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Tuesday, June 25, 2024 | Back issues
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Ban on gender-affirming care for trans youth to face Supreme Court scrutiny

The high court’s next term will include a major fight over transgender rights.

WASHINGTON (CN) — The Supreme Court agreed on Monday to review Tennessee’s ban on gender-affirming care for transgender children.

Over the last three years, over 20 states have banned gender-affirming health care for transgender children. Transgender children and their parents from Tennessee told the justices that their review was necessary to settle a lower court divide on whether the bans were constitutional. The Biden administration also challenged Tennessee’s law.

“The legal uncertainty surrounding this medical care is creating chaos across the country for adolescents, families, and doctors,” Chase B. Strangio, an attorney with the American Civil Liberties Union Foundation, representing the children and parents from Tennessee, wrote in their petition.

Tennessee’s ban applies only to transgender children, while permitting the same care for others who are not seeking treatment for gender dysphoria.

Considered a serious medical condition by major medical groups, gender dysphoria can lead to severe physical and psychological harm. The World Professional Association of Transgender Health set guidelines to treat gender dysphoria, including puberty-blocking interventions for children whose condition may be worsened by the permanent physical changes that accompany puberty.

A group of 57 transgender adults led by actors Elliot Page and Nicole Maines told the justices that treatment for their gender dysphoria was critical to their well-being. The amicus brief submitted in Tennessee’s appeal said early treatment not only relieved their conditions but even saved some of their lives.

“Amici who began treatment as minors have no regrets and are emphatic that a delay in treatment — with the resultant progression of permanent and unwanted changes to their bodies — would have caused needless suffering,” the group wrote. “Amici who were unable to begin treatment until adulthood confirm this.”

Tennessee’s SB1 prohibits adolescents from using puberty blockers and hormones to treat gender dysphoria. The law bans health care providers from prescribing any drug that would alter a minor’s sex that is inconsistent with the minor’s biological sex. Minors seeking gender-affirming treatment consistent with their biological sex would still be able to receive these treatments.

Doctors who violate SB1 face fines of $25,000 for each treatment, professional discipline and potential civil liability in private lawsuits.

“The law precludes transgender adolescents, their parents, and their doctors from assessing medical needs related to gender dysphoria on an individual basis and instead imposes a one-size-fits-all prohibition on the only evidence-based treatments available,” Strangio wrote. “And the law imposes this ban using explicit sex classifications: medications that are permitted for a minor of one sex are prohibited for a minor of another sex.”

Noting that gender-affirming health care has been provided to transgender children for decades, the Biden administration argued that Tennessee’s ban violates the equal protection clause of the Constitution.

“By their terms, operation, and design, those laws classify based on sex and transgender status,” U.S. Solicitor General Elizabeth Prelogar wrote. “And they inflict profound harms on transgender adolescents and their families by denying medical treatments that the affected adolescents, their parents, and their doctors have all concluded are appropriate and necessary to treat a serious medical condition.”

Tennessee disputed the medical associations’ evidence, claiming that transition interventions in pediatric medicine are unproven and risky. The state said its ban intended to protect minors from the potential health consequences of these treatments.

“Tennessee reasonably concluded that the well-documented risks of cross-sex hormones outweigh any purported benefits,” Cameron Norris, an attorney with Consovoy McCarthy representing Tennessee, wrote in the state’s brief.

The law was put on ice by a lower court but revived by the Sixth Circuit. 

Lambda Legal, a civil rights organization focused on lesbian, gay, bisexual, and transgender communities, applauded the court’s decision to hear the case, noting that similar laws have been shot down by the justices. The group was one of several organizations supporting the parents’ petition. 

"This court has historically rejected efforts to uphold discriminatory laws, and without similar action here, these punitive, categorical bans on the provision of gender-affirming care will continue to wreak havoc on the lives of transgender youth and their families," Tara Borelli, senior counsel at Lambda Legal, said in a statement.  "We are grateful that transgender youth and their families will have their day in the highest court, and  we will not stop fighting to ensure access to this life-saving, medically necessary care."

Per its custom, the court did not explain its decision to hear the case. 

The court did not act on a similar appeal from parents in Kentucky. 

Follow @KelseyReichmann
Categories / Appeals, Civil Rights, Health, Politics

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