he expects his ruling will be appealed to the Montana Supreme Court.

“Today’s ruling permits our clients to breathe a sigh of relief,” Akilah Deernose, executive director of the ACLU of Montana, said in a statement. “But this fight is far from over. We look forward to vindicating our clients’ constitutional rights and ensuring that this hateful law never takes effect.”

The law, set to go into effect in four days, would have prohibited the use of puberty blockers, cross-sex hormones, and surgical treatment for gender dysphoria, a term used to describe the conflict between the gender assigned at birth and the desired identifying gender.

Gov. Greg Gianforte (R-MT) signed the bill into effect in April after introducing amendments to make it clear that public funds would not be used to pay for gender transition surgeries or care.

The bill “protects Montana children from permanent, life-altering medical procedures until they are adults, mature enough to make such serious decisions,” Gianforte wrote in a letter accompanying the amendments.

Transgender youth and advocates argued that the law would violate their rights to equal protection, the right to seek health, and the right to dignity. Parents of transgender youth said the state's law, passed during the Montana Legislature's 2023 legislative session, would violate their constitutional rights to make medical decisions for their children.

The American Civil Liberties Union argued in its complaint that the treatments for gender transition surgeries and care have been approved by major U.S. medical organizations, such as the American Medical Association and the American Academy of Pediatrics.

“Montana’s ban is a direct assault on the freedom and well-being of transgender youth, their families, and their medical providers,” Malita Picasso, staff attorney for the American Civil Liberty Union, said in a previous statement.

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Montana is one of 22 states that have taken steps to enact bans on gender transition surgeries or healthcare for minors, with several of those states facing lawsuits from the ACLU or other civil rights organizations. Some of the bans have been blocked by courts, such as in Texas and Arkansas, while others have taken effect in other states like Missouri.

A study from Columbia University released in August found that gender transition surgeries in the United States nearly tripled from 2016 to 2019 before dropping in 2020. However, the study found that gender transition procedures are rare for minors, with fewer than 3,700 performed on U.S. patients ages 12 to 18 during that same time frame.