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Judge Rules In Favor Of Tennessee’s Ban On Gender-Affirming Care For Minors

The Sixth Circuit Court of Appeals has allowed for the Tennessee law that restricts transgender youth from accessing gender-affirming medical care to remain in effect. This ruling comes months after the court initially blocked the law from taking effect in July.

Lambda Legal, the American Civil Liberties Union (ACLU), the ACLU of Tennessee (ACLU-TN), and Akin Gump Strauss Hauer & Feld LLP filed the lawsuit on behalf of Samatha and Brian Williams of Nashville and their 15-year-old daughter, L.W., in April of this year. The suit was also filed on behalf of two other families, as well as Dr. Susan N. Lacy.

The state law was signed by Governor Bill Lee in March. It prohibits healthcare professionals from administering gender-affirming care to minors. The law was set to take effect on July 1st.

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.

“The law prohibits medical providers from treating transgender youth with evidence-based, gender-affirming medical treatment and requires youth currently receiving gender-affirming care to end that care by March 31st, 2024,” said the ACLU.

Following the ruling, Lambda Legal, ACLU, ACLU-TN, and Akin Gump Strauss Hauer & Feld LLP issued a joint statement calling the ruling a “devastating result for transgender youth and their families in Tennessee and across the region.”

“The disastrous impact of Tennessee’s law and all others like it has already been felt in thousands of homes and communities,” the statement said. “Denying transgender youth equality before the law and needlessly withholding the necessary medical care their families and their doctors know is right for them has caused and will continue to cause serious harm. We are assessing our next steps and will take further action in defense of our clients and the constitutional rights of transgender people in Tennessee and across the country.”

Tennessee Attorney General Jonathan Skrmetti called the ruling “a big win for democracy.”

“Decisions that are not clearly resolved by the Constitution should be resolved by the people through their elected representatives,” Skrmetti said in a statement. “I am so proud of our team who stood strong against the overwhelming resources arrayed against Tennessee in this case.”

Jeffrey S. Sutton, chief judge for the Sixth Circuit Court of Appeals, delivered the opinion, citing work from medical organizations such as the World Professional Association for Transgender Health.

“Throughout this period, the association expressed caution about using medical interventions that would alter the secondary characteristics of an individual’s biological sex,” Sutton wrote.

Sutton also argued that there is a “long tradition of permitting state governments to regulate medical treatments for adults and children.”

“So long as a federal statute does not stand in the way and so long as an enumerated constitutional guarantee does not apply, the states may regulate or ban medical technologies they deem unsafe,” Sutton said.

The opinion also said that “parental rights do not alter this conclusion because parents do not have a constitutional right to obtain reasonably banned treatments for their children.”

However, the dissenting opinion, written by circuit judge Helene N. White, argues that the law “deprives parents of their right to make medical decisions affecting their children.”

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New TN Law Further Prohibits Transgender Participation In School Sports

Tennessee private schools are now authorized to “regulate a student’s participation in the school’s athletic activities or events based upon a student’s biological sex.”

Governor Bill Lee signed SB1237 into law on Thursday, April 28th. The bill was introduced by Senator Joey Hensley (R-Hohenwald.)

According to the Tennessee General Assembly, a student that is enrolled in a private school in the state of Tennessee is only eligible to participate in sports activity where “membership  in the Tennessee Secondary School Athletic Association is required, in accordance with the student’s immutable biological sex as determined by anatomy and genetics existing at the time of birth”

While this amendment to the bill allows for schools to prohibit a student from joining a team based on their “biological sex,” it does allow for female students to participate in male sporting events if there is not a separate team for that sport.

The governor has signed off on several similar measures in the past. In April of 2022. Chalkbeat Tennessee reporter Marta W. Aldrich reported that HB1895, attached “financial penalties to a 2021 law that prohibited trans athletes from competing on middle and high school teams based on their gender identity.” A similar bill also prohibited  males from participating in sports “designated for females,” on the collegiate level.

In 2021, Hensley introduced SB0228, which stated that a student’s eligibility for a specific sport in public middle and high schools, must be determined by “the student’s sex at the time of the student’s birth, as indicated on the student’s original birth certificate.”

This bill is currently at the center of the lawsuit L.E. v. Lee filed by the American Civil Liberties Union {ACLU} of Tennessee, Lamda Legal, and the law firm of Wilmer Hale. According to the ACLU, 15-year-old Luc Esquievel and his family have sued the state of Tennessee, as he was not able to try out for the boys’ golf team at Farragut High School in Knoxville, Tennessee.


According to the Movement Advancement Project, Tennessee is one of 21 states that have bans on transgender youth participation in sports.

