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Supreme Court Hears Arguments Regarding Transgender Healthcare Ban

(Credit: Sharon McCutcheon on Unsplash)

Today, the Supreme Court of the United States (SCOTUS) heard arguments in the case regarding gender-affirming care for Tennessee youth.

The case of United States v. Skrmetti challenges Tennessee’s ban on trans healthcare for minors in the state. This hearing marked the first time SCOTUS has heard a case regarding healthcare for the trans community.

In September of 2023, the Sixth Circuit Court of Appeals allowed for the law restricting transgender youth from accessing gender-affirming medical care to remain in effect. 

The ruling came months after the court initially blocked the law from taking effect in July of the same year. 

The state law was signed by Governor Bill Lee in March of 2023 and prohibits healthcare professionals from administering gender-affirming care to minors. This legislation makes gender-affirming hormone therapy and puberty blockers inaccessible and trans people in Tennessee will not have access to this care until they reach the age of 18. 

GLAAD (formerly the Gay & Lesbian Alliance Against Defamation) said this is one of approximately 25 bans passed by Republican-led legislatures. They, along with other national and local leaders, said the court’s ruling could affect gender-affirming care for youth nationwide.

Prior to today’s hearing, Senator Heidi Campbell (D-Nashville) called the ban unconstitutional and condemned Tennessee leaders for “waging a costly legal battle” as opposed to addressing issues such as traffic and “unaffordable healthcare.”

“This political gamesmanship, funded by our hard-earned tax dollars, is not only cruel but also a violation of fundamental rights,” Campbell said in a statement. “Tennessee’s discriminatory ban is unconstitutional, and it does nothing to improve the lives of our citizens. Tennesseans deserve leaders who focus on solving real problems — not manufactured culture wars that harm families and divide our communities.”

In a release issued after arguments were heard, the office of Tennessee Attorney General Jonathan Skrmetti said the case seeks to “protect vulnerable kids from risky and unproven medical practices.” Skrmetti added that his office reviewed medical evidence and cited instances in European countries where healthcare such as puberty blockers are restricted.

“The Office of the Tennessee Attorney General presented a robust legal and evidence-based defense of the State’s legislative response to the recent explosion of childhood gender-transition interventions. The law at issue restricts the provision of irreversible medical interventions to minors with gender dysphoria — a psychiatric condition marked by mental distress from a conflict between a person’s sex and asserted gender identity,” the statement said.

Skrmetti added that their arguments were based on “constitutional clarity and common sense.”

Kelley Robinson, president of the Human Rights Campaign, said today’s arguments highlighted the lack of any legal or medical basis for denying transgender youth the same protections afforded under the U.S. Constitution. Robinson said despite Skrmetti’s team’s efforts to disprove this logic, “Transgender healthcare is best practice, medically necessary, and supported by almost every medical association in the country.”

“It’s healthcare, plain and simple, and no politician should be able to interfere in the healthcare decisions best made by families and doctors,” Robinson said. “Now the Supreme Court has the opportunity to follow the facts, the science, and the law, and affirm our constitutional promise of equal protection for all.” 

The Supreme Court is expected to reach a decision in this case by June.

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Legal Professionals Urge SCOTUS to Stop Tennessee’s Gender-Affirming Care Ban

Photo: Tingey Injury Law Firm on Unsplash

Legal experts have filed a brief on behalf of transgender youth in the state in hopes of stopping a Tennessee law banning gender-affirming care for minors from taking effect.

The American Civil Liberties Union of Tennessee (ACLU-TN) said they are urging the Supreme Court of the United States to stop the state from banning hormone therapy for trans adolescents.

Last week ACLU-TN joined the American Civil Liberties Union, Lambda Legal, and Akin Gump Strauss Hauer & Feld LLP in filing a brief on behalf of Samantha and Brian Williams of Nashville and their 16-year-old transgender daughter, Dr. Susan Lacy of Memphis, and two families who filed anonymously.

This brief is in response to a June 2024 decision to hear a challenge to Tennessee’s ban. Advocates claim the law is a violation of the U.S. Constitution’s Equal Protection Clause.

