U.S. District Judge James Moody considered an effort by the American Civil Liberties Union to block a new Arkansas law that effectively bans gender-affirming health care for transgender minors, prohibits doctors from even providing referrals, and allows private insurers to refuse coverage of gender-affirming care to transgender persons at any age.
"To pull this care midstream from these patients, or minors, would cause irreparable harm," Moody said, ruling from the bench. "Public interest calls favor to the plaintiffs."
The law, which plaintiffs like Amanda Dennis argue would have a devastating impact beyond Arkansas borders, was slated to go into effect next week on July 28.
"We can all kind of go home and breathe a sigh of relief now," Dennis told ABC News after the hearing. "We're very hopeful for the next steps to come, but stay ready and geared up to fight for as long as we have to to protect these kids."
One of those kids is 15-year-old Dylan Brandt who praised the decision in a press conference on behalf of the transgender kids and their families who sued the state outside the courtroom.
"We want other trans kids to know that you are not alone. We have your back. And we will continue to fight on your behalf," he said. "We will not allow the state to steal our joy, and we're glad that the court listened."
Arkansas Attorney General Leslie Rutledge said in a statement that her office will appeal the decision.
Here's what you need to know:
When did HB1570 pass?
In April, the GOP-led Arkansas state legislature passed HB1570, the first bill in the country that would effectively ban transgender youth from gender-affirming care -- despite a surprise veto by Republican Gov. Asa Hutchinson.
While Hutchinson supported two earlier anti-transgender bills in the state legislative session this spring, he called the third bill a "government overreach" and refused to sign it.
He warned lawmakers they'd set a bad precedent by getting overly involved in decisions between physicians, patients and their families -- but since the Arkansas legislature requires only a simple majority to overrule a veto, the law moved on.
Republican sponsors say the bill is meant to protect minors, who, they say, are too young to make decisions on transition-related medical care.
However, health care experts say gender-affirming care, or treatment that affirms a person's gender identity, is life-saving. For minors, any surgery is far more often the exception, but therapy and reversible treatments such as puberty blockers and hormone replacements can be prescribed to combat the distress of gender dysphoria, or the incongruence between one's assigned sex at birth and gender identity.
Activists argue that if the Arkansas law is allowed to go into effect, it will have detrimental effects on the mental, emotional and physical health of transgender people -- beyond state borders.
What's at stake?
The ACLU filed its challenge to HB1570 on behalf of four transgender youths, as well as their families, and two medical doctors back in May, arguing that the law is both unconstitutional and cruel.
One of the plaintiffs, Brooke Dennis, is nine-years-old, entering the fourth grade and hopes to pursue rhythmic gymnastics when she grows up. She was assigned male at birth, but her mother, Amanda, says Brooke has known she was a girl since she was two.
"[After accepting Brooke's new pronouns,] it was as if a cloud lifted and Brooke's smile came back. We had a happy, bright-eyed child again, and we were relieved to see our child flourishing once more," said parents Amanda and Shayne Dennis in a brief submitted to the court.
But under the new law, Brooke won't be able to get puberty-blocking hormones. Her mother told ABC News, that without access to the therapy Brooke will soon need, her daughter's mental, emotional and physical health are at stake -- and that's not something she's willing to risk as a parent.
"We would have to move," Dennis said. "It would mean new jobs, a new home, all of the stress of picking up your entire life and starting over somewhere else. That's a really, really frightening thing to even have to consider after all that Brooke and our family have been through."
Another plaintiff, Dylan Brandt, said in the brief that starting hormone therapy gave him a level of confidence he didn't know was possible -- and that "the thought of having that wrenched away and going back to how I was before is devastating."
Dr. Kate Stewart, a professor at the University of Arkansas for Medical Sciences Fay W. Boozman College of Public Health, told ABC News that health professionals in the state have already had experience with minors they say have become suicidal because of the law.
"We've seen how treatment can be life or death," Stewart said, speaking in her personal capacity. "Anecdotally, I'm already hearing increased reports of emergency rooms seeing kids that are in crisis, just being so concerned about this law passing. It's nothing short of devastating."
Stewart also raised concerns that since the law limits one's scope of practice, it will also discourage medical professionals from working in Arkansas.
"It's basically telling people how they can practice medicine," she said.
Dr. Hannah Radecki, who completed medical school at the University of Arkansas for Medical Sciences in Little Rock and is finishing her residency in family medicine at Middlesex Health in Connecticut, said what she called Arkansas lawmakers' dictating health care decisions is why she's not returning to the state, though she says she had planned to.
"Arkansas has now become a state where the people who decide how to practice medicine are not doctors. It's politicians that are deciding what is and isn't safe and appropriate medical care," she said in an interview to ABC News. "It just completely takes Arkansas off the list for me of where I will eventually establish a practice."
Radecki added that "doctors who will decide not to practice in the state are doing so not because of their own selfish reasons, but because they cannot envision denying medical care to a patient when they know that that is the best treatment for the patient."
Activists warn Wednesday's hearing was just the "first step" in an ongoing legal battle as the state is expected to appeal.
Judge Moody left it to the government's attorneys to report back to the court on how much time they will need to prepare their appeal.
Chase Strangio, deputy director of transgender health at the ACLU, said afterward that the judge questioning the state's arguments showed how its arguments are "legally indefensible."
"As much as they tried to say that this wasn't an anti-trans law, as much as they tried to say that this law didn't discriminate against trans people or on the basis of sex, those were not credible arguments, and I don't think that they could seriously defend them," he said.
"But we know that throughout American history, a lot of legally indefensible laws have been here and been in effect," he added. "And so we will keep working to strike them down but without losing sight of how significant the harm is from even the proposal of these bills."
Until the next hearing, the plaintiffs, including Brooke and her parents, Brandt and his mother, Joanna Brandt, Sabrina Jennen and her parents, Lacey and Aaron Jennen, and Parker Saxton and his father, Donnie Saxton, along with Drs. Michelle Hutchison and Kathryn Stambough, are celebrating Wednesday's victory but continue to weigh how they'll respond if the law does pass.
Dennis said her family has taken comfort in knowing they have the support of "loving people that want to see our children be able to grow up and express who they are as humans."
"We're doing everything that we can to stop this dangerous legislation, not just for our daughter, but on behalf of transgender kids all over the United States," Dennis told ABC News Tuesday night. "Because we know, right now, all eyes are on Arkansas."
The injunction comes as nearly 100 anti-transgender bills are being considered in state legislatures around the nation, according to the Human Rights Campaign, the highest number of any year on record.
Arkansas also is one of three states that does not have a hate crime law, which activists say puts the LGBTQ+ population at further risk of discrimination.