Brandt v. Griffin, 551 F.Supp.3d 882

Arkansas enacted Act 626 (H.B. 1570, 2021), banning physicians and other providers from providing or referring minors for “gender transition procedures.”
Plaintiffs: four transgender minors (Patient Plaintiffs), their parents (Parent Plaintiffs), and two physicians (Physician Plaintiffs); they sought a preliminary injunction enjoining enforcement of Act 626.
Claims: violations of the Equal Protection Clause, the Due Process Clause (parental rights), and the First Amendment (speech/referral ban).
The court found Plaintiffs and physicians have standing (including physician third-party standing) to challenge the statute and its private-rights-of-action enforcement mechanism.
The court applied heightened scrutiny to the Equal Protection challenge (treating transgender people as at least quasi‑suspect and sex‑based classification) and strict scrutiny to the First Amendment content/viewpoint restriction.
The court held Plaintiffs likely to succeed on the merits, found irreparable harm, and entered a preliminary injunction prohibiting enforcement of Act 626 during litigation.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Standing to sue and third‑party standing	Plaintiffs and physicians have personal and third‑party standing to enjoin official and private enforcement	State argued limited standing or that claims improper	Court: Patient/Parent Plaintiffs and Physician Plaintiffs have standing, physicians may assert third‑party rights on behalf of patients
Equal Protection (classification based on sex/transgender status)	Act 626 singles out transgender minors for treatment denial; medical consensus supports gender‑affirming care	State says law protects children, prevents experimental/harmful treatment	Court: heightened scrutiny applies; Act 626 is not substantially related to asserted interests and likely unconstitutional
Due Process (parental right to direct medical care)	Parents have fundamental right to seek medically recommended care for children; law infringes that liberty	State claims compelling interest in protecting minors’ health/ethics	Court: strict scrutiny applies; State failed to show compelling interest or narrow tailoring; plaintiffs likely prevail
First Amendment (referrals and speech)	Ban on referrals and related speech restricts providers’ and patients’ speech and access to information	State contends law regulates professional conduct, not speech	Court: referral ban is regulation of speech, content/viewpoint‑based, subject to strict scrutiny, and likely unconstitutional

Bostock v. Clayton Cnty., 140 S. Ct. 1731 (2020) (employment discrimination against transgender persons is discrimination on the basis of sex)
Grimm v. Gloucester Cty. Sch. Bd., 972 F.3d 586 (4th Cir. 2020) (recognizing transgender people as at least quasi‑suspect class for some purposes)
United States v. Virginia, 518 U.S. 515 (1996) (intermediate scrutiny requires an "exceedingly persuasive justification")
Reed v. Town of Gilbert, 576 U.S. 155 (2015) (content‑ and viewpoint‑based regulations are presumptively unconstitutional)
Sorrell v. IMS Health Inc., 564 U.S. 552 (2011) (creation and dissemination of information are speech covered by the First Amendment)
Nat’l Ass’n for Advancement of Colored People v. Button, 371 U.S. 415 (1963) (government may not evade speech protections by labeling regulation as professional conduct)
Washington v. Glucksberg, 521 U.S. 702 (1997) (framework for substantive‑due‑process fundamental rights analysis)
Troxel v. Granville, 530 U.S. 57 (2000) (parental rights to direct care and custody are fundamental liberty interests)
June Med. Servs. LLC v. Russo, 140 S. Ct. 2103 (2020) (discussion allowing plaintiffs to assert third‑party rights where enforcement against litigant would indirectly violate third parties’ rights)
Elrod v. Burns, 427 U.S. 347 (1976) (loss of First Amendment freedoms constitutes irreparable injury)