Many medical treatments could be affected by U.S. Supreme Court transgender health care rulingWASHINGTON, DC - DECEMBER 04: Transgender rights supporters and opponent rally outside of the U.S. Supreme Court as the high court hears arguments in a case on transgender health rights on December 04, 2024 in Washington, DC. The Supreme Court is hearing arguments in US v. Skrmetti, a case about Tennessee's law banning gender-affirming care for minors and if it violates the Constitution’s equal protection guarantee. (Photo by Kevin Dietsch/Getty Images)
Many medical treatments could be affected by U.S. Supreme Court transgender health care ruling

Many medical treatments could be affected by U.S. Supreme Court transgender health care ruling

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US Supreme Court upholds Tennessee law banning youth transgender care

The U.S. Supreme Court upheld a Republican-backed ban in Tennessee on gender-affirming medical care for transgender minors. The court, in a 6-3 ruling powered by its conservative justices, decided that the ban does not violate the Constitution’s 14th Amendment promise of equal protection. The ruling affirmed a lower court’s decision that backed Tennessee’s law, which bars medical treatments such as puberty blockers and hormones for people under age 18 experiencing gender dysphoria. Since returning to office in January, Republican President Donald Trump has taken a hardline stance against transgender rights. The law allows these medications to be used for any other purpose, including to address congenital defects, early-onset puberty or other conditions. It aims to encourage minors to “appreciate their sex” by prohibiting healthcare workers from prescribing puberty blocker and hormones to help them live as “a purported identity inconsistent with the minor’s sex”Providers can be sued and face fines and professional discipline under the law for any violations. Several other state restrictions have been enacted in recent years targeting transgender people.

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Summary Transgender rights are a flashpoint in US culture wars

Tennessee bans treating minors for gender dysphoria

Challengers said law violates constitutional rights

Conservative justices power 6-3 ruling; liberals dissent

WASHINGTON, June 18 (Reuters) – The U.S. Supreme Court upheld a Republican-backed ban in Tennessee on gender-affirming medical care for transgender minors on Wednesday in a setback for transgender rights that could bolster efforts by states to defend other measures targeting transgender people.

The court, in a 6-3 ruling powered by its conservative justices, decided that the ban does not violate the U.S. Constitution’s 14th Amendment promise of equal protection, as challengers to the law had argued. The ruling affirmed a lower court’s decision that backed Tennessee’s law, which bars medical treatments such as puberty blockers and hormones for people under age 18 experiencing gender dysphoria. The Supreme Court’s three liberal justices dissented.

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“Tennessee concluded that there is an ongoing debate among medical experts regarding the risks and benefits associated with administering puberty blockers and hormones to treat gender dysphoria, gender identity disorder and gender incongruence. (The law’s) ban on such treatments responds directly to that uncertainty,” conservative Chief Justice John Roberts wrote for the court’s majority.

Gender dysphoria is the clinical diagnosis for significant distress that can result from an incongruence between a person’s gender identity and the sex assigned at birth.

Chase Strangio, a transgender American Civil Liberties lawyer who represented some of the challengers in the case, called the ruling “a devastating loss for transgender people, our families and everyone who cares about the Constitution.”

Transgender rights as an issue has become a major flashpoint in the U.S. culture wars. Since returning to office in January, Republican President Donald Trump has taken a hardline stance against transgender rights.

Wednesday’s ruling will have a broad impact as Tennessee’s law is one of 25 such policies , opens new tab enacted by conservative state lawmakers around the United States. U.S. Attorney General Pam Bondi, a Trump appointee, in a social media post applauded the ruling and encouraged other states to “follow Tennessee’s lead and enact similar legislation to protect our kids.”

Various other state restrictions have been enacted in recent years targeting transgender people, from bathroom use to sports participation, some limited to minors but others extending to adults.

Liberal Justice Sonia Sotomayor expressed dismay that the Supreme Court largely deferred to the state legislature’s policy choices in upholding the ban.

“By retreating from meaningful judicial review exactly where it matters most, the court abandons transgender children and their families to political whims. In sadness, I dissent,” Sotomayor wrote, joined by fellow liberal Justices Elena Kagan and Ketanji Brown Jackson.

The Justice Department under Democratic former President Joe Biden ‘s administration had challenged the law. Trump’s administration told the Supreme Court in February that Tennessee’s ban was not unlawful, reversing the government’s position.

