The Supreme Court heard arguments Wednesday regarding a current Tennessee law banning gender-affirming medical care for transgender youth—and witnessed history.
Chase Strangio, a staff attorney for the ACLU, defended the transgender community and became the first openly trans lawyer to make an argument before the highest court in the land.
Conservative lawmakers defended the legislation by arguing that transgender youth could ultimately regret using puberty blockers or seeking other gender-affirming care.
However, as the Associated Press reported in 2023, the number of transgender people who detransition—or regret switching genders and revert back to their gender assigned at birth—is minuscule.
Conservative justices suggested that states should make the call, and not the court. But Solicitor General Elizabeth Prelogar pointed out that allowing Tennessee to impose a ban on gender-affirming medication could potentially lead to a “nationwide ban.”
The case, United States v. Skrmetti, will ultimately determine just how much states can meddle in the medical affairs of transgender youth and, potentially, all Americans.
Transgender rights have been at the forefront of public discourse lately, with Donald Trump and many Republicans lambasting the issue during their 2024 campaigns.
The Human Rights Campaign, an LGBTQ+ advocacy group, argues that the push for gender-affirming care is more important than ever as a growing number of states impose laws on decisions typically made between a minor, their family, and their health care provider. In 2023 alone, 19 states passed laws to stop gender-affirming care for people under 18, according to CNN
“Rather than protecting kids, these laws are preventing parents and young people from making informed medical decisions, and doctors and health care providers from providing best-practice care to their patients,” the organization argued.
Indeed, the Health and Human Services Department’s Office of Population Affairs found that this type of medical care for transgender minors—which has rarely included gender-affirming surgeries—is “crucial” to the “overall health and well-being” of these children. The department also notes that transgender youths “face significant health disparities” compared to cisgender people, or people who identify with their gender assigned at birth.
Part of this disparity in health care access contributes to the striking number of LGBTQ+ youth who “seriously considered attempting suicide” in 2021, a national survey reports. Advocates for transgender care fear that upholding the medical ban in Tennessee will exacerbate the mental health crisis for trans youth.
The case came before the Supreme Court as trans bathroom bans have been popping up in many states—and even on Capitol Hill.
Ohio passed a sweeping bill in late November that bans transgender people from using restrooms, locker rooms, or gender-specific changing areas in government buildings or universities that align with their gender identity.
Congress also instated its own trans bathroom ban, with GOP House Speaker Mike Johnson and Rep. Nancy Mace leading the charge on anti-trans rhetoric as the House readies to welcome Sarah McBride, the first trans person elected to Congress.
While no formal ruling was reached on Wednesday, experts on the matter inferred from justices’ statements and questions that the conservative majority will likely uphold the ban in question.
Legal journalist Mark Joseph Stern wrote on Bluesky that he fears conservative justices will use a “loophole” that would uphold the Tennessee law by saying they must remain neutral on the “too controversial” matter, and leave the decision up to individual states.
