A federal appeals court on Tuesday allowed Indiana’s ban on gender-affirming care to go into effect, removing a temporary injunction a judge issued last year.

The ruling was handed down by a panel of justices on the 7th Circuit Court of Appeals in Chicago. It marked the latest decision in a legal challenge the American Civil Liberties Union of Indiana filed against the ban, enacted last spring amid a national push by GOP-led legislatures to curb LGBTQ+ rights.