A federal appeals court on Thursday allowed Tennessee and Kentucky to enforce laws banning gender-affirming medical care for minors, such as puberty blockers, hormones and surgery. By a 2-1 vote, the Cincinnati, Ohio-based 6th U.S. Circuit Court of Appeals rejected a challenge by families of transgender children who had argued that the bans discriminated on the basis of sex. The ruling is the second by a federal appeals court upholding such laws, after the 11th Circuit ruling revived an Alabama law. On the other side of the ledger, federal district courts in Arkansas, Florida, Georgia and Indiana have overturned such bans, as has a state court in Montana.