ATLANTA (AP) — Citing a recent ruling affecting Alabama, Georgia officials asked a federal judge Tuesday to allow the state to resume enforcement of its restriction on hormone therapy for transgender people under the age of 18.

Judge Sarah Geraghty should vacate her order blocking Georgia’s hormone therapy ban because an appeals court allowed enforcement of a similar Alabama law, attorneys for the state of Georgia said in a court filing.

A three-judge panel of the 11th U.S. Circuit Court of Appeals ruled Monday that Alabama can implement a ban on the use of puberty blockers and hormones to treat transgender children. It vacated a judge’s temporary injunction against that law.

The 11th Circuit includes Georgia. Its ruling came a day after Geraghty issued a preliminary injunction blocking Georgia’s hormone therapy restriction.

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“In its opinion, the Eleventh Circuit expressly addressed — and rejected — each of the core legal theories plaintiffs here advanced in support of their motion for preliminary injunction,” attorneys for Georgia said in their court filing.

Groups representing the plaintiffs in Georgia’s case did not immediately have comment.

The Georgia law, Senate Bill 140, allows doctors to prescribe puberty-blocking medications, and it allows minors who are already receiving hormone therapy to continue.

But it bans any new patients under 18 from starting hormone therapy. It also bans most gender-affirming surgeries for transgender people under 18. It took effect on July 1.

In her ruling, Geraghty said the transgender children who sought the injunction faced “imminent risks” from the ban on starting hormone therapy, including depression, anxiety, disordered eating, self-harm, and suicidal ideation. She said those risks outweighed any harm to the state from an injunction.

The 11th Circuit judges who ruled on Alabama’s law said states have “a compelling interest in protecting children from drugs, particularly those for which there is uncertainty regarding benefits, recent surges in use, and irreversible effects.”

Doctors typically guide children toward therapy or voice coaching long before medical intervention.

At that point, puberty blockers and other hormone treatments are far more common than surgery. They have been available in the U.S. for more than a decade and are standard treatments backed by major doctors’ organizations including the American Medical Association.

At least 22 states have now enacted laws restricting or banning gender-affirming medical care for transgender minors, and most of those states face lawsuits.

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