In a landmark case with potential ramifications for transgender youth across the nation, the Supreme Court heard arguments Wednesday regarding Tennessee's ban on gender-affirming care for minors. The central question revolves around whether such state bans infringe upon the Equal Protection Clause of the 14th Amendment.
Conservative justices, including Chief Justice Roberts and Justice Kavanaugh, expressed reservations about overturning the Tennessee law (Senate Bill 1). They suggested that state legislatures, as elected representatives of the people, are better positioned than the court to regulate medical procedures. Chief Justice Roberts emphasized that none of the justices are medical professionals, highlighting the court's deference to legislative bodies on such matters.
Justice Alito pointed to studies citing negative outcomes for adolescents who have undergone gender transition treatments. If the court upholds the lower court's decision in favor of the ban, similar laws in over 20 other states could be solidified.
The case, United States v. Skrmetti, challenges the Tennessee law that prohibits gender-affirming care for minors and subjects healthcare providers who offer such care to penalties. The law defines these treatments as those intended to allow a minor "to identify with, or live as, a purported identity inconsistent with the minor’s sex" or to address "purported discomfort or distress from a discordance between the minor’s sex and asserted identity."
A student leads a demonstration in Knoxville, Tennessee, protesting the state’s 2022 transgender athlete ban. (Saul Young/Knoxville News-Sentinel /USA Today)
This case marks the first time the Supreme Court has addressed restrictions on puberty blockers, hormone therapy, and surgery for transgender minors. The Biden administration and the ACLU, representing the parents of three transgender adolescents and a Memphis doctor, are challenging the law. They argue that the law discriminates based on sex, requiring a higher level of judicial scrutiny.
The core legal debate concerns the appropriate level of scrutiny for evaluating the constitutionality of these bans. The petitioners argue for heightened scrutiny, requiring states to demonstrate a compelling interest. Tennessee contends that the rational basis test, a less stringent standard, is sufficient.
The petitioners argue that the law discriminates based on sex, using the example of a hypothetical individual named John Doe who seeks puberty blockers to undergo male puberty. They assert that the law prohibits this treatment solely because John's sex assigned at birth was female. They contend that if John's assigned sex were male, the restriction would not apply.
The U.S. Supreme Court building in Washington, D.C. (AP Photo/Mariam Zuhaib)
Tennessee argues that the law is not sex-based but rather purpose-based, focusing on protecting minors from what they characterize as "risky and unproven medical interventions." They claim the law differentiates based on medical purpose, not sex, asserting that providing testosterone to a boy with a deficiency is different from providing it to a girl experiencing gender dysphoria.
A flag supporting LGBTQ+ rights at the Kansas House of Representatives. (AP Photo/John Hanna, File)
Justices questioned both sides on the law's classification and application. Justice Jackson drew parallels to Loving v. Virginia, a landmark case on interracial marriage. Justice Kagan questioned the law's stated purpose of encouraging minors to accept their assigned sex. Tennessee maintains that the law serves compelling interests in protecting minors' health and the integrity of the medical profession, even under heightened scrutiny.
The court's decision, expected before July 2025, will significantly impact the landscape of transgender healthcare for minors nationwide.
