A federal judge on Tuesday struck down an Arkansas law that sought to ban gender-affirming health care for transgender minors, siding with four transgender children, their families and two doctors who challenged the state’s first-in-the-nation ban in a 2021 lawsuit.

U.S. District Judge Jay Moody on Tuesday issued a permanent injunction against the Arkansas law, which would have prohibited health care providers in the state from administering puberty blockers, hormone replacement therapy and surgeries to transgender youths under 18.

In his order, Moody wrote that the law, which he temporarily blocked in 2021, violated the constitutional rights of transgender young people and their families and would cause “immediate and irreparable harm” if it were to go into effect. It also violated the First Amendment rights of doctors by prohibiting them from referring minor patients to other providers, he said.

“The Act also discriminates against transgender people,” Moody wrote Tuesday. “The law prohibits medical care that only transgender people choose to undergo, i.e, medical or surgical procedures related to gender transition.”

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Arkansas in 2021 passed the nation’s first law restricting gender-affirming health care for transgender youths. It was vetoed by then-Gov. Asa Hutchinson (R), who in April announced his bid for the White House, but it became law after the state’s GOP-controlled legislature voted to override Hutchinson’s veto.

Moody blocked the law from taking effect in July 2021, pending litigation in a lawsuit filed by the American Civil Liberties Union (ACLU) and others.

“I’m so grateful the judge heard my experience of how this health care has changed my life for the better and saw the dangerous impact this law could have on my life and that of countless other transgender people,” said Dylan Brandt, a 17-year-old transgender boy from Arkansas and one of the plaintiffs in the case, in a Tuesday statement.

“My mom and I wanted to fight this law not just to protect my health care, but also to ensure that transgender people like me can safely and fully live our truths,” he said. “Transgender kids across the country are having their own futures threatened by laws like this one, and it’s up to all of us to speak out, fight back, and give them hope.”

Including Arkansas, 20 states have passed laws that heavily restrict or ban gender-affirming health care for transgender people. Laws in Alabama, Florida and Indiana are blocked by preliminary injunctions from federal courts.

In a statement on Tuesday, Arkansas Attorney General Tim Griffin (R) said he plans to appeal Moody’s decision.