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gender-affirming healthcare
Supreme Court Signals It Will Uphold 'State-Sanctioned Discrimination' in Transgender Care Case
"We the people means all the people," said the ACLU. "There is no 'transgender' exception to the U.S. Constitution."
Dec 04, 2024
Attorneys who argued against Tennessee's ban on gender-affirming healthcare at the U.S. Supreme Court on Wednesday expressed hope that the court's nine justices will take "the opportunity to affirm the essential freedom and equality of all people before the law," while reports indicated that the right-wing majority is inclined to uphold the ban.
"Every day this law inflicts further pain, injustice, and discrimination on families in Tennessee and prevents them from receiving the medical care they need," said Lucas Cameron-Vaughn, staff attorney at the ACLU of Tennessee, which represented three families and a physician. "We ask the Supreme Court to commit to upholding the promises of the U.S. Constitution for all people by putting an end to Tennessee's state-sanctioned discrimination against trans youth and their families."
The law, S.B. 1, which was passed in March 2023, bars medical providers from prescribing puberty-delaying medications, other hormonal treatment, and surgical procedures to transgender minors and youths with gender dysphoria.
The Supreme Court case, United States v. Skrmetti, applies only to the ban on puberty blockers and hormonal therapy for minors; a lower court found the plaintiffs did not have legal standing to challenge the surgery ban.
The ACLU, the ACLU of Tennessee, Lambda Legal, and a law firm were joined by the Biden administration in arguing that Tennessee allows doctors to prescribe puberty blockers and other hormonal treatments for youths with congenital defects, early puberty, diseases, or physical injuries.
As such, said the plaintiffs, Tennessee's ban for transgender and nonbinary youths violates the U.S. Constitution's 14th Amendment, which guarantees equal treatment under the law.
"My heart—and the heart of every transgender advocate fighting this fight—is heavy with the weight of what these laws mean for people's everyday lives."
The court's three liberal justices—Justices Sonya Sotomayor, Elena Kagan, and Ketanji Brown Jackson—all indicated they believed Tennessee has tried to classify people according to sex or gender with the law.
"One of the articulated purposes of this law is essentially to encourage gender conformity and to discourage anything other than gender conformity," said Kagan. "Sounds to me like, 'We want boys to be boys and we want girls to be girls,' and that's an important purpose behind the law."
Matthew Rice, the lawyer representing Tennessee in the case, claimed the state simply wants to prevent "regret" among minors, and the court's six conservative justices signaled they were inclined to allow Tennessee to ban the treatments—which are endorsed by the American Academy of Pediatrics and other top medical associations.
Chief Justice John Roberts said the nine justices should not overrule the decision made by lawmakers representing Tennessee residents, considering there is debate over the issue, and pointed to changes some European countries have made to their gender-affirming care protocols for minors.
Representing the Biden administration, U.S. Solicitor General Elizabeth Prelogar acknowledged that there has been debate about gender-affirming care in the U.S. and abroad, but pointed out that countries including the U.K. and Sweden have not outright banned treatment.
"I think that's because of the recognition that this care can provide critical, sometimes lifesaving benefits for individuals with severe gender dysphoria," she said.
Following the arguments, plaintiff Brian Williams, who has a 16-year-old daughter in need of gender-affirming care, addressed supporters who had assembled outside the Supreme Court.
"Tennessee's ban on gender-affirming medical care is an active threat to the future my daughter deserves," said Williams. "It infringes not only on her freedom to be herself but on our family's love for her. We are not expecting everyone to understand everything about our family or the needs of transgender young people like our daughter. What we are asking for is for her freedom to be herself without fear. We are asking for her to be able to access the care she needs and enter adulthood knowing nothing is holding her back because of who she is."
Sotomayor said there is "very clear" evidence "that there are some children who actually need this treatment."