Lucas Cameron-Vaughn, staff attorney at the ACLU of Tennessee, said that Tennessee and other Southern states have “become a testing ground for targeted assault on the constitutional rights of trans Tennesseans.”

In September of 2023 the Sixth Circuit Court of Appeals allowed for the law restricting transgender youth from accessing gender-affirming medical care to remain in effect. The ruling came months after the court initially blocked the law from taking effect in July of the same year.

Governor Bill Lee signed the legislation into law March of 2023, and it prohibits healthcare professionals from administering gender-affirming care to minors. This legislation makes gender-affirming hormone therapy and puberty blockers inaccessible, and trans people in Tennessee will not have access to this care until they reach the age of 18. Similar restrictions have been made in states like Arkansas and Alabama.

“Every day this law remains in place, it inflicts further pain, injustice, and discrimination on trans youth and their families,” Cameron-Vaughn said in a statement. “Make no mistake — if the Supreme Court fails to protect trans Tennesseans’ access to the medical care they need to survive and thrive, local politicians will go even further. They will continue to rewrite the history that our schools teach, discriminate based on what we look like, where we’re from, and who we love, and control if, when, and how Tennesseans choose to start their families.”

Parents of the 16-year-old plaintiff said it has been “painful” to see their child not be able to access “life-saving healthcare,” and they’ve had to travel outside of the state for care.

“We have a confident, happy daughter now, who is free to be herself and she is thriving,” Samantha Williams, mother of 16-year-old L.W., said. “Tennessee’s ban has forced us at great expense to seek routine healthcare visits out of state and may at some point force us to leave Tennessee — the only home our children have ever known. No family should have to make this kind of choice.”

Officials said oral arguments are expected to be heard this term.

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Advocacy Organizations Welcome SCOTUS’ Decision To Rule on Trans Healthcare Ban

Photo: Tingey Injury Law Firm on Unsplash

Advocacy groups and organizations have shared their thoughts on the Supreme Court of The United States’ (SCOTUS) decision to hear a challenge on Tennessee’s ban on gender-affirming care for minors in the state.

While the case will not be heard until next fall, organizations such as the ACLU and OUTMemphis are hoping that SCOTUS rules in favor of trans youth.

“This case started with trans youth in the Mid-South and Tennessee and the folks who care for them, after our state passed laws denying life-saving health care,” Molly Quinn, executive director of OUTMemphis said. “ A year later, with more than 20 states outlawing this care and over 500 anti-LGBTQ+ bills, this fight is a centerpiece of the pathway to queer and trans justice in our country, which we will never give up on. If the court sides with Tennessee’s unlawful ban, the state can and will escalate its discrimination against trans people and the broader LGBTQ+ community.”

In September of 2023 the Sixth Circuit Court of Appeals allowed for the law restricting transgender youth from accessing gender-affirming medical care to remain in effect. 

The ruling came months after the court initially blocked the law from taking effect in July of the same year.

The state law was signed by Governor Bill Lee in March of 2023, and prohibits healthcare professionals from administering gender-affirming care to minors.This legislation makes gender-affirming hormone therapy and puberty blockers inaccessible and trans people in Tennessee will not have access to this care until they reach the age of 18. Similar restrictions have been made in states like Arkansas and Alabama.

According to the American Civil Liberties Union (ACLU) they along with the ACLU of Tennessee, Lambda Legal, and Akin Gump Strauss Hauer and Feld LLP asked the Supreme Court to review the September ruling.

“The United States intervened in the plaintffs’ case at the district court and also asked the court to review the Sixth Circuit decision,” the ACLU said in a statement.

Quinn added that trans youth want “the freedom to live joyful and authentic lives,” and said their livelihood could be at stake if the court sides with the state.

“A better and freer world takes every kind of effort, and we hope the court will limit state overreach as Tennessee and states like it attempt to stand in the way of our futures,” Quinn said.

Lucas Cameron-Vaughn, a plaintiff’s attorney on the case and OUTMemphis Board of Directors member, said this case is about “curbing government interference in our lives.” In a statement released by ACLU-TN, Cameron-Vaughn shared Quinn’s sentiments regarding Tennessean’s rights to live their truth.

