Gender affirming care bans haven’t had a great time standing up in federal court in the past decade or so.
Groups like the ACLU and Lambda Legal have gone to great lengths to establish precedent that gender doesn’t have to be defined at birth, gender dysphoria is a genuine medical condition, and that gender affirming care helps with dysphoria.
That, combined with the precedent in Bostock that sexuality and gender identity can be covered by bans on sex discrimination makes it look like these bans will continue to fail when challenged.
Granted, the Federalist Society ghouls and their friends know this too and are trying to push back. Also, the Supreme Court could rule on 303 Creative v. Elenis tomorrow and absolutely devastate LGBT protections in the name of religious freedom. That would make this comment irrelevant almost immediately. As for now, we’ll probably see a lot more bans fail in federal court though