A federal judge in Maryland has issued a preliminary injunction against Donald Trump’s executive order threatening loss of federal funding for medical professionals and institutions that provide gender-affirming care to trans people under 19. That means the policy cannot be enforced while the lawsuit against it proceeds.

This and Trump’s executive order denying recognition of transgender identity “threaten to disrupt treatment of patients, stall critical research, and gut numerous programs in medical institutions that rely on federal funding,” U.S. District Judge Brendan A. Hurson wrote in his ruling, released Tuesday. “Accordingly, the Plaintiffs have shown that they are likely to succeed on the merits, that they would suffer irreparable harms absent an injunction, and that the balance of equities and the public interest tip in their favor.”

Hurson had already issued a temporary restraining order blocking the policy, and it was set to expire Wednesday. The preliminary injunction extends the block for as long as it takes to hear the lawsuit.

Two transgender young adults, five trans adolescents and their families, and two organizations — PFLAG National and GLMA: Health Professionals Advancing LGBTQ+ Equality — filed the suit February 4 challenging the health care order and the gender identity order. The Trump administration directed federal agencies to withhold funds from health care providers and institutions that offer gender-affirming care, including puberty blockers and hormone therapies, to anyone under 19 for the purpose of gender transition. The treatments are allowed for nontrans people who have early-onset puberty, disorders of sexual development, or other conditions.

The suit was filed in U.S. District Court in Maryland. It names Trump as a defendant, along with the Department of Health and Human Services and other federal officials and agencies. The plaintiffs are represented by Lambda Legal, the American Civil Liberties Union, the ACLU of Maryland, and the law firms of Hogan Lovells and Jenner & Block.

The restrictions placed on funding by the executive orders are likely to be found unconstitutional, Hurson wrote, as the president is trying to withdraw funding that has been approved by Congress, therefore violating the separation of powers between the executive, legislative, and judicial branches of the federal government. The orders also will probably be found in violation of the U.S. Constitution’s guarantees of equal protection and due process of law, he noted.

People whose care would be disrupted by the health care order stood to suffer irreparable harm, he continued, as would institutions. The order has been interpreted to ban all federal funding to institutions that provide gender-affirming care to trans youth and young adults, whether or not that funding is related to this specific care, and therefore much funding for hospitals and other organizations was in jeopardy, according to Hurson. Some have already stopped providing the care.

“The court’s decision stopping implementation of these perverse and discriminatory executive orders targeting gender-affirming medical care removes a pall of confusion that affected medical institutions across the country and that threatened transgender young people, their families, and the medical professionals who care for them,” Omar Gonzalez-Pagan, senior counsel and health care strategist at Lambda Legal, said in a press release. “With this decision, doctors and hospitals across the country can continue to provide evidence-based, essential, and often lifesaving gender-affirming medical care to transgender people under 19 without fear of retribution.”

“Today’s decision provides relief to transgender young people, their families, and their medical providers who have been thrown into chaos by this administration,” added Joshua Block, senior staff attorney for the ACLU’s LGBTQ & HIV Project. “This order from President Trump is a direct effort to threaten the well-being of transgender people while denying them equal protection under the law, enacted by coercing doctors to follow Trump’s own ideology rather than their best medical judgment. As Judge Hurson has said himself, it is hard to fathom a form of discrimination more nefarious than that which pretends the group of people being targeted doesn’t even exist.”

“Again, the court has ruled to ensure hospitals, doctors, and healthcare professionals in our communities can continue the work to keep our families healthy,” Brian K. Bond, chief executive officer of PFLAG National, said in the release. “Transgender people and their supportive parents and families are good and decent people who deserve the freedom to be themselves and to thrive. PFLAG National and our vast network of chapters, members, and supporters will continue to ensure that love leads in this fight for justice for transgender people.”

“Today’s ruling is a crucial step in resisting the extremist agenda of the Trump administration and reaffirming that trans and nonbinary people deserve dignity, respect, and access to the health care they need,” said Alex Sheldon, executive director of GLMA. “This administration has tried to bully providers into abandoning their ethical obligations, but we will not back down. We will continue to fight for health professionals’ freedom to do their jobs based on medical expertise — not political ideology — and for the right of every patient to receive carefree from discrimination and fear.”

The anti-trans health care order has also been blocked in a separate lawsuit in a federal court in Washington State. The suit was filed by the  Democraticattorneys general of Washington, Oregon, and Minnesota, along with three doctors who argued that the order violated constitutional protections and overstepped presidential authority. Judge Lauren King issued a temporary restraining order in mid-February and a preliminary injunction last Friday.