“Tennesseans deserve the freedom to live their lives as their authentic selves without government interference, yet every day this law remains in place, it inflicts further pain and injustice on trans youth and their families,” Cameron-Vaughn said. “The Court has the power to protect trans youth’s right to access the healthcare they need by striking down this discriminatory law.”

Other organizations are hoping that SCOTUS can provide more guidance and relief nationwide and that this will set the proper precedent for the country moving forward.

During a press conference to reflect on the two-year anniversary of the Dobbs v. Jackson Women’s Health Organization ruling, Planned Parenthood of Tennessee and North Mississippi CEO Ashley Coffield said it’s remarkable that the law will be heard.

“I agree with the Biden Administration that this is a really confusing time for families of minors with gender dysphoria and that it is critical that we have legal guidance to follow so that this is not like abortion, where it is state-by-state and is a total mess, and people are confused and scared and don’t know what’s going on,” Coffield said.

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Advocacy Groups and Organizations React To Law Banning Gender-Affirming Care for Minors

(Credit: Sharon McCutcheon on Unsplash)

A bill that bans gender affirming healthcare for minors in Tennessee was signed into law on Thursday, March 2nd by Governor Bill Lee. The law will go into effect on July 1, 2023 but groups on all sides of the issue are speaking out.

Senate Bill 1 prohibits “licensed healthcare professionals, establishments, and facilities from performing or offering to perform on a person under 18 years of age, or administering or offering to administer to a minor, a medical procedure if the performance or administration of the procedure is for the purpose of enabling a minor to identify with, or live as, a purported identity inconsistent with the immutable characteristics of the reproductive system that define the minor as male or female, as determined by anatomy and genetics existing at the time of birth.”

The bill also prohibits healthcare providers from “treating purported discomfort or distress from a discordance between the minor’s sex and asserted identity.”

This legislation also allows civil litigation against a healthcare provider who performs such procedures. These lawsuits could be brought within 30 years from the date the minor reaches 18 years of age, or within 10 years from the date of the minor’s death if the minor dies. It also allows relatives of a minor to bring a wrongful death action against a healthcare provider in such cases under certain conditions.

Up until recently, Tennessee law allowed for minors to access gender-affirming care.

Groups like Heritage Action For America, a conservative organization, have praised Lee’s passage of the legislation. In a statement, vice president of field operations for the organization, Janae Stracke, said that “the last things girls and boys struggling with gender confusion need are dangerous cross-sex hormones and experimental, life-altering operations.”

Stracke also said that minors “need compassionate care that addresses the underlying mental health problems associated with gender confusion and dysphoria,” and that “SB 1 will protect Tennessee children from lifelong physical and psychological pain.”

While the signing of this bill into law has been praised by some groups, others have been vocal about their opposition, saying that this legislation is actually harmful for minors.

In February, Jace Wilder of the Tennessee Equality Project said that the legislation “ignores the actual wishes and desires of the trans youth.”

Molly Rose Quinn, executive director of OUTMemphis said that “these bills are aggressive attacks on best-practice medical care and free speech,” and Lee’s decision to sign them “amounts to state sponsored violence.”

“The government has no place inserting itself into the private medical decisions that should be made by doctors, patients, and their families alone,” Quinn said.

Jenna Dunn, trans services specialist for OUTMemphis said, “to the youth of Tennessee and to the parents that support them, I want you to always remember that no matter what happens in life you are amazing, you are beautiful, worthy of joy, happiness, and respect. Do not ever allow anyone to tear you down mentally or physically, always demand respect and don’t accept anything less.”

Ivy Hill, director of gender justice for the Campaign for Southern Equality said, “the passage of this law cutting off trans young people’s access to life-saving care is devastating — but it won’t stop our community from holding and supporting each other.”

“Legal partners are preparing to challenge the law, community groups are supporting trans folks with strategies for healing and resilience, and we’re honored to be connecting families with funding, information, and provider referrals to preserve continuity of care for as many people as we can. No law can stop the transgender community from charting our paths to thriving and living authentically,” said Hill.