Tennessee’s law, passed in 2023, aims to encourage minors to “appreciate their sex” by prohibiting healthcare workers from prescribing puberty blockers and hormones to help them live as “a purported identity inconsistent with the minor’s sex.”

Providers can be sued and face fines and professional discipline under the law for any violations. The law allows these medications to be used for any other purpose, including to address congenital defects, early-onset puberty or other conditions.

Item 1 of 3 People gather and react outside the U.S. Supreme Court on the day it heard arguments over an appeal by U.S. President Joe Biden’s administration of a lower court’s decision upholding a Republican-backed ban in Tennessee on gender-affirming medical care for transgender minors, in Washington, U.S., December 4, 2024. REUTERS/Leah Millis/File Photo [1/3] People gather and react outside the U.S. Supreme Court on the day it heard arguments over an appeal by U.S. President Joe Biden’s administration of a lower court’s decision upholding a Republican-backed ban in Tennessee on gender-affirming medical care for transgender minors, in Washington, U.S.,… Purchase Licensing Rights , opens new tab Read more

Tennessee Attorney General Jonathan Skrmetti welcomed Wednesday’s ruling, saying that the state legislature had “voted to protect kids from irreversible decisions they cannot yet fully understand.”

Several plaintiffs – three transgender minors and their parents, as well as a doctor who provides the type of care at issue – sued to challenge the Tennessee law’s legality. Biden’s Justice Department subsequently intervened in the lawsuit, opposing Tennessee’s law.

The challengers argued that the law discriminates against these adolescents based on sex and transgender status, violating the 14th Amendment.

‘DIGNITY AND EQUALITY’

Some transgender people gathered at a church near the Supreme Court building and denounced the ruling.

“I am myself trans, and I am very concerned about efforts to erase transgender people from public life,” Nicky Sundt said in an interview.

The ACLU’s Strangio said, “We are as determined as ever to fight for the dignity and equality of every transgender person.”

Tennessee has said it is banning “risky, unproven gender-transition interventions,” pointing to “scientific uncertainty,” tightened restrictions in some European countries and “firsthand accounts of regret and harm” from people who discontinue or reverse treatments.

Medical associations, noting that gender dysphoria is associated with higher rates of suicide, have said gender-affirming care can be life-saving, and that long-term studies show its effectiveness.

Lucas Cameron-Vaughn, a lawyer at the ACLU of Tennessee, said, “This ruling creates a class of people who politicians believe deserve healthcare, and a class of people who do not.”

A federal judge blocked the law as likely violating the 14th Amendment but the Cincinnati-based 6th U.S. Circuit Court of Appeals later reversed the judge’s preliminary injunction.

In a June 11-12 Reuters/Ipsos poll of Americans, 53% of respondents said they supported “laws that prevent transgender children under the age of 18 from getting medical treatment related to gender identity and gender transitioning.” Another 28% opposed such laws and the rest were unsure or did not answer the question. Among Republicans, support for such laws was at 57% and opposition at 28%. Among Democrats, support was at 23% and opposition at 54%.

The Supreme Court on May 6 permitted Trump’s administration to implement his ban on transgender people in the military while legal challenges play out. Trump has taken actions targeting “gender ideology” and declaring that the U.S. government will recognize two sexes: male and female. Trump issued executive orders curtailing gender-affirming medical treatments for youth under 19 and excluding transgender girls and women from female sports , while rescinding Biden’s orders combating discrimination against gay and transgender people.

Reporting by Andrew Chung in Washington; Additional reporting by John Kruzel and Leonardo Benassatto in Washington and Jonathan Allen in New York; Editing by Will Dunham

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Source: Reuters.com | View original article

Many medical treatments could be affected by Supreme Court transgender ruling

Legal and health policy experts say the court’s June ruling upholding a Tennessee ban on gender-affirming care for minors leaves the door open for other challenges. The ruling could give states leeway to make rules on any other sex-related treatment — potentially affecting people of all genders, experts say. Twenty-six other states have similar laws to Tennessee’’ Twenty-five other states. have similar law to Tennessee.’ ‘Everyone has a sex. Everyone is now much more vulnerable to sex discrimination in this country, even if it hasn’t. taken place yet,’ one expert says. ‘The court has basically decreed a new form of legal and political vulnerability that did not exist before the Skrmetti case,” another says.‘This case really kind of now altered the legal landscape in a pretty pretty way,�’ another expert adds. � ‘This ruling marks a deeply concerning direction,’ says Kellan Baker, executive director of the LGBTQ Institute for Health Research and Policy.

