NASHVILLE, Tenn. (AP) — Attorneys representing Tennessee transgender teens and their families asked the U.S. Supreme Court on Wednesday to block a ban on gender-affirming care for minors that a lower court allowed to go into effect.

Should the nation’s highest court agree to take the case, it would mark the first time the justices could weigh in on restrictions on puberty blockers and hormone therapy for transgender people under 18.

Since 2021, more than 20 states have enacted laws restricting or banning such treatments, even though they have been available in the United States for more than a decade and are endorsed by major medical associations.

According to court documents filed Wednesday, the American Civil Liberties Union is asking the Supreme Court to review a September decision handed down by the 6th U.S. Circuit Court of Appeals that allowed bans in Kentucky and Tennessee to remain in effect.

Tennessee Attorney General Jonathan Skrmetti has described the decision as a “big win for democracy.”

Meanwhile, in Kentucky, attorneys representing transgender youth, their families and their medical providers say they also intend to petition the Supreme Court later this week.

Advocates for trans kids argue that having access to puberty blockers and hormone therapy is safe, necessary health care backed by every major medical group.

“Over the past few months this vicious law has already had a disastrous impact in homes and communities across Tennessee,” said Lucas Cameron-Vaughn, staff attorney for the ACLU of Tennessee, in a statement. “Families are losing access to much-needed medical care that has allowed their children to flourish. This law denies these families’ dignity and signals to their children that they do not have the freedom to lead healthy and happy lives.”

Tennessee’s Republican-dominant General Assembly, as well as some Democratic lawmakers, quickly advanced the ban earlier this year after Nashville’s Vanderbilt University Medical Center was accused of opening its transgender health clinic because it was profitable. Videos surfaced of a doctor at the private hospital touting that gender-affirming procedures are “huge money makers.” Another video showed a staffer saying anyone with a religious objection should quit.

The statute banned Tennessee health care providers from providing hormone treatments or surgeries for transgender teens where the purpose is to allow the child to express a gender identity “inconsistent with the immutable characteristics of the reproductive system that define the minor as male or female.”

The law also includes a phase-out period by March 31, 2024, for ongoing medical treatments and said no new treatments could be started. Health care providers who violated the law risked facing a $25,000 penalty and other disciplinary actions.

In Wednesday’s petition, the ACLU wrote that the appeals court “broke with numerous precedents of this Court.”

Elsewhere around the U.S., federal courts have been quick to block restrictions and bans from going into effect. A federal judge struck down Arkansas’ ban as unconstitutional in June, sparking state officials to ask an appeals court to review that decision. A federal judge initially blocked a ban in Alabama, but an appeals court has since allowed it to be enforced while attorneys fight that decision.

“It scares me to think about losing the medication that I need and if this law continues, my family may have to leave Tennessee – the place I have lived and loved my entire life,” said L.W., a 15-year-old transgender girl who is one of the unidentified plaintiffs in the Tennessee case. “And with so many new laws like Tennessee’s, it is hard to imagine where we can even go. I want the justices to know transgender people are not going away and that we deserve the same rights as everyone else.”