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Tennessee Equality Project Speaks on Trans Healthcare Bill

Credit: state of Tennessee

Tennessee medical professionals could lose their license if they provide gender-affirming care to minors with a new law now under consideration by the Tennessee General Assembly.

the proposed legislation says that these procedures can “lead to the minor becoming irreversibly sterile, having increased risk of disease and illness, or [suffer] from adverse and sometimes fatal psychological consequences.”

This legislation also allows civil litigation against a healthcare provider who performs such procedures. These lawsuits could be brought within 30 years from the date the minor reaches 18 years of age, or within 10 years from the date of the minor’s death if the minor dies. It also allows relatives of a minor to bring a wrongful death action against a healthcare providers in such cases under certain conditions.

In October of 2022, the Flyer reported that Tennessee law currently allows for access to gender-affirming healthcare for youth.

Jace Wilder studies and teaches transgender policies for the Tennessee Equality Project.

“We really have to keep a critical eye on what is the goal of our legislature, and what initiatives or what funding they’re getting to really just continue to police and criminalize a minority group of people,” Wilder said.

The Flyer was able to talk with Wilder, about gender affirming care for minors, misconceptions around the procedures, and what could be next for trans youth in Tennessee. — Kailynn Johnson

Why would doctors choose not to delay care for minors who are transitioning?

Jace Wilder: So, one of the things that gets left behind a lot is the narrative of the effects of delaying care. That includes suicide rates going up. That one has been proven over and over again. Lack of access to care, lack of actual equitable care, and — even more so — not having support from both family and from medical providers proves to have worse outcomes for those youth that have to delay their care.

When they see laws like this, that prohibit them from accessing their own care, they automatically can see that their state doesn’t really care about them, or care about their health care access. So, when it comes to delaying care, you’re also reinforcing that isolation.

Whenever we go into doctors’ offices, the assumption right now is that you just go in, and you get on hormones, and you get surgery, and it’s all just kind of like this one movement. But the reality is that, according to both [World Professional Association for Transgender Health – WPATH], which is the organization that provides the standards of care for trans people…is that doctors can just sometimes provide counseling to families about how to respect and encourage their trans child after they come out, provide education for those parents, who may be not ready to take that step with their child about accessing health care, or accessing HRT and surgeries, and continue to counsel them.

This bill will eliminate the ability to even have those conversations because it’s seen as coercion…and can be declared child abuse of a parent to just ask their doctor about how to care for their trans kid.

You mentioned that one of the harmful effects of this bill would be that trans youth would believe that their state doesn’t care about them. The text of the bill states that, “the legislature must take action to protect the health and welfare of minors.” Do you believe that this statement contradicts the actual legislation?

JW: It ignores the actual wishes and desires of the trans youth. What they’re doing is ignoring years and years of advocacy and science from both scientists who care and doctors that actually care for trans youth, and the families that have seen the positive effects of transition or have seen the positive effects of just providing support for trans youth. It’s ignoring all that in favor of acting like a hero, while villainizing a minoritized community. They’re just ignoring what is actually wanted by trans youth and their families.

You also talked a little bit earlier about how a lot of people kind of have this misconception that there is just one approach to trans healthcare. Do you think any of these misconceptions have contributed to the legislature pushing for this legislation to be passed?

JW: I think that some of the misconception comes from…one, the speed of it. The standards of care that they are provided with show that there are certain ages in which they are already not allowed to give hormone replacement therapy or puberty blockers.

They, also already laid out who is allowed and who is not allowed to have surgeries, and all hospitals, any hospital or medical clinic with any kind of accreditation, that would make it legal for them to even function have to follow those standards of care because they’re implemented by the hospitals.

A lot of times we get stuck in this narrative that it’s all this one giant conspiracy to speed up the process to transition people who should not be transitioned. The reality is people are actually struggling to even access the care in the first place, and when they do it takes a really long time to get through that process, if they even do by the time they’re 18.

What do you all think is next for trans healthcare in Tennessee?