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Transgender rights supporters and opponents rally outside of the U.S. Supreme Court as the high court hears arguments in a case on transgender health rights in December 2024 in Washington, D.C. Legal and health policy experts say the court’s June ruling upholding a Tennessee ban on gender-affirming care for minors leaves the door open for other challenges — and restrictions. (Kevin Dietsch/Getty Images)

This story originally appeared on Stateline.

The justices’ reasoning in the recent U.S. Supreme Court ruling upholding Tennessee’s ban on youth gender-affirming care could have much broader implications, perhaps opening the door to state restrictions on health care for other groups of people, experts say.

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The ruling could give states leeway to make rules on any other sex-related treatment — potentially affecting people of all genders, according to legal and health policy scholars.

In U.S. v. Skrmetti, three families and a physician argued that a Tennessee law barring the use of puberty blockers and hormone treatments for transgender minors violates the U.S. Constitution’s equal protection clause. They asserted that the law discriminates on the basis of sex, since the state allows the use of similar treatments for cisgender boys and girls with other medical conditions.

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The court weighed the argument of whether the law treats people differently, subject to what is called heightened scrutiny. Under this higher level of judicial review, the state must identify an important objective for a law and demonstrate how it helps accomplish that goal.

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But the court’s conservative majority last month ruled that the Tennessee ban doesn’t merit such scrutiny because its restrictions are based on age and the medical uses of certain drugs, not sex. Twenty-six other states have similar laws to Tennessee’s.

The Tennessee law “prohibits healthcare providers from administering puberty blockers and hormones to minors for certain medical uses, regardless of a minor’s sex,” Chief Justice John Roberts wrote. “The law does not prohibit certain medical treatments for minors of one sex while allowing those same treatments for minors of the opposite sex.”

Justice Elena Kagan disputed that view during oral arguments.

“The whole thing is imbued with sex. It’s based on sex,” Kagan said. “You might have reasons for thinking it’s an appropriate regulation and those reasons should be tested and respect given to them, but it’s a dodge to say, ‘This is not based on sex, it’s based on medical purpose,’ when the medical purpose is utterly and entirely about sex.”

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Tennessee’s law says the state has a “compelling interest in encouraging minors to appreciate their sex.”

Some legal and policy experts say the court’s reasoning in Skrmetti could allow states to enact further restrictions on abortion, contraception, in vitro fertilization or other health care, particularly sex-specific treatment, sidestepping previous protections.

Jules Gill-Peterson, an associate professor of transgender history at Johns Hopkins University, called the ruling “consequential.”

“The court has basically decreed a new form of legal and political vulnerability that did not exist before the Skrmetti case,” she said. ”Everyone has a sex. Everyone is now much more vulnerable to sex discrimination in this country, even if it hasn’t taken place yet.”

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She added that women, especially, could see rollbacks.

“It will greatly advance people’s ability to discriminate against women,” she said. “This case really kind of now altered the legal landscape in a pretty significant way.”

The court has basically decreed a new form of legal and political vulnerability that did not exist before the Skrmetti case.

– Jules Gill-Peterson, Johns Hopkins University associate professor

The ruling marks “a deeply concerning direction,” said Kellan Baker, executive director of the Institute for Health Research and Policy at Whitman-Walker, an LGBTQ+ health nonprofit in the Washington, D.C., area.

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“At any time and for any reason, a state legislature could decide that any medical indication is suddenly not politically palatable, and move to ban access to any type of care that legislature wants to target,” Baker said.

He added that the decision is likely to have “serious political ramifications” for more than just transgender people.

Eric Neiman, an attorney at Epstein Becker Green, a law firm focused on health care and employment cases, agreed the ruling “could allow states to regulate all kinds of medical procedures for children and adults.”

Ultimately, Neiman said, the decision indicates “deference to states in decision-making about care that can be provided to children.”

Sex-based protections

The decision builds on the 2022 Dobbs ruling that overturned Roe v. Wade, said Katie Keith, the founding director of the Health Policy and the Law Initiative at the O’Neill Institute at Georgetown University Law Center.

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“I don’t know that we would have seen this decision in the same way if we hadn’t had the Dobbs decision three years ago and the erosion of sex-based protections,” she said.

Keith pointed to state actions that followed Dobbs, such as a decision by Iowa’s attorney general to halt funding for emergency contraceptives for sexual assault victims. The policy drew significant outcry, which resulted in the office resuming funding.

