A judge on Monday upheld a Missouri law that bans doctors from performing transgender procedures on children.

Cole County Circuit Judge R. Craig Carter ruled that the state’s Save Adolescents from Experimentation (SAFE) Act does not violate the constitution, siding with GOP Governor Mike Parson, who was sued over the law. The law bans giving minors puberty blockers, cross-sex hormones, and performing surgeries like mastectomies on girls who identify as boys.

Carter’s decision, which cited the numerous medical risks and dangers of transgender procedures, comes before the U.S. Supreme Court is set to hear oral arguments on a challenge to a similar law in Tennessee on December 4.

“The Court has left Missouri’s law banning child mutilation in place, a resounding victory for our children. We are the first state in the nation to successfully defend such a law at the trial court level,” said Attorney General Andrew Bailey, who defended the law in a two-week trial. “I’m extremely proud of the thousands of hours my office put in to shine a light on the lack of evidence supporting these irreversible procedures. We will never stop fighting to ensure Missouri is the safest state in the nation for children.”

The suit was brought by the ACLU of Missouri and Lambda Legal on behalf of a parent and her minor child.

Carter rejected arguments that the treatments were medically backed and that Missouri’s law violated the equal protection clause. He said that there was “an almost total lack of consensus as to the medical ethics of adolescent gender dysphoria treatment.”

He argued that if he followed the logic of the plaintiffs, “any person – including a minor – would be able to do anything from meth, to ecstasy, to abortion as long as a single medical professional was willing to recommend it.”

Carter pointed to research showing that many minors naturally outgrow gender dysphoria and noted the medical harms of the procedures.

“The gender dysphoria treatment prohibited by Missouri uses drugs and surgeries to either inhibit normal healthy human growth or surgically remove and replace healthy human organs,” he wrote. “Such an approach to treatment is well outside normal medicine, and medical ethicists are unable to agree on the propriety thereof.”

Missouri is one of 26 states that have banned transgender procedures on minors in recent years.