JW: We’re seeing is this escalation to even saying that trans people who are 25 — legal adults who can vote, legal adults who can drink, who can serve for their country — these individuals don’t have the right to determine their own health care, based off of this weird idea that the state knows best. But this only for this very small group that cannot be heard in their own legislature.

It’s just going to push and possibly extend out to the age of 25. In fact, [Rep. William Lamberth (R-Portland)] kind of mentioned that  alongside [Daily Wire host] Matt Walsh in the House committee hearing that just happened.

We’re also seeing that in the drag queen bill they labeled drag as impersonation of another gender, meaning that we’re really getting on that ledge of going back to the 1980s. It’s drawing back to that idea that impersonating another gender is somehow criminal, and that being another gender than you were born as is a criminal act. So, we are seeing the full on policing and criminalization of trans folks at this point.

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ACLU Of TN and TN Equality Project Discuss Future of Trans Healthcare for Minors

(Credit: Sharon McCutcheon on Unsplash)

For 2023, the American Civil Liberties Union of Tennessee (ACLU-TN) and Tennessee Equality Project (TEP) expect bans on hormones and surgeries for minors, forced outing and mandatory reporting, gender affirming care being defined as child abuse, religious exemptions for counselors, and doctors being criminalized for professional misconduct.

The ACLU-TN and TEP made this prediction during a presentation titled “The Reality of Trans Healthcare in Tennessee: A Conversation With Trans Advocates,” on Friday, October 21, 2022.

Advocates joined together to not only give an overview of the state of trans healthcare in Tennessee, but to inform attendees on the process of receiving care for youth, potential obstacles, and different forms of care. 

This session comes after it was announced that Vanderbilt University Medical Center, which Dulce Torres Guzman of Tennessee Lookout said was a “leader in transgender healthcare,” would be temporarily stopping gender affirming surgeries for minors.

According to the ACLU-TN and TEP, Tennessee law currently allows for families to access gender-affirming healthcare for youth. It is also legal for medical providers to provide this care to youth. The ACLU-TN said that if lawmakers try to pass legislation that violates the rights of trans people, their plan of attack is to “fight it in the legislature.”

“As the ACLU-TN of Tennessee and as the Tennessee Equality Project we are sworn and heavily dedicated to access to gender affirming care for youth,” said Henry Seaton, ACLU-TN’s first-ever trans justice advocate.

In 2022 SB 657/HB 578 was withdrawn, which according to the ACLU-TN “prohibited any sort of intervention for gender identity, or any gender affirming care for prepubescent minors and minors in general. It also would have punished violations as “child abuse.”

SB 2360/HB 2451 failed, which required parents to have access to information in their child’s school such as teacher names, book titles in the library, and curriculum. It also would have prohibited healthcare providers to give treatment to minors without parental consent.

The ACLU-TN also said that SB2696/HB 2835 was placed in a general subcommittee and encompasses a number of policies that touch on gender affirming care, the usage of state funds to “prepare a minor for treatment, the ability of school staff to “out” a student to their parents, and more.

According to advocates from the ACLU-TN and TEP, the process for minors to receive care is extensive, and is “influenced largely by access to education, care, and safe support systems.” Advocates said that there is a lot that needs to be done before a child can receive care due to a number of obstacles. 

Some of these obstacles include families not having the education that they need or not having a safe support system.

The TEP said that the most common form of care is social assistance, which involves educating parents so that the child can start socially transitioning at school, home, and with their friends. After this, a child may start Hormone Replacement Therapy (HRT) after the “appropriate stages of development, but never before puberty.”

If gender dysphoria still poses a threat to the “biopsychosocial safety of the youth,” then surgery will be allowed. The American Psychiatric Association (APA) defines gender dysphoria as “psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity.”

Surgery is only considered after a series of mental and physical health evaluations, and familial counseling. TEP also said that genital surgery does not occur before the age of 18.

There are a lot of factors that contribute to the reasons why healthcare providers opt to not delay care to minors. TEP said that there are increased risks in suicide, self-harm, and mental illness. TEP also said that kids who were able to transition as youth contributed to a 73% decrease in suicidal behavior and ideation in the first six months.