On Monday, a judge upheld a Missouri law that prohibits doctors from performing transgender procedures on children.

Cole County Circuit Judge R. Craig Carter ruled that the state’s Save Adolescents from Experimentation (SAFE) Act does not violate the constitution, siding with GOP Governor Mike Parson, who was sued over the law. The law bans the use of puberty blockers, cross-sex hormones, and surgeries like mastectomies for minors identifying as the opposite gender.

Carter’s decision, which cited the significant medical risks associated with transgender procedures, comes just ahead of the U.S. Supreme Court’s scheduled oral arguments on a challenge to a similar law in Tennessee on December 4, The Daily Wire reported on Tuesday.

“The Court has left Missouri’s law banning child mutilation in place, a resounding victory for our children. We are the first state in the nation to successfully defend such a law at the trial court level,” said Attorney General Andrew Bailey, who defended the law in a two-week trial. “I’m extremely proud of the thousands of hours my office put in to shine a light on the lack of evidence supporting these irreversible procedures. We will never stop fighting to ensure Missouri is the safest state in the nation for children.”

The ACLU of Missouri and Lambda Legal brought the lawsuit on behalf of a parent and her minor child. 

Carter rejected arguments that the treatments were medically backed and that Missouri’s law violated the equal protection clause. He said that there was “an almost total lack of consensus as to the medical ethics of adolescent gender dysphoria treatment.”

He argued that if he followed the plaintiffs’ logic, “any person – including a minor – would be able to do anything from meth, to ecstasy, to abortion as long as a single medical professional was willing to recommend it.”

Carter referenced research indicating that many minors naturally outgrow gender dysphoria and highlighted the permanent medical harms associated with the procedures.

“The gender dysphoria treatment prohibited by Missouri uses drugs and surgeries to either inhibit normal healthy human growth or surgically remove and replace healthy human organs,” he wrote. “Such an approach to treatment is well outside normal medicine, and medical ethicists are unable to agree on the propriety thereof.”

Missouri is among 26 states that have enacted bans on transgender procedures for minors in recent years.