Leah Litman, a University of Michigan law professor, wrote in a recent essay in The Atlantic that Roberts and the other conservative justices revived “an outdated case” when they cited the 1974 decision in Geduldig v. Aiello, in which the justices ruled it was permissible to deny certain benefits for pregnancy-related disabilities.

“If the Republican appointees plan to revive this older case, they will take the law and the country back to a time when the government used the existence of ‘biological differences’ between men and women to excuse all kinds of discrimination against women,” Litman wrote.

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Also at stake are previous appellate court decisions out of West Virginia and North Carolina that protected transgender adults’ access to public insurance coverage for transgender care. The Supreme Court threw out those rulings and ordered appellate judges to reevaluate in light of the Skrmetti decision. Another case involving gender-affirming medical care out of Idaho will also have to be reevaluated.

‘Scientific and policy debates’

Critics of gender-affirming health care for youth hailed the Skrmetti ruling, citing recent research that calls into the question the efficacy of such treatments. The decision was “a monumental victory, for children, science, and common sense,” Kristen Waggoner, president and CEO of Alliance Defending Freedom, wrote in an emailed statement.

But dozens of leading U.S. medical organizations, including the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry, have stressed that gender-affirming care for minors is safe and essential.

“Denying patients access to this care not only undermines their health and safety, it robs them of basic human dignity,” Dr. Susan J. Kressly, president of the American Academy of Pediatrics, said in a statement following the decision. “The ruling also sets a dangerous precedent for legislative interference in the practice of medicine and the patient-physician relationship that is at the core of our health system.”

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But in his opinion, Roberts insisted that the case carries “scientific and policy debates.” “The Equal Protection Clause does not resolve these disagreements. Nor does it afford us license to decide them as we see best,” he wrote.

Justices Ketanji Brown Jackson and Sonia Sotomayor said the majority’s arguments mirror those made in defense of banning interracial marriage in the Loving v. Virginia case. The Supreme Court struck down the ban in 1967.

“In a passage that sounds hauntingly familiar to readers of Tennessee’s brief, Virginia argued in Loving that, should this Court intervene, it would find itself in a ‘bog of conflicting scientific opinion upon the effects of interracial marriage,’” Sotomayor wrote in her dissent.

Advocates say the narrowness of the Skrmetti decision could make it possible to challenge state bans on health care for trans youth on other grounds.

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“[The ruling] is not a blanket endorsement of the various state bans on medical care for transgender youth. It is a tortured and narrow upholding of Tennessee’s,” said Baker, of Whitman-Walker. “The court sidestepped the actual question about equal protection.”

For example, a plaintiff could argue that parents have a constitutional right to make medical decisions for their children. Supporters of transgender rights also noted the decision did not take aim at equal protection rights for transgender adults, but other obstacles remain amid an onslaught from the Trump administration.

President Donald Trump has issued an executive order recognizing only biological sex and not gender identity. The administration has also frozen federal grant money dedicated to LGBTQ+ health and issued warnings for gender-affirming care for minors.

And the administration last month finalized a rule barring health plans offered on Affordable Care Act exchanges from covering gender-affirming care — defined as surgeries, puberty blockers and hormone treatment — as an essential health benefit. The decision means that payments for such care cannot be applied toward deductibles.

“[The court] signaled that perhaps some of the kinds of protections, or maybe just backstops, people had been hoping existed, they’re just not there,” Gill-Peterson said.

Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org.

Source: Yahoo.com | View original article

What to know about the Supreme Court’s ruling on transgender care for youth

The Supreme Court has upheld Tennessee’s ban on gender-affirming surgery for transgender youth. Chief Justice John Roberts wrote that the ban does not violate the Constitution. The ruling is likely to reverberate across the country. Most Republican-controlled states already have similar bans on the surgery. But the ruling doesn’t automatically end the cases against other bans onGender-affirmed care. It still could find more protections against stateutions based on arguments rooted in the U.S. Constitution. It also may not make any difference immediately on many fronts of transgender rights.Several states have passed laws or executive orders intended to protect access to gender-Affirming care for transgender people. But it isn’t clear whether the question about whether the care is available for minors will continue to be debated in court. It is also unclear if the Supreme Court will take up the issue in the future, as it has not ruled on the issue before in the past. It could also take time for the ruling to become known to the public.

