Seventh Circuit Tightens Standing in Telehealth-Abortion Challenges: No “Probabilistic” Members, No Generalized Stigma, and No Redress Where Other Statutes Independently Bar the Conduct

I. Introduction

In Satanic Temple, Inc. v. Todd Rokita (7th Cir. Jan. 6, 2026), The Satanic Temple, Inc. (“TST”), a Massachusetts nonprofit describing itself as a religious institution, sought to expand its New Mexico–based telehealth medication-abortion model to members physically located in Indiana. Indiana, however, criminalizes knowingly or intentionally violating detailed abortion-performance requirements, including an in-person examination/dispensing/consumption regime for abortion-inducing drugs, and prohibits telehealth for abortions.

TST sued Indiana Attorney General Todd Rokita and Marion County Prosecutor Ryan Mears in their official capacities, seeking to enjoin enforcement of IND. CODE § 16-34-2-7(a) (the felony provision) and to obtain declaratory relief under Indiana’s Religious Freedom Restoration Act. Defendants moved to dismiss for lack of Article III standing. The district court dismissed on standing grounds, relying on evidentiary submissions beyond the pleadings because Defendants presented a factual standing challenge. The Seventh Circuit affirmed.

The key issues were (1) whether TST had associational standing without identifying any specific Indiana member injured by the challenged enforcement, (2) whether TST had organizational (individual) standing to bring a pre-enforcement challenge based on a threat of prosecution, and (3) whether enjoining only § 16-34-2-7(a) could redress the claimed harms given other Indiana statutes independently prohibiting telehealth abortion.

II. Summary of the Opinion

The Seventh Circuit held that TST failed to establish standing in any form:

No associational standing: TST could not rely on statistical probability to avoid identifying at least one member who suffered (or imminently would suffer) a concrete injury; generalized “stigmatic injury” allegations were unsupported and amounted to an ideological objection rather than a cognizable, particularized harm.
No organizational standing: TST did not show concrete plans to engage in the prohibited conduct in Indiana, and its existing operational model (nurse-prescribed abortifacients via telehealth) could not satisfy Indiana’s abortion-provider requirements. Additionally, enjoining the felony provision would not redress the injury because other Indiana statutes (not challenged) independently barred telehealth abortion.

Because standing failed—primarily at the injury-in-fact stage—the court affirmed dismissal for lack of subject matter jurisdiction.

III. Analysis

A. Precedents Cited

1. Standing as a jurisdictional prerequisite

The court framed standing as an “essential piece” of subject matter jurisdiction, grounding its approach in foundational separation-of-powers decisions:

Kokkonen v. Guardian Life Ins. Co. of Am. and Thompson v. Army & Air Force Exch. Serv.: federal courts possess limited jurisdiction conferred by statute and bounded by Article III.
Raines v. Byrd (quoting Simon v. E. Kentucky Welfare Rts. Org.): the “case or controversy” requirement is fundamental and limits adjudication to disputes with a real personal stake.
TransUnion LLC v. Ramirez (and Am. Legion v. Am. Humanist Ass'n as quoted therein): standing ensures courts resolve only real controversies with real impacts on real persons.
Seventh Circuit applications reinforcing the jurisdictional nature of standing: Word Seed Church v. Vill. of Hazel Crest, Parents Protecting Our Child., UA v. Eau Claire Area Sch. Dist., and Prairie Rivers Network v. Dynegy Midwest Generation, LLC.

2. Organizational standing vs. associational standing

The court used:

Milwaukee Police Ass'n v. Bd. of Fire & Police Com'rs of City of Milwaukee and Havens Realty Corp. v. Coleman to describe when an organization sues for injuries to itself.
Hunt v. Washington State Apple Advert. Comm'n to restate the three-part associational standing test.
United Food & Com. Workers Union Loc. 751 v. Brown Grp., Inc. to emphasize that the “member-with-standing” requirement is an Article III necessity and that the third Hunt prong is prudential/administrative.
Disability Rts. Wisconsin, Inc. v. Walworth Cnty. Bd. of Supervisors and Prairie Rivers Network v. Dynegy Midwest Generation, LLC for the Seventh Circuit’s formulation that associational standing is derivative of individual standing.