A 2022 study led by researchers at the University of Washington found that transgender and nonbinary youths aged 13-20 were 60% less likely to experience moderate or severe depression and 73% less likely to be suicidal after receiving gender-affirming care.
Prelogar asked the justices to "think about the real-world consequences of laws like S.B. 1," highlighting the case of a plaintiff identified as Ryan Roe.
Roe had such severe gender dysphoria that "he was throwing up before school every day," said Prelogar. "He thought about going mute because his voice caused him so much distress. And Ryan has told the courts that getting these medications after a careful consultation process with his doctors and his parents, has saved his life."
"But Tennessee has come in and categorically cut off access to Ryan's care," she added. "This law harms Ryan's health and the health of all other transgender adolescents for whom these medications are a necessity."
Tennessee is home to about 3,100 transgender teenagers, and about 110,000 transgender youths between the ages of 13-17 live in the 24 states where gender-affirming care is restricted.
More than 20 states have laws that could be impacted by the court's ruling in United States v. Skrmetti.
"My heart—and the heart of every transgender advocate fighting this fight—is heavy with the weight of what these laws mean for people's everyday lives," said Chase Strangio, co-director of the ACLU's LGBTQ & HIV Project. "But I also know that every out trans person has embraced the unknown in the name of living free from shame or the limits of other people's expectations."
"My heart aches for the parents who spent years watching their children in distress and eventually found relief in the medical care that Tennessee now overrides their judgment to ban," said Strangio. "Whatever happens today, tomorrow, and in the months and years to come, I trust that we will come together to fight for the realized promise of our Constitution's guarantee of equal protection for all."
A ruling in the case is expected in June.
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As Supreme Court Case Looms, 164 US Lawmakers Defend Trans Youth
"Decisions about healthcare belong to patients, their doctors, and their families—not politicians," said Rep. Mark Pocan.
Sep 03, 2024
As LGBTQ+ rights advocates prepare for oral arguments in a U.S. Supreme Court case about bans on gender-affirming healthcare for trans youth, 164 members of Congress on Tuesday urged the justices to strike down Tennessee's 2023 law.
Tennessee is one of over two dozen states that has recently banned some or all of such care for trans minors, according to the Movement Advancement Project. In response to challenges from advocacy groups and the Biden administration, the right-wing high court agreed to take the case in June.
Arguments in United States v. Skrmetti are expected in the fall. The justices will decide whether Tennessee Senate Bill 1—which bans surgery, puberty blockers, and hormone treatment for trans youth—violates the Equal Protection Clause of the 14th Amendment to the U.S. Constitution.
Congressional Democrats' new "friend of the court" brief argues that the court "should be highly skeptical of legislation banning safe and effective therapies that comport with the standard of care," and "should carefully examine the deeply troubling role that animosity towards transgender people has played in state legislation."
"The law at issue in this case is motivated by an animus towards the trans community and is part of a cruel, coordinated attack on trans rights by anti-equality extremists."
The amicus brief is led by House Judiciary Committee Ranking Member Jerry Nadler (D-N.Y.), Congressional Equality Caucus Chair Mark Pocan (D-Wis.), Rep. Frank Pallone Jr. (D-N.J.), Sen. Jeff Merkley (D-Ore.), and Senate Health, Education, Labor, and Pensions (HELP) Subcommittee on Primary Health and Retirement Chair Ed Markey (D-Mass.).
"For years, far-right Republicans have been leading constant, relentless, and escalating attacks on transgender Americans," Markey said in a statement. "Their age-old, discriminatory playbook now threatens access to lifesaving, gender-affirming care for more than 100,000 transgender and nonbinary children living in states with these bans if the Supreme Court upholds laws like Tennessee's at the heart of Skrmetti that are fueled by ignorance and hate."
"It takes a special type of cruelty to target children for who they are," he continued. "I am proud to stand with my colleagues against dangerous, transphobic attacks and to reaffirm that our nation's commitment should be to equality and justice for all."
