The US Supreme Court has agreed to consider a Tennessee law banning certain medical treatments for transgender minors, the first time judges will decide on the constitutionality of such statewide bans, and the outcome of which could have broad ramifications for about 25 states that have enacted similar measures.
Republican-led state legislatures have pushed to curtail transgender rights in recent years, with laws targeting gender-transition care and regulating other parts of life, including which bathrooms students and others can use and on which sports teams they can play.
The New York Times reports that the case will be heard in the court’s next term in October, though no date has been set yet for oral argument.
The court’s decision to take up the case signals a willingness by at least some of the judiciary to delve into yet another polarising social issue, even as they have yet to rule on some of the biggest cases for this term, which include emergency abortion care and disinformation on social media.
The Biden administration and a number of legal advocacy groups representing transgender youths had asked the court to intervene after a federal appeals court upheld the ban. In Tennessee, the law prohibits three types of transgender medical care for minors – puberty blockers, cross-sex hormones and gender-transition surgeries.
The administration has argued that the law violates the equal protection clause of the 14th Amendment because it “frames that prohibition in explicitly sex-based terms”.
In his brief, the Attorney-General for Tennessee, Jonathan Skrmetti, argued that the number of minors receiving diagnoses and medical treatment for gender dysphoria had risen sharply in recent years, prompting Tennessee and other states to respond.
The laws, he said, were enacted “to ensure that potentially irreversible sex-transition interventions of uncertain benefit are not performed on minors who may not be able to fully grasp their lifelong consequences and risks”.
Such treatments, he warned, “carry serious and potentially irreversible side effects, including infertility, diminished bone density, sexual dysfunction, cardiovascular disease and cancer”.
The Biden administration strongly resisted that notion, saying such treatment is rare and citing guidelines that medical interventions for transgender adolescents occur only in “appropriate cases” and after undergoing a thorough assessment to determine that it is warranted.
The number of teenagers who identify as transgender has rapidly risen over recent years, but data suggest that only a small number receive puberty blockers or hormones.
Surgeries in adolescents are exceedingly rare. About 100 000 transgender minors live in the states that have passed laws restricting gender-affirming care, according to the Williams Institute at UCLA.
Many American medical groups have endorsed youth gender treatments as evidence-based and necessary.
Lambda Legal, one of the groups challenging the Tennessee ban, voiced cautious optimism that the court would hear the case.
“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,” said Tara Borelli, senior counsel for the group.
Skrmetti, who is defending the ban, said he looked forward to arguing before the court, and that the case will “bring much-needed clarity to whether the Constitution contains special protections for gender identity”.
Until this week, the court had mostly refrained from wading into transgender rights.
Recently, the judges temporarily allowed Idaho to enforce a state ban that limited medical treatment for transgender youth. The law makes it a felony for doctors to provide transgender medical care for minors, including hormone treatment.
The judges did not decide on the substance of the case, but the decision, issued in response to an emergency application, split largely along ideological lines.
The Tennessee case traces back to November 2022, when a group of legislators introduced a Bill outlawing transgender care for minors.
Violations of the law are punishable by a fine of $25 000 for each prohibited prescription or treatment, professional discipline and potential civil liability.
A group of legal advocacy organisations, including the American Civil Liberties Union, the ACLU of Tennessee and Lambda Legal, sued the state of Tennessee, seeking to block the new law.
See more from MedicalBrief archives:
US judge blocks part of controversial law, green-lights meds for transgender youth
US moves to limit transgender treatments for young Americans
Texas law bans transgender girls from female school sports
Texas sued to block investigations into parents over transgender surgery