3. Evidentiary burdens on a factual standing challenge

Because Defendants raised a factual attack on standing, the court applied:

Apex Digit., Inc. v. Sears, Roebuck & Co. (quoting Lujan v. Defs. of Wildlife) to require the plaintiff to support standing “with the manner and degree of evidence” appropriate to the litigation stage.
Flynn v. FCA US LLC to distinguish facial vs. factual standing challenges and to bar late-presented evidence/arguments not raised in the district court.

4. Associational standing and the “identify a member” requirement

The opinion’s center of gravity is its rejection of “probabilistic standing” in associational suits, heavily anchored in:

Summers v. Earth Island Inst.: organizations must “identify” or “name” affected members because probabilistic approaches are hard to verify; statistical likelihood does not substitute for an identified injured member unless all members are affected.
NAACP v. Alabama ex rel. Patterson: distinguished as a compelled-disclosure case involving statewide membership exposure, not a standing substitute that permits an organization to proceed without identifying any injured member.
The court also cited an analogous abortion-related standing decision: Satanic Temple v. Labrador (9th Cir. 2025), noting that probabilistic estimates may describe a risk but do not show an actually injured member exists.
In a footnote, the court pointed to possible mechanisms (pseudonymity) used elsewhere: Speech First, Inc. v. Shrum and Am. All. for Equal Rts. v. Fearless Fund Mgmt., LLC, but emphasized TST did not seek such relief in the district court.

5. Injury-in-fact doctrine: concreteness, particularization, imminence, and stigma

Food & Drug Admin. v. All. for Hippocratic Med.: injury must be real and individualized; moral/ideological objections do not confer standing.
Spokeo, Inc. v. Robins (quoting Valley Forge Christian Coll. v. Ams. United for Separation of Church & State, Inc.): standing requires the plaintiff to have personally suffered actual or threatened injury.
Allen v. Wright: stigmatic injury may be cognizable when tied to discriminatory treatment, but generalized stigma allegations alone are insufficient.

6. Pre-enforcement standing and “credible threat” requirements

Hays v. City of Urbana: plaintiffs may bring pre-enforcement challenges when forced to comply or face sanctions.
Susan B. Anthony List v. Driehaus (quoting Clapper v. Amnesty Int'l USA): the threatened harm must be “certainly impending” or present a “substantial risk,” not merely possible.
Sweeney v. Raoul (quoting Babbitt v. United Farm Workers Nat'l Union): a credible threat plus an intention to continue possibly unlawful conduct can establish injury—but it must be backed by concrete plans.
Lujan v. Defs. of Wildlife: “some day” intentions without concrete plans do not suffice.

7. Standing element sequencing

Meyers v. Nicolet Rest. of De Pere, LLC: once injury-in-fact fails, courts need not address traceability/redressability further.
Nat'l Wrecking Co. v. Int'l Bhd. of Teamsters, Loc. 731: perfunctory or meritless remaining arguments may be left undiscussed.

B. Legal Reasoning

1. Why “probabilistic standing” failed

TST’s associational theory rested on an expert declaration estimating that, among roughly 11,300 Indiana members, about 94 could become “involuntarily pregnant” over a year and that at least one such person likely exists at any given time. The Seventh Circuit rejected this as an attempt to satisfy the first Hunt prong through statistics rather than an actual injured member.

The court treated Summers v. Earth Island Inst. as controlling: probabilistic methods create verification problems and invite speculation about whether an injured member exists. The court further identified an independent defect: the declaration did not show that any such hypothetical member would actually seek an abortion, leaving the alleged injury untethered to the challenged legal barrier.

On the First Amendment anonymity argument, the court distinguished NAACP v. Alabama ex rel. Patterson as addressing compelled disclosure that would itself chill association. Here, no comparable statewide disclosure order existed, and TST’s request was not for protection against state-compelled membership production but for an exemption from the Article III requirement that at least one member be identified as injured. The court also observed (in footnote) that pseudonymous identification may be available, but TST did not pursue it.

2. Why stigmatic injury failed

TST alternatively argued that “Indiana’s Abortion Ban” stigmatized all members as “evil people.” The court acknowledged that stigmatic harms can constitute injury in fact in the discrimination context (citing Allen v. Wright), but found TST offered no evidence of concrete, individualized stigmatic injury. Instead, the asserted injury resembled a generalized ideological objection, which Food & Drug Admin. v. All. for Hippocratic Med. disallows as a basis for standing.

