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Thursday, the Texas Supreme Court cleared the way for a ban on gender-affirming care for minors to begin.

A lower court had placed a temporary block against the ban last Friday. But the state Supreme Court lifted that injunction without any explanation.

The American Civil Liberties Union called the high court’s decision “cruel” and says it will make kids “fearful of what awaits them.” But Jonathan Covey, a lead advocate of the law, says the ruling is in a child’s best interest.

The law bans transition surgeries, hormone therapies, and puberty blockers for those under 18. Children already on the medications must now be weaned off in a “medically appropriate” manner.

Texas joins 14 other states with active laws to protect children from permanent body-altering decisions. A full hearing is still expected in the lower court.