Supreme Court takes up challenge to ban on gender-affirming care
The Supreme Court is currently dealing with a wide range of issues, including presidential immunity, abortion and the powers of federal administrative agencies. However the docket that the justices have for the term 2024-25 has been dominated by lower-profile matters. On Monday, however, this changed when the justices once again waded into the culture battles, specifically the debate about rights for transgender individuals. The justices announced their decision in a list released Tuesday morning. They agreed to review a case that challenges a Tennessee law banning gender-affirming treatment for transgender children.
The case will be heard by the justices in the fall. A decision is likely to come in late June or early in July 2025.
The American Medical Association and other major medical groups in the United States have opposed state efforts to restrict gender affirming care. The American Medical Association, in a letter sent to the National Governors Association in 2021, cited research that showed gender-affirming health care could lead to, among other things, “dramatic reductions of suicide attempts as well as reduced rates of depression and anxiousness.”
Tennessee passed the law that is at the heart of the case, in 2023. The law prohibits gender-affirming treatments, including hormone treatments and gender transition surgeries, for patients who are transgender under the age of 18. Two exceptions were made to this general rule. It allowed hormone treatment for patients under 18 who are starting puberty early and also allowed providers to continue administering hormone therapy to those patients until March 31, 2024. The law allows for lawsuits against providers of health care who violate the restrictions. They could also lose their license to practice medicine.
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In the Tennessee case, the challengers are a transgender girl aged 16 who received estrogen therapy and puberty blocking drugs, as well as a transgender male aged 13 who received testosterone therapy and puberty blocking drugs. Along with their parents, the youths and a doctor that treats transgender people filed a federal lawsuit against Tennessee officials, asking the court to prevent the state from enforcing its ban on hormone therapy and gender-transition surgery.
The Biden administration took up the case in accordance with a federal statute that allows the government intervenes in private cases that allege violations of the right of equal protection under law, “if the Attorney-General certifies that this case is of public importance.”
U.S. district judge Eli Richardson was appointed by the former president Donald Trump to the bench. He ruled that challengers had no legal right to contest a ban on gender-transition surgery because they hadn’t indicated they wanted such surgery. Richardson suspended the rest of the ban while the litigation was ongoing. Richardson agreed with the challengers, saying that parents have the right to make decisions about their child’s health care, including the right to request medical treatment on their behalf.
Kentucky’s legislative body passed a similar prohibition in 2023 over the veto of Gov. Andy Beshear is a Democrat. Seven transgender teenagers and their parents challenged the Kentucky law in court, asking for an order to prevent the state from enforcing the ban on hormone therapy and puberty blocking drugs. U.S. district judge David Hale granted the request but put it on hold until the state appealed.
The U.S. Court of Appeals, 6th Circuit, reversed the rulings of the trial judges and reinstated the bans in Tennessee and Kentucky last fall. Chief Judge Jeffrey Sutton argued that, because it was “difficult to predict the long-term effects of abandoning any age limit for” gender affirming care in 2015, judges who are on a life-tenure should be cautious and humble when announcing substantive constitutional rights.
Both cases were challenged in the Supreme Court by the challengers, who asked the justices to consider the case, and the Biden Administration, which filed its own complaint against the Tennessee ban.
The Tennessee challengers said that “legal uncertainty” regarding the availability of gender affirming care for transgender teens “is creating chaos throughout the country for teenagers, families, and doctors.” In addition, the Kentucky plaintiffs noted that “21 states have prohibited adolescents from receiving medical care for gender disorders, throwing their lives into chaos.”
In their petitions, the challengers raised a number of different issues. They noted that the courts of appellate are divided over the central question in both Tennessee and Kentucky: whether or not (and if so, then how) states may ban gender affirming care, such as puberty blocking agents and hormone therapy, for transgender teenagers. The Supreme Court is not considering the ban on gender affirming surgeries in this case.
The challengers said that these cases raise other questions for the court to resolve. For example, how courts should evaluate state laws that discriminate against transgender people, whether they should be subjected to a stricter review and whether such laws violate parents’ fundamental rights to decide on medical care for their child.
Both states stressed that the court’s decision to allow them to enforce the laws was the right one. They also urged the justices not to accept the challengers request to “remove an important and continually evolving issue from the democratic process.” In any case, they said, there isn’t a real divide among the courts of appellations regarding the questions raised by these two cases. If there was a disagreement, they said, the court would have to wait until a case had a more complete factual record. This, they added, might be soon, given the amount of litigation that is ongoing about laws such as the Tennessee and Kentucky prohibitions.
The just
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