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LGBTQ Advocate: Lawsuit Challenging Transgender Bathroom Law Was ‘Morally Imperative’

The Tennessee law that bans transgender students from using the restroom that matches their gender identity is a “classic example of discrimination,” said the head of a Tennessee-based LGBTQ advocacy group. 

Chris Sanders, executive director of the Tennessee Equality Project (TEP), said The Tennessee Accommodations for All Children Act (also known as the School Facilities Law), signed by Governor Bill Lee in May, unfairly takes away transgender students’ basic rights. 

“Whenever you tell a group of students they need to use a separate restroom, you are telling them that they are different and what they are entitled to is different as a result,” Sanders said. “When it’s done by an official government entity, then that is the government carrying out that discrimination.”

TEP, which advocates for the equal rights of LGBTQ people in Tennessee, helped find plaintiffs for a lawsuit recently filed by the Human Rights Campaign (HRC) that seeks to block the law from being enforced. 

Federal district court judge Eli Richardson denied HRC’s motion for a preliminary injunction last week, citing an “unreasonable delay in filing the lawsuit.” The court will now conduct a hearing on the motion. A date for the hearing has not yet been set. 

Regardless of the outcome of the lawsuit, Sanders said “it was the right thing to do.” 

“For us and for HRC, it was morally imperative to do this,” Sanders said. “I don’t know what’s going to happen, but I think there’s a good chance the law will be struck down.” 

Sanders said for years the far right has been pushing bathroom bills targeting the transgender community that serve “as a way of whipping up fear about transgender people.” 

The School Facilities law is “dehumanizing” and “stigmatizing,” he said. 

“It’s a divisive tactic,” Sanders said. “The law says to everyone that there is something wrong with trans people and that you shouldn’t share the bathroom with them. Trans people just want to use the bathroom in peace like everyone else.”

“Trans people just want to use the bathroom in peace like everyone else.”

By passing the law, the leaders of the state are sending a message that they don’t understand transgender youth, Sanders said. That lack of understanding leads to harmful policies like the bathroom law.

“That’s a really destructive message,” Sanders said. “When your government not only doesn’t care about you, but is willing to go to great lengths to pass laws attacking you, it’s the worst kind of message you could send to youth.” 

Instead of passing anti-transgender laws, Sanders said Tennessee legislators should focus on passing laws that are trans-affirming, prohibiting discrimination in housing, education, and employment. He adds that dscrimination based on gender identity and sexual orientation needs to be banned under state law and that there needs to be a comprehensive anti-bullying policy for students at the state level. 

“There are a lot of changes that could be made at the state level to protect LGBTQ youth, but the state is unfortunately not moving in that direction,” Sanders said. 

Compounding the Struggle 

Dr. KT Hiestand, a licenced psychologist who specializes in treatment for LGBTQ individuals in Memphis, said navigating life can already be a challenge for transgender youth without the addition of discriminatory laws. 

Dr. KT Hiestand

Many transgender youth struggle with gender dysphoria, which is the medical term for the discomfort one feels about their body because of features that do not match their gender identity. For example, a transgender boy might be uncomfortable with having a high-pitched voice or the development of breasts. 

Gender dysphoria is known to lead to depression and anxiety, Hiestand said. Transgender youth, especially in the South, also often struggle to find support for their identity. Trans youth are kicked out of their family homes and become homeless at much higher rates than their peers, he said. Trangender youth also are 40 percent more likely than their peers to attempt suicude. 

“Laws like the bathroom one adds to the negative experience that trans youth are already having,” Hiestand said. “It can be enough to push them over the edge.”

It can be enough to push them over the edge.

Hiestand said the law can also create a mistrust in government among transgender youth. 

“Think of a kid who has gone through some real struggles with first trying to figure out themselves and then coming out, but who has made progress,” he said. “Now, it feels like the government is out to get them. It’s really scary and it affects their ability to trust government authority.”

Under the law, trans students who do not want to use the restroom matching their gender assigned at birth are required to use a single-occupancy restroom. This often means using a restroom in a teacher’s lounge or another isolated restroom. 

“The problem with this is that it sets them apart from other students,” Hiestand said. “It’s not a positive feeling being different from all of your peers.”

Additionally, this can be logistically challenging, Hiestand said. As a result, many trangender students will avoid using the bathroom when they are at school by not drinking anything during the school day. This sets them up for a slew of medical issues, he said.  

The other option for trangender students is to use a restroom that “feels completely wrong to them.” This is mentally harmful and can potentially be physically harmful, Hiestand said. 

“Transgender youth are not here to cause problems for people in the restroom,” he said. “They simply want to get in, do their business, and get out.”