A Texas judge on Friday expanded her order blocking the state from investigating families of transgender youth who have received gender- affirming medical care.

Judge Amy Clark Meachum issued a temporary injunction preventing the state from investigating members of the LGBTQ advocacy group PFLAG Inc. over the medical care. The group has more than 600 members in Texas.

Meachum in July issued an order blocking the investigations against two families of transgender children who had sued the state. Meachum’s order on Friday also blocked the state from investigating the family of another teen that had sued, though the family said after the lawsuit was filed they learned the investigation against them had been dropped.

Meachum wrote that without the order, the families would “suffer probable, imminent, and irreparable injury in the interim.”

The ruling was the latest against the state’s efforts to label gender-affirming care as child abuse.

The Texas Supreme Court in May allowed the state to investigate parents of transgender youth for child abuse while also ruling in favor of one family who was among the first contacted by child welfare officials following the order by Republican Gov. Greg Abbott.

The latest challenge was brought by Lambda Legal and the American Civil Liberties Union on behalf of the families of three teenage boys — two 16-year-olds and a 14-year-old — and PFLAG.

“Once again a Texas court has stepped in to say what we knew from the beginning: State leaders have no business interfering with life-saving care essential for transgender youth,” Adri Perez with the ACLU of Texas said in a statement.

The Texas Department of Family and Protective Services said as of last week it had opened 12 investigations since Abbott’s directive was issued. Only four remain open and no youth have been removed from their homes as a result of the investigations, the department said.

A judge in March put Abbott’s order on hold after a lawsuit was brought on behalf of a 16-year-old girl whose family said it was under investigation. The Texas Supreme Court in May ruled that the lower court overstepped its authority by blocking all investigations going forward.

The lawsuit that prompted that ruling marked the first report of parents being investigated following Abbott’s directive and an earlier nonbinding legal opinion by Attorney General Ken Paxton labeling certain gender-confirming treatments as “child abuse.” The Texas Department of Family and Protective Service has said it opened nine investigations following the directive and opinion.

Abbott’s directive and the attorney general’s opinion go against the nation’s largest medical groups, including the American Medical Association, which have opposed Republican-backed restrictions filed in statehouses nationwide.

The latest injunction follows rulings in other states against Republican-led efforts to restrict gender affirming care for children. A federal appeals court panel last month ruled Arkansas can’t enforce its law banning gender affirming care for minors, and the state plans to ask for the full appeals court to review that decision. A federal judge in May blocked a similar law in Alabama.

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