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The U.S. Supreme Court has upheld Tennessee’s ban on gender-affirming surgery for transgender youth in a ruling that’s likely to reverberate across the country.

Most Republican-controlled states already have similar bans.

In his majority opinion Wednesday, Chief Justice John Roberts wrote that Tennessee’s ban does not violate the Constitution’s equal protection clause, which requires the government to treat similarly situated people the same.

READ MORE: Judge says Trump administration can’t limit passport sex markers for many transgender, nonbinary people

Since President Donald Trump returned to office this year, the federal government has been trying to restrict access.

Here are some things to know about gender-affirming care and the court’s ruling:

What is gender-affirming care?

Gender-affirming care includes a range of medical and mental health services to support a person’s gender identity, or their sense of feeling male, female, neither or some combination of both. Sometimes that’s different from the sex they were assigned at birth.

The services are offered to treat gender dysphoria, the unease a person may have because their assigned gender and gender identity don’t match. Studies, including one from 2023 by researchers at institutions including London Children’s Hospital and Children’s Hospital of Philadelphia, have found the condition is linked to depression and suicidal thoughts.

Gender-affirming care encompasses counseling and treatment with medications that block puberty and hormone therapy to produce physical changes. Hormone therapy for transgender men causes periods to stop, increases facial and body hair and deepens voices. The hormones used by transgender women can have effects such as slowing growth of body and facial hair and increasing breast growth. Fewer than 1 in 1,000 U.S. adolescents receive gender-affirming medications, a study released this year found.

Gender-affirming care can also include surgery, including operations to transform genitals and chests. These surgeries are rarely offered to minors.

There are documented uses of genital surgery for adults dating back to the 1920s. But for youth, gender-affirming care has been more common since the 1990s.

What is the controversy?

As a medical consensus emerged in support of gender-affirming care for youth, the issue also became politically divisive in other ways. Some states approved measures to protect transgender people, who make up around 1% of the nation’s population.

Many critics dismiss the idea that gender is changeable and lies along a spectrum. About two-thirds of U.S. adults believe that whether a person is a man or woman is determined by biological characteristics at birth, an Associated Press-NORC Center for Public Affairs Research poll conducted in May found.

In the last five years, most GOP-controlled states have passed laws to block transgender girls from sports competitions for girls. About half the Republican-controlled states have now banned transgender people from using school bathrooms that align with their gender identity.

Opponents of gender-affirming care sometimes refer to it as “mutilation” and say people who transition when they’re young could later regret it.

What could the ruling mean for bans in states besides Tennessee?

In addition to Tennessee, 26 other states have passed bans or restrictions on gender-affirming care for youth. Judges have struck down the bans in Arkansas and Montana, though the legal fights there aren’t over.

All of the laws have been adopted in the past five years and nearly all have been challenged in court.

The Supreme Court’s decision may doom some of those challenges. But lawyers who challenged Tennessee’s law said the ruling applies only to that policy – and that it doesn’t automatically end the cases against other bans on gender-affirming care.

Lambda Legal lawyer Karen Loewy noted that the opinion focused on the fact that it involved minors and that the court did not find sex-based discrimination against transgender people.

Further, some of the lawsuits against the bans — including in Kansas, Montana, North Dakota and Ohio — are based on arguments rooted in state constitutions. It still possible that judges could find more protections in those state constitutions than are in the U.S. Constitution.

What will the ruling mean for states without bans on gender-affirming care?

It probably won’t make any difference immediately.

Several of those states have laws or executive orders intended to protect access to gender-affirming care for transgender minors.

But the question about whether the care will continue isn’t only about what’s legal. It’s also about funding.

That’s where Trump comes in.

Trump campaigned last year pledging to rein in rights of transgender people. He’s followed through on many fronts, though court challenges have resulted in some of his efforts being blocked, at least for now.

What has Trump done on transgender issues?

He has ordered that no federal taxpayer money be used to pay for the care for those under 19. Enforcement of that order is on hold.

Trump has also tried to block federal funding from institutions — including hospitals and the universities that run some of them — that provide gender-affirming care for youth. A judge has blocked that effort while challenges to it proceed.

His administration published recommendations that therapy alone – and not medication – be used to treat transgender youth. The position contradicts guidance from major medical organizations. But it could impact practices.

Other actions Trump has taken include initiating the removal of transgender troops from military service; ordering that transgender women and girls be kept out of sports competitions for females; erasing the word “transgender” from some government websites; and saying the government would recognize people only by their sex at conception.

