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.

The law was slated to go into effect on July 1, 2023. But the month before, U.S. District Court Judge James Patrick Hanlon issued an injunction preventing most of it from taking effect. Hanlon blocked the state from prohibiting minors’ access to hormone therapies and puberty blockers, but allowed the law’s prohibition on gender-affirming surgeries to take effect.