FAYETTEVILLE, Ark. (KNWA/FOX24) — The country is watching the trial over Arkansas’ “Safe Act.” It’s the first state law in the U.S. that bans gender-affirming care for minors and the first to be taken to a trial.

It’s happening in U.S. District Judge James Moody’s court. Four Arkansas families, along with the ACLU are taking the state to court over this law.

The ACLU called Dr. Dan Karasic as its first expert witness on Monday. He’s a psychiatrist with 29 years of working with people who are transgender.

When asked about the impacts of treatment and hormone therapy, Dr. Karasic said he’s seen “dramatic relief” of gender dysphoria, and even depression in some cases.

Attorneys representing the state brought up an article written in part by the doctor. It’s about gender reassignment surgeries for people under 18. The doctor said he does not recommend surgeries for that age group, but said there are “exceptional circumstances.”

Both sides of this trial said they are working to protect kids, but differ on how that should be done.

“This is a big deal,” said State Representative Robin Lundstrum, District 87. “We need to slow down and look at the science.”

“All transgender Arkansans deserve the right to receive the health care that they need,” said Chase Strangio, Deputy Director for Transgender Justice at the ACLU.

The Brandt family, Dennis family, Jennen family and Saxton family are challenging the law saying that it is unconstitutional.

State Rep. Lundstrum was the lead sponsor for then-House Bill 1570 in the 2021 legislative session. It passed with overwhelming support in the Arkansas House and Senate, but Gov. Asa Hutchinson vetoed it.

Governor Hutchinson called the bill “well-intended” but felt the law would create new standards of “interference between parents and doctors.” His veto was overridden in both chambers as well.

“It basically says under 18, we’re protecting children from chemically and surgically castrating themselves,” said Lundstrum. “Children deserve the right to grow up and be safe.”

The ACLU has three arguments. The first is that singling out gender-affirming care violates the equal protection rights of transgender youth.

“The second, is that the law intrudes on the fundamental right of parents to make medical decisions for their children,” said Leslie Cooper, Deputy Project Director for the ACLU LGBTQ and HIV Project. “These are decisions that their children and their children’s doctors all agree is appropriate.”

The third is that it violates free speech rights of doctors to provide information to patients and their families.

State Rep. Lundstrum worries about what is happening behind the scenes for kids who are transgender.

“When a child has gender dysphoria, what they really need is good quality counseling,” she said. “Maybe they’ve been bullied, maybe there’s been sexual abuse.”

She said gender-affirming counseling is not counseling and that it’s pushing kids towards a particular agenda.

The Jennen family is from Fayetteville. Mom Lacey Jennen said they are fighting for the rights of their daughter, who would lose the health care they said has been life-changing for her.

“This is not a journey we began without careful thought,” she said. “We have had many long, serious discussions with Sabrina with our mental health providers and with our medical doctors about treatment options, risk and benefit. We prayed about the decisions we all had to make as a family and we know without a doubt that moving forward with gender-affirming hormone therapy was the right decision.”

The National Library of Medicine estimates that 82% of transgender people have considered suicide and 40% have attempted suicide, with those rates highest among transgender youth.

“More parents are pleading with you not to take away their child’s health care that they depend on to live,” she said. “That is cruel.”

This case is part of a national movement.

Since Arkansas passed its law, Alabama passed a law making it a felony to prescribe gender-affirming puberty blockers and hormones to transgender minors. In May, a U.S. District judge issued a preliminary injunction that stops the state from enforcing the medication ban, but leaves in place a ban on gender-affirming surgery, while this law is challenged in court.

In February, Texas Gov. Greg Abbott issued an executive order to the Department of Family and Protective Services to investigate parents who allow their transgender children to have gender-affirming care. In June, a judge issued a temporary stop on that order.

In August, the 8th Circuit Court of Appeals issued a temporary block on Arkansas’ law, as well.

The UCLA Williams Institute researches sexual orientation and gender identity in law and public policy. It estimates there are about 1,800 transgender youths between the ages of 13 and 17 in Arkansas.

State Rep. Lundstrum said they should wait until they’re 18 to make such a big decision.

“All we’re saying is let’s let them grow up because the long-term consequences are pretty severe,” she said.

“Transgender people will continue to be loved by their families will continue to be cared for by their doctors, and will continue to tell the stories of the ways in which this health care has always and continues to drastically improve the quality of their lives,” said Strangio.

Both sides said that no matter the outcome of the Arkansas trial, it’s expected to be appealed to the 8th Circuit, and could make it all the way to the Supreme Court.