The Missouri Supreme Court unanimously upheld a law barring transgender procedures for minors and prohibiting all ages from using Medicaid coverage for transgender procedures.

The decision on Tuesday affirmed a 2024 Cole County Circuit Court ruling that sided with the state on all counts, the Missouri Independent reported.

Judge Kelly Broniec wrote the ruling, saying, “There is no fundamental right to seek care the legislature has prohibited. Because (the law) does not infringe on a fundamental right, rational-basis review is appropriate.”

A statute, under rational-basis review, is presumed sensible unless challengers can show the law is arbitrary and irrational.

Challengers represented by the ACLU of Missouri and LGBTQ+ rights law firm Lambda Legal alleged that the law discriminates on the basis of sex and transgender status, which the court rejected.

The law “classifies only based on medical use and age,” Broniec wrote. The decision aligned with a U.S. Supreme Court decision in June that upheld Tennessee’s transgender procedures ban.

The state Supreme Court rejected claims that the Medicaid ban violated the state’s constitution. According to the ruling, adults can still receive transgender procedures if they pay out-of-pocket, but the state cannot be obligated to cover the care through its Medicaid program.

“The state has a legitimate interest in ensuring limited public funds are used efficiently,” Broniec wrote.

ACLU of Missouri and Lambda Legal attorneys did not say outright whether they would appeal the decision, but Lambda Legal lawyer Nora Huppert said that attorneys “will continue to explore every legal avenue to protect the rights and health of transgender people in Missouri.”