That’s resulted in efforts to move transgender women inmates to men’s prisons and change how passports are issued to transgender and nonbinary people. A judge this week blocked the Trump administration from limiting passport sex markers for many transgender and nonbinary Americans.

Associated Press writers Matthew Brown in Billings, Montana; Jack Dura in Bismarck, North Dakota; and Kenya Hunter in Atlanta contributed to this report.

Source: Pbs.org | View original article

Supreme Court Upholds Gender-Affirming-Care Ban

The Supreme Court upheld a Tennessee law that bars doctors from providing gender-affirming care for trans minors. The ruling does not ban such care nationwide, but it permits the at least 25 bans that states have passed against medical and surgical care for transgender youth. Some states, such as Florida, have similarly moved to restrict access to such care for adults. The decision comes as the Trump Administration targets transgender Americans on the federal level as well, seeking to bar requests for updated gender markers on federal identification documents that align with the holder’s gender identity. The effort to bar accurate gender markers was blocked by a federal judge on Tuesday, but the ruling will pose a significant obstacle for legal challenges to the mounting restrictions being placed on gender-Affirming care across the country. The state of Tennessee is home to about 3,000 transgender youth, according to UCLA School of Law’’s Williams Institute. Nationwide, there are an estimated 300,000Transgender adolescents. Many activists lament to its potential effect on transgender youth whose lives are going to be irrevocably changed as a result of the decision.

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The Supreme Court has delivered a major blow to transgender rights with its decision to uphold a Tennessee law that bars doctors from providing gender-affirming care including puberty blockers, hormones, and surgical procedures for trans minors in the state. The Wednesday decision in the landmark U.S. v. Skrmetti case is expected to upend access to healthcare for trans and nonbinary youth far beyond Tennessee. While the ruling does not ban gender-affirming care nationwide, it permits the at least 25 bans that states have passed against medical and surgical care for transgender youth. Some states, such as Florida, have similarly moved to restrict access to such care for adults.

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The opinion comes as the Trump Administration targets transgender Americans on the federal level as well, seeking to bar requests for updated gender markers on federal identification documents that align with the holder’s gender identity and releasing a U.S. Department of Health and Human Services report aiming to discredit gender-affirming care as treatment for individuals with gender dysphoria. The effort to bar accurate gender markers was blocked by a federal judge on Tuesday. The Supreme Court’s decision will pose a significant obstacle for legal challenges to the mounting restrictions being placed on gender-affirming care across the country. In the ruling, the conservative majority rejected arguments that barring such care violated the equal protection clause of the 14th Amendment. “This case carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field,” Chief Justice John Roberts wrote for the majority in the court’s 6-3 ruling. “The Equal Protection Clause does not resolve these disagreements.”

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Here’s what to know about the decision and how it will impact care. What does the Supreme Court’s decision mean for gender-affirming care? The lawsuit at the core of the U.S. v. Skrmetti, filed by the families of three transgender adolescents and a Memphis-based medical provider, challenged the Tennessee ban on gender-affirming care for minors under the equal protection clause, citing sex discrimination. The state of Tennessee, meanwhile, argued that the ban would help protect children from what it referred to as “experimental” medical treatment, though every major medical and mental health association supports gender-affirming care as a legitimate health practice, per GLAAD. The justices found that the law is a standard state regulation on medical care and does not discriminate on the basis of sex. “The law does not prohibit certain medical treatments for minors of one sex while allowing those same treatments for minors of the opposite sex,” the majority opinion reads.

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Justices Sonia Sotomayor, Ketanji Brown Jackson and Elena Kagan dissented. “Male (but not female) adolescents can receive medicines that help them look like boys, and female (but not male) adolescents can receive medicines that help them look like girls,” Sotomayor wrote in a dissent joined in full by Jackson and in part by Kagan. “By retreating from meaningful judicial review exactly where it matters most, the Court abandons transgender children and their families to political whims. In sadness, I dissent.” The state of Tennessee is home to about 3,000 transgender youth, according to UCLA School of Law’s Williams Institute. Nationwide, there are an estimated 300,000 transgender adolescents. The Supreme Court’s ruling will also allow gender-affirming-care bans in states beyond Tennessee to go into effect, though it does not enact a nationwide ban. That means transgender minors living in a state with a ban will have to seek care in other states in order to continue receiving medication or other gender-affirming treatments.

