Alabama can begin immediately enforcing a ban outlawing the use of puberty blockers and hormones to treat transgender people under 19, a federal appeals court ruled Thursday, granting the state’s request to stay a preliminary injunction that had blocked enforcement of the 2022 law.

The 11th U.S. Circuit Court of Appeals had previously ruled that the injunction should be vacated, but the decision had been effectively on hold while families with transgender children asked the full appellate court to reconsider the decision. The Thursday order will allow the ban to take effect while the full court decides whether it will revisit the decision.