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The Texas Supreme Court has upheld a ban on child sex changes, ruling that such a policy does not violate the state’s constitution.

Justices voted by a majority of eight to one in favor of allowing the law, which was passed by Texas legislators last year, to remain in place.

Under the legislation, doctors are prohibited from prescribing hormones and puberty blockers, and it also prevents them them from performing sex change procedures on minors.

“The legislature made a permissible, rational policy choice to limit the types of available medical procedures for children, particularly in light of the relative nascency of both gender dysphoria and its various modes of treatment and the legislature’s express constitutional authority to regulate the practice of medicine,” Texas Supreme Court Justice Rebecca Huddle wrote.

“We therefore conclude the statute does not unconstitutionally deprive parents of their rights or physicians or health,” she continued.

Justice Debra Lehrmann, the only judge who opposed the ruling, wrote in her dissent that the law was “cruel” and “unconstitutional” and went against past efforts by the court to create a “a robust conceptualization of parental autonomy.”

“This particular parental right — to make potentially lifesaving medical decisions for one’s children — certainly does not fall within the same category as tattooing, tobacco use or even child labor,” she wrote.

Texas Attorney General Ken Paxton celebrated the ruling, saying in a statement that the court had succeeded in  “protecting children from dangerous gender confusion procedures by prohibiting puberty blockers, cross-sex hormones, and mutilative surgeries on minors.”

“We will always defend children in Texas from these irreversible procedures,” he added.

Over a dozen Republican controlled states including Arizona, Florida and Georgia have banned child sex changes over the past few years, as legislators seek to protect children from irreversible decisions and potential medical harms.