The Arkansas Supreme Court cited “basic biological truths” Thursday when it upheld a state statute mandating that gay married couples wishing to have the names of both spouses listed on their children’s birth certificate needed to get a court order to do so.

“We cannot say that naming the nonbiological spouse on the birth certificate of the child is an interest of the person so fundamental that the State must accord the interest its respect under either statute,” the Arkansas Supreme Court majority decision said.

In Fox's case, the plaintiff, Cheryl Maples, who sued the state of Arkansas on the behalf of three same-sex couples who had conceived their children by utilizing sperm donation treatments, argued that rejecting gay married couples from listing both names hindered their ability to get health insurance for their children under the name of the unrecognized parent, according to local reports Thursday. The three married couples who were issued birth certificates that only had the names of the children's biological birth mothers said this violated their constitutional rights to due process and equal protection of the laws.

Maples pointed to the fact that the names of both parents were always listed on the birth certificates of children of heterosexual couples, regardless of how the child was conceived or whether the child had biological connections to both parents. 

"There's no requirement that DNA be given or that there be a biological relationship to a child to get on a birth certificate for a father, for the non-birth parent," Maples said. "All you have to do is legitimize the child and you're entitled, if you're heterosexual. This is wrong."

Attorney General Leslie Rutledge later appealed Fox’s decision that the state’s birth certificate law violated the federal Supreme Court's ruling in Obergefell v. Hodge that declared same-sex marriage a fundamental right. The state Supreme Court ultimately said Fox had made “inappropriate remarks” in his ruling and that the state can constitutionally reject issuing lesbian couples a birth certificate that has the names of the child’s two mothers.

“Obergefell did not address Arkansas’s statutory framework regarding birth certificates, either expressly or impliedly,” wrote Arkansas Supreme Court Associate Justice Josephine Hart in the Court's majority opinion.

Hart pointed to biological reasons as to why the Legislature and state Health Board were refraining from listing same-sex couples as parents on state birth certificates. He said identifying the biological parent was invaluable to the child for medical reasons and it was also an “important government objective” in order to record public heath patterns. Hart said if any changes were to be made to the state birth certificate law created in 2010, it was the job of the legislators to do so, and not the circuit court.

“In the situation involving the female spouse of a biological mother, the female spouse does not have the same biological nexus to the child that the biological mother or the biological father has. It does not violate equal protection to acknowledge basic biological truths,” Hart wrote in the majority decision.

Maples said she hasn’t decided if she was going to appeal to the U.S. Supreme Court yet, ABC News reported Thursday.