This portion of the opinion underscores a critical distinction: stigmatic injury is not a free-standing doctrine that converts broad moral offense into Article III injury; it must be tied to legally cognizable, particularized harm, typically linked to discriminatory treatment or direct exposure to unequal conduct.

3. Why TST lacked organizational standing for a pre-enforcement challenge

TST claimed it faced prosecution risk if it provided telehealth medication abortion in Indiana. The court applied the pre-enforcement framework (Hays v. City of Urbana; Susan B. Anthony List v. Driehaus; Sweeney v. Raoul) and held that TST failed at the threshold: it did not present evidence of concrete plans to violate Indiana law, making the threat too speculative under Lujan v. Defs. of Wildlife.

The court also emphasized a practical/legal mismatch: Indiana requires abortions to be performed by an Indiana-licensed physician in specified facilities, while TST’s model used a nurse practitioner prescribing abortifacients via telehealth and TST conceded it had no Indiana hospital/surgical-center ties and did not plan to open an in-person clinic. A last-minute oral-argument reference to a physician was disregarded under Flynn v. FCA US LLC because it was not presented to the district court.

4. Redressability and the “unchallenged statute” problem

Even if prosecution under § 16-34-2-7(a) were enjoined, the court found redressability lacking because other Indiana laws independently prohibited the challenged conduct—most notably IND. CODE § 16-34-1-11, which separately bars telehealth for abortions, including prescribing or filling prescriptions intended to result in an abortion. The court also cited additional regulatory constraints, including IND. CODE § 16-34-2-4.5(a).

This is a significant standing move: plaintiffs must align the scope of the injunction sought with the legal architecture that causes the injury. Narrowly attacking a single enforcement provision while leaving intact multiple independent prohibitions can defeat causation and redressability—even before the merits are reached.

C. Impact

Stricter evidentiary demands for associational standing in abortion and telehealth disputes: Organizations cannot rely on membership size and statistical pregnancy-risk modeling to satisfy Hunt’s first prong in the Seventh Circuit; they must identify a member (potentially via pseudonym, if properly sought) who is concretely affected and whose injury is linked to the challenged law.
Generalized “stigma” arguments face skepticism: The decision reinforces that stigma must be substantiated and particularized; broad claims of moral condemnation are likely to be treated as non-justiciable grievances.
Pre-enforcement challenges require real operational intent: Plaintiffs must show concrete plans to engage in the proscribed conduct. Abstract “we would like to do X” statements, especially when current business models cannot legally operate in the forum state, will not suffice.
Remedy-design matters for standing: Litigants must account for overlapping statutory schemes. When other unchallenged statutes would still block the conduct, standing can fail on redressability grounds, incentivizing more comprehensive pleading and target selection.

IV. Complex Concepts Simplified

Standing: The constitutional requirement that the plaintiff be personally affected—courts do not decide issues in the abstract. A plaintiff must show (1) a real injury, (2) caused by the defendant’s conduct, (3) that a court order can likely fix.
Associational standing: An organization can sue for its members, but only if at least one member could sue individually. Here, that meant identifying (not merely hypothesizing) at least one Indiana member who faced an actual or imminent, concrete harm.
Factual vs. facial standing challenge: A facial challenge tests only the complaint’s allegations. A factual challenge permits the court to look at evidence (declarations, admissions, discovery responses). In a factual challenge, allegations alone are not enough.
Pre-enforcement challenge: You can sue before being prosecuted, but you must show a credible threat of enforcement plus a real plan to engage in the prohibited conduct—not a vague “someday” intent.
Redressability: Even if a court agrees with you, the ruling must likely solve your problem. If other unchallenged laws would still prevent what you want to do, the court’s order would not redress the injury.

V. Conclusion

Satanic Temple, Inc. v. Todd Rokita is a standing-focused decision that blocks merits review where plaintiffs attempt to challenge abortion-related restrictions through (1) statistical likelihood rather than an identified injured member, (2) unproven generalized stigma theories, and (3) pre-enforcement claims unsupported by concrete plans. Equally important, it underscores that standing can fail when the requested injunction targets only one provision while other unchallenged statutes independently prohibit the desired conduct. The opinion therefore functions as a procedural roadmap—especially in regulated, multi-statute areas like abortion and telemedicine—requiring careful plaintiff selection, evidentiary development, and remedy design before federal jurisdiction will attach.