MONTANA, United States (AP) — Montana health officials say transgender people can’t change their birth certificates even if they undergo gender-confirmation surgery, in defiance of a court order that temporarily blocked the Republican-controlled state’s bid to restrict transgender rights.

The state health department said in an emergency order that sex is “immutable” and should be recorded at birth, while gender is a “social…construct” that should not be listed on birth certificates.

The move comes a month after a state judge temporarily blocked enforcement of a law that required transgender people to have undergone a “surgical procedure” before being allowed to change their gender on their birth certificates.

District Judge Michael Moses of Billings ruled the law is unconstitutionally vague because it did not specify what procedure must be performed. The law also required transgender people to obtain a court order indicating they’d had a surgical procedure.

Health officials said the April 21 ruling had put them in “an ambiguous and uncertain situation” and led them to craft the temporary emergency order that was issued late Monday. The order goes beyond the Legislature’s restrictions on transgender rights.

Many transgender people choose not to undergo gender-confirmation surgeries. Such procedures are sometimes deemed unnecessary or too expensive, two transgender Montanans argued in their July 2021 lawsuit challenging the Montana law.