Transgender rights case lands at Supreme Court amid debate over ban on medical treatments for minors

WASHINGTON — The Supreme Court will hear arguments Wednesday in only his second major transgender rights case, challenging a Tennessee law that prohibits it gender-affirming care for minors.

The justices’ decision, not expected for several months, could affect similar laws enacted by another 25 states, as well as a range of other efforts. to regulate the lives of transgender peopleincluding which ones sports competitions they can participate and which ones bathrooms they can use.

The case comes before a conservative-dominated court after the presidential election in which Donald Trump and his allies vowed to reverse protections for transgender people.

Four years ago, the court ruled in favor of Aimee Stephens, who was fired by a Michigan funeral home after informing the owner that she was a transgender woman. The court ruled that transgender people, as well as gays and lesbians, are protected by a landmark federal civil rights law that bans sex discrimination in the workplace.

The Biden administration and the families and health care providers who challenged the Tennessee law are urging the justices to apply the same kind of analysis that the majority, made up of liberal and conservative justices, embraced in the case four years ago when she found that “Sex plays an undeniable role” in employers’ decisions to punish transgender people for traits and behavior they otherwise tolerate.

The issue in the Tennessee case is whether the law violates the equal protection clause of the 14th Amendment, which requires the government to treat people in similar situations the same.

Tennessee law bans puberty blockers and hormone treatments for transgender minors, but not “across the board,” attorneys for the families wrote in their Supreme Court brief. The lead attorney, Chase Strangio of the American Civil Liberties Union, is the first openly transgender person to argue before the justices.

The administration states that there is no way to determine whether “treatments should be withheld from a particular minor” without considering the minor’s gender.

“That is sex discrimination,” wrote Attorney General Elizabeth Prelogar in her court filing.

The state recognizes that the same treatments banned for transgender minors can be prescribed for other reasons. But it rejects the claim that there is discrimination on the grounds of sex. Instead, it says lawmakers acted to protect minors from the risks of “life-changing gender transition procedures.”

The law “draws a line between minors seeking drugs for gender transition and minors seeking drugs for other medical purposes. And boys and girls are on both sides of that line,” Tennessee Attorney General Jonathan Skrmetti wrote in the state Supreme Court brief.

While challengers rely on the 2020 ruling in Bostock v. Clayton County for support, Tennessee is relying on the court’s precedent-shattering 2022 Dobbs decision, which ended nationwide abortion protections and returned the issue to the United States.

The two sides fought in their legal filings over the appropriate level of scrutiny the court should apply. It is more than an academic exercise.

The lowest level is known as rational basis review, and almost every law viewed that way is ultimately enforced. The federal appeals court in Cincinnati, which allowed the law to be upheld, ruled that lawmakers acted rationally to regulate medical procedures, well within their authority.

The Court of Appeal overturned a trial court that applied a higher level of scrutiny and scrutiny that applies in cases of sex discrimination. In this more in-depth investigation, the state must identify an important goal and demonstrate that the law helps achieve that goal.

If the judges opt for enhanced supervision, they can refer the case back to the appeals court to apply it.

Gender-affirming care for youth is supported by every major medical organization, including the American Medical Association, the American Academy of Pediatrics, and the American Psychiatric Association.

But Tennessee points to health authorities in Sweden, Finland, Norway and the United Kingdom who have found the medical treatments “carry significant risks with unproven benefits.”

None of those states have passed a ban similar to Tennessee’s and individuals can still receive treatment, Prelogar wrote in response.

The Williams family of Nashville, Tennessee are among those challenging the state law. Brian Williams said that due to puberty blockers and hormone treatments, his transgender daughter, LW, is a “16-year-old planning her future, making her own music and looking at colleges.”

But because of Tennessee’s ban, she must travel to another state to get the health care that “we and her doctors know is right for her.”