US Supreme Court hears challenge to state ban on gender-affirming care

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The US Supreme Court began hearing a challenge on Wednesday to a Tennessee law banning gender-affirming medical treatments for transgender minors, a case with repercussions for similar state prohibitions across the country.

Two dozen Republican-led states have enacted laws restricting medical care for transgender people under the age of 18 such as puberty blockers or hormone therapy, and the issue has become a hot-button topic for conservatives in recent years.

Supporters of the Tennessee law gathered outside the court building in downtown Washington ahead of oral arguments holding signs reading “Stop the Harm,” “Let Kids Grow” and “Kids’ Health Matters.”

The Justice Department of Democratic President Joe Biden has joined the families of transgender youth in opposing the law, arguing that it violates the Constitution’s Equal Protection Clause since it denies transgender people access to treatments otherwise permitted to others.

“It doesn’t matter what parents decide is best for their children,” US Solicitor General Elizabeth Prelogar told the court’s nine justices. “It doesn’t matter what patients would choose for themselves.

“And it doesn’t matter if doctors believe this treatment is essential for individual patients.”

Chase Strangio, an attorney for the American Civil Liberties Union, which is representing three transgender adolescents, their parents, and a Memphis-based doctor challenging the Tennessee law, has described it as one of the most significant LGBTQ cases to ever reach the conservative-majority Supreme Court.

Strangio will be the first openly transgender lawyer to argue before the top court and in an essay published on Tuesday in The New York Times he said he “will not just be presenting legal arguments to the justices, I will also be embodying them.”

“My presence at the Supreme Court as a transgender lawyer will have been possible because I have had access to the very medical treatment at the center of this case,” he wrote. “Though some doubt the lifesaving properties of this care, I know them personally.”

Strangio said the stakes are particularly high since President-elect Donald Trump has pledged to impose a federal ban on gender-affirming care for transgender minors and restrict it for transgender adults.

– ‘Political pawns’ –

The Tennessee legislation known as Senate Bill 1, or SB1, was signed into law in March 2023 and purports to “protect the health and welfare of minors” by prohibiting medical procedures “that might encourage minors to become disdainful of their sex.”

Tennessee Attorney General Jonathan Skrmetti, in a brief with the Supreme Court, said the state law is intended to “protect minors from the life-altering risks of uncertain gender-transition interventions.”

Puberty blockers have been used on teens contemplating gender transition to delay the onset of unwanted physical changes.

Advocates say gender-affirming care can be lifesaving for children struggling with gender dysphoria.

Kelley Robinson, the president of Human Rights Campaign, which lobbies for LGBTQ rights, said the Tennessee law and similar legislation in other Republican-led states turn transgender youth into “political pawns.”

“No politician should ever be able to interfere in the decisions best made by families and doctors — but that’s exactly what these discriminatory bans allow,” Robinson said.

“Nearly every major medical organization agrees: gender-affirming care isn’t a political statement; it’s healthcare that can prevent depression, reduce suicide risk, and help children thrive,” she said. “This is about healthcare, plain and simple.”

Trump repeatedly raised transgender issues, which have become a frontline in the “culture wars” between conservatives and progressives, during his White House campaign.

Two of the biggest debates are whether transgender women should be allowed in female bathrooms and be allowed to participate in women’s sports.

According to a study by UCLA’s Williams Institute, an estimated 1.6 million people aged 13 and older in the United States identify as transgender.

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