US Supreme Court to rule on legality of gender-affirming care bans for transgender youth

The US Supreme Court announced Monday it will review the legality of state efforts to ban gender-affirming medical care for minors — a contentious issue in a nation deeply divided over transgender rights and the role of medical intervention in youth gender identity.

The case, US v. Skrmetti, centers on a Tennessee law enacted in March 2023 that bans healthcare providers from performing medical procedures on minors or administering treatments intended to help minors identify with a gender different from their sex as assigned at birth. The law also curtailed then-ongoing gender-affirming care for minor patients.

In the immediate aftermath of the law’s passage, the families of three transgender teenagers sued Tennessee Attorney General Jonathan Skrmetti, the state’s health department, its medical board, and several other officials. The plaintiffs argued that the law violated their Equal Protection rights, as enshrined in the 14^th Amendment of the US Constitution, and sought to enjoin the law from taking effect. They argued the law “discriminates on the basis of sex and transgender status by prohibiting certain medical treatments only for transgender patients and only when those treatments are performed ‘for the purpose of . . . [e]nabling a minor to identify with, or live as,’ a gender identity other than the sex designated at birth.”

In June 2023, the Federal District Court for the Middle District of Tennessee sided with the plaintiffs, granting a preliminary injunction. But the following month, the injunction was overturned by the Sixth Circuit Court of Appeal. In November, the plaintiffs appealed to the Supreme Court.

The US then intervened on the plaintiffs’ side, arguing that the Supreme Court’s opinion was imperative given that the Tennessee law is part of a broader wave of gender-affirming care bans that had resulted in multiple circuit-level conflicts, asserting:

Those laws, and the conflicting court decisions about their validity, are creating profound uncertainty for transgender adolescents and their families around the Nation—and inflicting particularly acute harms in Tennessee and other States where the laws have been allowed to take effect.

At present, half the states in the nation have passed laws barring transgender youth from obtaining gender-affirming care — with state policies diverging on the expansiveness of the definition of such treatments. A handful of states — Alabama, Florida, Idaho, North Dakota, Oklahoma, and South Carolina, according to the advocacy group MAP — make it a felony to provide gender-affirming care to youths.

According to a report released earlier this year by the UCLA School of Law, 93 percent of transgender teens (aged 13-17) in the US live in states that have either passed or proposed legislation aiming to block such treatments. The number of states that have banned gender-affirming care for minors has surged in the past two years, from four in 2022 to 25 as of the time of writing. This period has seen a widening rift between Conservative and Progressive values across the US, which has had an impact on state and federal policies ranging from reproductive rights to border security.

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