Pocan emphasized that "decisions about healthcare belong to patients, their doctors, and their families—not politicians."
"The law at issue in this case is motivated by an animus towards the trans community and is part of a cruel, coordinated attack on trans rights by anti-equality extremists," he added. "We strongly urge the Supreme Court to uphold the Constitution's promise of equal protection under the law and strike down Tennessee's harmful ban."
The brief is co-signed by another 150 Democrats in the House of Representatives, eight other Democratic senators, and Sen. Bernie Sanders (I-Vt.), who caucuses with the party. It is also supported by the ACLU and the Human Rights Campaign (HRC).
"Thank you to the many members of Congress for standing with transgender and nonbinary youth across our country in asking the Supreme Court to find bans on lifesaving gender-affirming care to be unconstitutional," said HRC vice president of government affairs David Stacy.
"The government should not be able to interfere in decisions that are best made between families and doctors, particularly when that care is necessary and best practice," Stacy stressed. "These bans are dangerous, animated purely by anti-transgender bias, and have forced families to make heartbreaking decisions to support their children."
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Supreme Court Denies Biden Administration's Request to Reinstate Expanded Title IX Rule
In a 5-4 ruling—with Justice Neil Gorsuch joining the liberals in dissent—the court delayed Biden's expansion of Title IX protections to include gender identity and sexual orientation.
Aug 16, 2024
The U.S. Supreme Court on Friday denied the Biden administration's emergency request to reinstate parts of its updated Department of Education Title IX rule expanding the definition of "discrimination on the basis of sex" to include sexual orientation, gender identity, and pregnancy status.
The nation's highest court ruled 5-4—with conservative Justice Neil Gorsuch joining liberal colleagues Sonia Sotomayor, Elena Kagan, and Ketanji Brown Jackson in dissent—that the Biden administration "has not provided this court a sufficient basis to disturb the lower courts' interim conclusions that the three provisions found likely to be unlawful are intertwined with and affect other provisions of the rule."
Republican attorneys general in more than two dozen states pushed courts to block the Biden administration's updated Title IX rule, which was set to take effect on August 1. The new rule has been on hold pending the outcome of litigation.
In her dissent, Sotomayor wrote: "A majority of this court leaves in place preliminary injunctions that bar the government from enforcing the entire rule—including provisions that bear no apparent relationship to respondents' alleged injuries. Those injunctions are overbroad."
While conservatives welcomed the ruling, LGBTQ+ advocates expressed disappointment.
"All young people deserve to show up to school and get an education without facing the threat of discrimination and bigotry. But five cruel justices on the Supreme Court just put countless LGBTQ+ students' health, safety, and lives in jeopardy," said Sarah Lipton-Lubet, president of the advocacy group Take Back the Court.
"The hateful right-wing movement with which these justices align themselves constantly invokes 'protecting children' as a false justification for their extremist agenda," Lipton-Lubet added. "But protecting children means keeping them safe from homophobic and transphobic violence; from gun violence; from attacks on equitable education; and from environmental destruction that threatens their futures. This court has failed them time and time again."
The Biden administration's effort to expand Title IX protections came amid a wave of anti-LGBTQ+ laws enacted in Republican-controlled states in recent years.
More than two dozen states have passed laws banning or restricting gender-affirming healthcare including puberty-blocking drugs, hormone therapy, and surgery for minors. At least 11 states have also passed laws banning transgender students from using school restrooms and other facilities consistent with their gender identity, and 25 states have banned transgender girls from competing on female scholastic sports teams.
Responding to Friday's decision, an Education Department spokesperson said that "while we do not agree with this ruling, the department stands by the final Title IX regulations released in April 2024, and we will continue to defend those rules in the expedited litigation in the lower courts."
Friday's ruling is not the last word on the Biden administration's Title IX rule, as the decision merely delays the issue pending further litigation that could ultimately be revisited by the Supreme Court in the future.
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