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It is still unclear how the ruling could affect potential gender-affirming-care bans for adults, according to Alex Reinert, a constitutional law and civil rights professor at Cardozo School of Law. “The court doesn’t address that,” he says. “But I think the reasoning that the court has provided would apply to attempts to regulate gender-affirming care for adults as well.” Many activists are lamenting the decision due to its potential effect on transgender youth. “The biggest human tragedy here are the trans kids whose lives are going to be irrevocably changed as a result of not being able to get the best practice healthcare that their parents want them to get, [and] that their doctors want them to get,” says Cathryn Oakley, senior director of legal policy at the Human Rights Campaign, a nonprofit advocating for LGBTQ+ rights. A 2022 study published in the National Library of Medicine found that gender-affirming care was associated with lower odds of depression and suicidality.

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A 2024 peer-reviewed study in Nature Human Behaviour in collaboration with Trevor Project researchers found that anti-transgender state laws caused an uptick in suicide attempts among transgender youth by as much as 72%. “Today’s ruling is a devastating loss for transgender people, our families, and everyone who cares about the Constitution,” said Chase Strangio, co-director of the ACLU’s LGBTQ & HIV Project who argued the case before the court, becoming the first out trans attorney to do so. “We are as determined as ever to fight for the dignity and equality of every transgender person and we will continue to do so with defiant strength, a restless resolve, and a lasting commitment to our families, our communities, and the freedom we all deserve.” What legal challenges could come next Legal experts say the decision will make it difficult to battle other gender-affirming-care bans, though not impossible. “The question presented to the Supreme Court was pretty narrow. It was very specifically this question of whether or not discrimination against trans people constitutes discrimination on the basis of sex,” says Oakley.

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Cases that pertain to protected classes, such as sex and gender, are typically reviewed under the lens of heightened scrutiny. The level of scrutiny matters because it dictates the type of rationale the government must have for passing a law, says Reinert. The majority ruled on Skrmetti with a rational review, meaning that they believed the Tennessee law did not deal with those issues but instead with matters of age and “the medical purpose for which the treatment is being sought,” Reinert says. “The plaintiffs argue that SB1 warrants heightened scrutiny because it relies on sex-based classifications. But neither of the above classifications turns on sex,” the majority opinion reads. “Rather, SB1 prohibits healthcare providers from administering puberty blockers or hormones to minors for certain medical uses, regardless of a minor’s sex. While SB1’s prohibitions reference sex, the Court has never suggested that mere reference to sex is sufficient to trigger heightened scrutiny.”

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In cases regarding the rational basis reviews of the law, “the state almost always wins,” Reinert says. Oakley says it’s possible future plaintiffs could contest state laws based on parental rights over their child’s medical treatment. Reinert concurs that additional legal challenges can be brought in the court system depending on the way other state laws are phrased or organized. But, he adds, the decision “almost certainly makes those challenges much harder to succeed at.” What medical groups say about gender-affirming care Gender-affirming care is espoused as a medically accepted treatment by every major medical association in the U.S., including the American Academy of Pediatrics, American Medical Association, and more. The American College of Pediatricians, which has been identified as an anti-LGBTQ+ hate group by the Southern Poverty Law Center, filed an amicus brief in support of the state of Tennessee. The group was first founded in 2002 by members who opposed the American Academy of Pediatrics’s endorsement of adoption by same-sex couples.

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Beyond the U.S., several European countries are assessing best practices for patients with gender dysphoria. The U.K. moved to ban puberty blocker prescriptions for youth in March 2024, citing a lack of evidence.

Some doctors who treat patients with gender dysphoria have expressed disappointment with the court’s ruling. “Today’s decision codifies the patchwork of state laws banning vs. allowing medically necessary healthcare for a singular group of young people into federal law,” Morissa Ladinsky, a professor at Stanford University School of Medicine and Child Health told TIME in an emailed statement. “This emboldens a more sinister reality. Providers can now discriminate in the delivery of health care. We can treat patients differently on the basis of age, sex and gender. Because we can, does not mean we must.”

