Supreme Court seems likely to uphold ban on gender-affirming care
The Supreme Court on Wednesday showed support for Tennessee's restrictions on gender-affirming care for minors experiencing gender dysphoria, delving into the contentious debate over medical treatment for transgender youth. The case tests the boundaries of state authority in regulating care that transgender adolescents and their advocates argue is vital for their well-being.
Tennessee's law, like similar measures in 24 other states, prohibits puberty blockers and hormone therapy for individuals under 18. The Biden administration, alongside three families and a doctor, challenged the law, arguing it violates constitutional rights. However, the Court's conservative majority appeared inclined to uphold Tennessee's stance, citing ongoing debate in the medical community about the benefits and risks of such treatments.
Conservative Justices Question Federal Challenge
During two hours of arguments, conservative justices frequently expressed skepticism about overturning the state law. Justice Brett Kavanaugh questioned whether courts should intervene in policy matters shaped by contested scientific findings, asking:
"If the Constitution doesn’t take sides... why isn’t it best to leave it to the democratic process?"
Chief Justice John Roberts pointed to studies from European countries like England and Sweden, where health authorities have recently restricted the use of puberty blockers and hormones for minors, citing insufficient evidence of efficacy. Roberts remarked:
"We’re not the best situated to address issues like that. Doesn’t that make a stronger case for us to leave those determinations to legislative bodies?"
U.S. v. Skrmetti
The case, U.S. v. Skrmetti, centers on Tennessee’s SB1 law, enacted in 2023. The law bars medical providers from administering treatments intended to enable minors to align with a gender identity different from their assigned sex at birth. Tennessee argues the law protects minors from treatments that could lead to regret or harm, emphasizing a "compelling interest" in helping them embrace their biological sex through puberty.
The legislation is part of a broader wave of GOP-led state measures restricting gender-affirming care for minors. President-elect Donald Trump has also vowed to curtail such treatments and ban transgender athletes from women’s sports, reflecting the growing partisan divide on these issues.
Skepticism About Constitutional Grounds
Several justices challenged the Biden administration’s assertion that Tennessee’s law discriminates based on sex, with some questioning the scientific evidence supporting gender-affirming treatments. Justice Kavanaugh highlighted international shifts in policy:
"If England’s pulling back and Sweden’s pulling back, it strikes me as a pretty heavy yellow light, if not red light, for this court... to constitutionalize the whole area."
Roberts echoed this, suggesting courts should defer to legislators:
"The Constitution leaves that question to the people’s representatives rather than to nine people, none of whom is a doctor."
Justice Samuel Alito pressed Solicitor General Elizabeth Prelogar, representing the federal government, on research regarding the risks and benefits of puberty blockers and hormone therapy, further underscoring the Court's concerns about the medical evidence underpinning the case.
The decision in U.S. v. Skrmetti could have significant implications for the balance of state and federal authority over gender-affirming care and the rights of transgender minors nationwide.