An attorney with the American Civil Liberties Union urged a federal appeals court Wednesday to continue blocking Arkansas’ ban on gender confirming treatments or surgery for children, saying reinstating the restriction would create uncertainty for families around the state.

A three-judge panel of the 8th U.S. Circuit Court of Appeals heard arguments in the state’s appeal of the preliminary injunction issued last year against ban, which was enacted by the majority-Republican Legislature. ACLU attorney Chase Strangio said allowing the law to be enforced would cause unnecessary disruption since a trial over it is scheduled to begin in October before the judge who issued the injunction.

“If the injunction were lifted now, these families would have to leave their homes, their communities, their jobs, travel to another state just to potentially return” months later, said Strangio, who is deputy director of transgender justice for the ACLU’s LGBTQ and HIV Project.

Arkansas was the first state to enact such a ban, which also prohibits doctors from referring youths elsewhere for such medical care. Republican Gov. Asa Hutchinson vetoed the ban but was overridden by the Legislature.

Multiple medical groups, including the American Medical Association, oppose the ban and have said the care is safe if properly administered. The Justice Department has also opposed the ban as unconstitutional. Gender confirming surgery is not performed on minors in Arkansas.

Arkansas has argued that the restriction is within the state’s authority to regulate medical practices.

“These gender transition procedures can be set apart from many of these long existing practices like cleft palate surgery because they are a very emerging area of medicine,” Deputy Solicitor General Dylan Jacobs told the court.

The ACLU filed the lawsuit on behalf of four transgender youths and their families, as well as two doctors who provide gender confirming treatments.

The appellate judges did not indicate when they rule.

The hearing came days after a Texas judge blocked the state from investigating families of transgender youth over gender medical confirming care they’ve received.

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