Source: Time.com | View original article

ACLU, Lambda Legal Respond to Supreme Court Ruling in U.S. v. Skrmetti

The Supreme Court issued its ruling in U.S. v. Skrmetti, a challenge brought by three transgender adolescents, their families, and a Memphis-based medical provider against a Tennessee law banning gender-affirming hormone therapies for transgender people under 18. The Court agreed with parts of the Sixth Circuit’s opinion that allowed the law to take effect. The decision is based on the record in and context of the Tennessee case and therefore does not extend to other cases concerning discrimination based on transgender status. “This is a heartbreaking ruling, making it more difficult for transgender youth to escape the danger and trauma of being denied their ability to live and thrive,” said Sasha Buchert, Counsel and Director of the Nonbinary and Transgender Rights Project at Lambda Legal.“Today the Supreme Court told Tennessee transgender youth and their families that they cannot access healthcare that is vitally important for a successful life” – Lucas Cameron-Vaughn, Senior Staff Attorney at the ACLU of Tennessee.

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WASHINGTON – This morning, the Supreme Court issued its ruling in U.S. v. Skrmetti, a challenge brought by three transgender adolescents, their families, and a Memphis-based medical provider against a Tennessee law banning gender-affirming hormone therapies for transgender people under 18.

The Court agreed with parts of the Sixth Circuit’s opinion that allowed the law to take effect, holding that Tennessee’s SB1 does not draw a sex-based (or a trans status-based) line and thus only necessitates deferential review by the courts. That means SB1 can remain in effect. Notably, however, the decision is based on the record in and context of the Tennessee case and therefore does not extend to other cases concerning discrimination based on transgender status.

“Today’s ruling is a devastating loss for transgender people, our families, and everyone who cares about the Constitution,” said Chase Strangio, Co-Director of the ACLU’s LGBTQ & HIV Project. “Though this is a painful setback, it does not mean that transgender people and our allies are left with no options to defend our freedom, our health care, or our lives. The Court left undisturbed Supreme Court and lower court precedent that other examples of discrimination against transgender people are unlawful. We are as determined as ever to fight for the dignity and equality of every transgender person and we will continue to do so with defiant strength, a restless resolve, and a lasting commitment to our families, our communities, and the freedom we all deserve.”

“This is a heartbreaking ruling, making it more difficult for transgender youth to escape the danger and trauma of being denied their ability to live and thrive,” said Sasha Buchert, Counsel and Director of the Nonbinary and Transgender Rights Project at Lambda Legal. “But we will continue to fight fiercely to protect them. Make no mistake, gender-affirming care is often life-saving care, and all major medical associations have determined it to be safe, appropriate, and effective. This is a sad day, and the implications will reverberate for years and across the country, but it does not shake our resolve to continue fighting.”

“Today the Supreme Court told Tennessee transgender youth and their families that they cannot access healthcare that is vitally important for a successful life,” said Lucas Cameron-Vaughn, Senior Staff Attorney at the ACLU of Tennessee. “This ruling creates a class of people who politicians believe deserve healthcare, and a class of people who do not. We will continue to stand with transgender people in Tennessee and are committed to realizing a world where all people belong, are valued, and can access the necessary healthcare they need.”

U.S. v. Skrmetti began when a lawsuit was filed by the American Civil Liberties Union, the ACLU of Tennessee, Lambda Legal, and Akin Gump Strauss Hauer & Feld LLP on behalf of Samantha and Brian Williams of Nashville and their 16-year-old transgender daughter, as well as two other plaintiff families filing anonymously and Memphis-based physician Dr. Susan Lacy. The plaintiff families and Dr. Lacy argued that the law violates the Equal Protection rights of transgender adolescents. Under President Joe Biden, the United States intervened to also argue that the Tennessee law violates the Equal Protection Clause of the 14th Amendment. After President Trump’s inauguration, the U.S. reversed its position.

Since 2021, 25 states have enacted categorical bans on gender-affirming medical care, such as hormone therapy and puberty-suppressant medications, for treating gender dysphoria in transgender youth yet readily allow those same medications for other and similar purposes for cisgender youth. Over 100,000 transgender people under 18 now live in a state with a ban on their health care.

In January 2025, the Trump administration issued an executive order directing federal agencies to withhold funds from medical providers and institutions that provide gender-affirming medical treatments such as puberty suppressants and hormone therapies to any trans person under 19. That order was soon challenged on behalf of families, medical providers, and advocates by the ACLU and the Lambda Legal and is blocked from enforcement by a preliminary injunction.

This case is a part of the ACLU’s Joan and Irwin Jacobs Supreme Court Docket.

Source: Aclu.org | View original article

Source: https://idahocapitalsun.com/2025/07/10/many-medical-treatments-could-be-affected-by-u-s-supreme-court-transgender-health-care-ruling/

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