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A federal appeals court gave Florida the green light Monday to begin enforcing for now state restrictions on gender-affirming care for minors and adults.

A federal judge in the state had ruled in June that the restrictions were unconstitutional, with the judge broadening a block he previously placed on them as part of a legal challenge brought by transgender Floridians and their parents.

But in a 2-1 decision, a panel from the 11th US Circuit Court of Appeals paused the judge’s ruling, allowing the state to start enforcing the 2023 law while the court determines the measure’s legality.

“Florida ‘will suffer irreparable harm from its inability to enforce the will of its legislature, to further the public-health considerations undergirding the law, and to avoid irreversible health risks to its children,’” Circuit Judges Britt Grant and Robert Luck, both of whom were appointed by former President Donald Trump, wrote in the ruling.

The judges said the lower court had used too high a standard when it reviewed the law, hinting at the possibility that they could uphold the restrictions under a less rigorous legal standard.

The law prohibits doctors and nurses from prescribing medication, including hormones or puberty blockers, to anyone under 18. It also provides new restrictions on access to gender-affirming care for trans adults and minors who are already undergoing such treatment by mandating that it only be provided by a physician. The measure requires a patient or their guardian to consent to the care in writing “while in the same room with the physician,” according to the ruling.

Writing in dissent, Circuit Judge Charles Wilson said that in the June ruling, US District Judge Robert Hinkle “identified sufficient record evidence to support concluding that the act’s passage was based on invidious discrimination against transgender adults and minors.”

Wilson, an appointee of former President Bill Clinton, pointed to various comments by state lawmakers around the time of the law’s passage that Hinkle leaned on when he struck it down.

“Gender-affirming care and identifying as transgender were referred to or described at various points as ‘evil,’” Wilson wrote. “Other sponsors (of the law) made statements reflecting a lack of belief in transgender identities and a desire to prevent transgender persons from living in their transgender identities.”

“Withholding access to gender-affirming care would cause needless suffering,” Wilson said in his dissent. “This matter is a medical issue, where patients are best left to make decisions alongside health professionals, with access to complete, unbiased information, as needed.”

Attorneys for the law’s challengers said in a joint statement later Monday that the court’s ruling “will deny transgender adults and adolescents lifesaving care and prevent Florida parents from making medical decisions that are right for their children.”

The challengers have the option of asking the Supreme Court to step in, which their lawyers hinted at in the statement. “The plaintiffs in this case are considering their options and will take every step possible to protect their right to equal treatment under Florida’s laws, which these restrictions egregiously violate,” they wrote.

CNN has reached out to Florida for comment on Monday’s ruling.

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