Supreme Court to Hear Major Trans Rights Case

The U.S. Supreme Court is set on Wednesday to hear arguments in a major transgender rights case testing the legality of a Republican-backed ban in Tennessee on gender-affirming medical care for transgender minors, one of 24 such policies enacted by conservative state lawmakers around the country.

The justices will consider an appeal by President Joe Biden's administration of a lower court's decision upholding Tennessee's prohibition on medical treatments such as puberty blockers and hormones for people under age 18 experiencing gender dysphoria. That is the clinical diagnosis for significant distress that can result from an incongruence between a person's gender identity and the sex assigned at birth.

The Biden administration and other challengers have argued that the law discriminates against these adolescents based on sex and transgender status, violating the U.S. Constitution's 14th Amendment promise of equal protection.

The case brings transgender rights, a major flashpoint in the U.S. culture wars, to the Supreme Court as President-elect Donald Trump prepares to take office on Jan. 20. Trump vowed during his election campaign to restrict gender-affirming care and transgender sports participation.

Tennessee's law, passed in 2023, aims to encourage minors to "appreciate their sex" by prohibiting healthcare workers from prescribing puberty blockers and hormones to help them live as "a purported identity inconsistent with the minor's sex."

Providers can be sued and face fines and professional discipline for violations. The law allows these medications to be used for any other purpose, including to address congenital defects, precocious puberty or other conditions.

Brian Williams, a plaintiff who sued the state along with his 16-year-old transgender child, known as L.W., told reporters on Monday that her joy and confidence are tied to the healthcare she has received.

"We are not expecting anyone to understand everything about our family or the needs of transgender young people like L.W.," Williams said. "What we are asking for is for her freedom to be herself without fear."

In a social media post on Monday, Tennessee Attorney General Jonathan Skrmetti said he is "defending Tennessee's right to protect kids" from "life-altering" medical procedures.

The state has said it is banning "risky, unproven gender-transition interventions," pointing to "scientific uncertainty," tightened restrictions in some European countries and "firsthand accounts of regret and harm" from people who discontinue or reverse treatments.

Medical associations, noting that gender dysphoria is associated with higher rates of suicide, have said gender-affirming care can be life-saving, and that long-term studies show its effectiveness.

Several plaintiffs — including L.W., two transgender boys and their parents, as well as a doctor who provides the type of care at issue — sued to challenge the law's legality. They are represented by the American Civil Liberties Union and LGBT rights group Lambda Legal.

The U.S. Justice Department subsequently intervened in the lawsuit. ACLU lawyer Chase Strangio, representing the original plaintiffs, is set on Wednesday to become the first openly transgender attorney to argue before the Supreme Court. A federal judge blocked the law as likely violating the 14th Amendment but the Cincinnati-based 6th U.S. Circuit Court of Appeals later reversed the judge's preliminary injunction. The Supreme Court's ruling is expected by the end of June.

The Supreme Court has a 6-3 conservative majority. In major case involving transgender rights, it ruled in 2020 that a landmark federal law forbidding workplace discrimination protects gay and transgender employees.