BISMARCK, N.D. (AP) — A North Dakota judge has upheld the state’s ban on gender-affirming care for children, in a blow to families who have had to travel out of state to obtain the medical treatments they said are crucial for their kids’ well-being.

District Judge Jackson Lofgren said in his decision Wednesday that the law discriminates based on age and medical purpose, not sex, and that there's little evidence the Legislature passed the law for “an invidious discriminatory purpose.” He also noted various concerns and ongoing debates over the medical treatments involved.

“The evidence establishes there is an ongoing international debate regarding the safety and effectiveness of the medical procedures prohibited by the Health Care Law. Where there is uncertainty, deference is given to the

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