Supreme Court will decide if states may prohibit hormones for transgender teens

People attend a rally as part of a Transgender Day of Visibility, Friday, March 31, 2023, by the Capitol in Washington. Transgender people and their allies gathered at venues across the country Friday as part of an annual, international recognition of transgender resilience, an observation that this year comes amid what some denounced as an increasingly hostile climate. (AP Photo/Jacquelyn Martin)
People attend a rally as part of a Transgender Day of Visibility by the Capitol in Washington in 2023. (Jacquelyn Martin / Associated Press)

The Supreme Court said Monday that it will hear a major case on transgender rights and decide whether states may prohibit the use of puberty blockers and other hormones for teens who suffer from gender distress.

The justices have not ruled on whether discrimination based on gender identity is unconstitutional.

In the last three years, however, many Republican-led states have enacted laws that forbid medical treatments intended to help youths under 18 transition to what the measures describe as a "purported identity inconsistent with the minor's sex."

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The Biden administration, the ACLU and Lambda Legal urged the court to hear cases from Tennessee and Kentucky and to rule discrimination against transgender youth violates the Constitution's guarantee of equal protection of the laws.

They argued that a law “targeting transgender individuals for disfavored treatment” is a form of sex discrimination and should be struck down as unconstitutional.

The court said it would hear arguments in the fall in the Tennessee case.

"We are grateful that transgender youth and their families will have their day in the highest court," said Tara Borelli, senior counsel at Lambda Legal. Without action from the court, "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."

Parents played a lead role in the legal challenges. Samantha Williams and her husband, Brian, had sued in Nashville on behalf of their transgender daughter, who was identified as L.W.

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“It’s hard to overstate the difference that our daughter’s medical treatment has made in her life and our family’s life,” Samantha Williams said when the appeal went to the Supreme Court.

“Before coming out and starting to receive this medical care she struggled to make friends, keep her grades up, or even accept hugs from her family. Now, we have a confident, happy daughter who is free to be herself. I want the Justices to see and understand my daughter and recognize her rights under the Constitution like any other person, and to see that if parents like me don’t have the right to determine what’s best for our children, then no parent does,” she said.

U.S. Solicitor Gen. Elizabeth Prelogar had urged the court to take up the issue. She said the state laws impose “a categorical ban on evidence-based treatments supported by the overwhelming consensus of the medical community.”

The American Civil Liberties Union and Lambda also said the state laws should be struck down because they “violate the fundamental right of parents to make decisions concerning the medical care of their children."

But justices voted to hear the Justice Department's appeal in U.S. vs. Skrmetti, which raises only the question of unconstitutional discrimination, not parents' rights.

In defense of his state’s law, Tennessee’s Atty. Gen. Jonathan Skrmetti described it as a measure “to protect children from unproven medical interventions.”

He said the number of minors diagnosed with gender dysphoria has “exploded” in recent years, and states have “seen a corresponding surge in unproven and risky medical interventions for these underage patients.”

He also said state lawmakers had “reasonably concluded that the well-documented risks of cross-sex hormones outweigh any purported benefits."

But the American Academy of Pediatrics, joined by 21 other medical and mental health organizations, filed a friend-of-court brief at the Supreme Court to dispute Tennessee’s contention that the hormone treatments are experimental or ineffective.

They said about 1.4 million people in the United States are transgender, and about 10% of them are children ages 13 to 17. They said “research shows that adolescents with gender dysphoria who receive puberty blockers or hormone therapy experience less depression, anxiety and suicidal ideation. ... Banning such care can put patients’ lives at risk.”

In April, the Williams Institute at the UCLA Law School said 24 states have adopted laws restricting treatment for transgender youth, potentially affecting about 114,000 minors or more than a third of the transgender youth in the United States. But many of those state laws have been temporarily blocked by judges.

If the court rules next year in favor of Tennessee, the decision would probably allow all of these laws to take effect. But the decision should have no effect in California and other states that have not restricted medical care for transgender youth.

The Supreme Court ruled four years ago that discrimination against transgender employees violates the Civil Rights Act of 1964 and its ban against sex discrimination in the workplace. But the justices have not ruled on whether the Constitution or federal education laws prohibit discrimination against transgender youth or adults.

However, in April, the justices by a 6-3 vote issued an order that set aside a judge's decision and allowed Idaho to enforce its law prohibiting medical treatments for transgender teens.

A federal judge also had initially blocked the Tennessee law from taking effect last year. But in July, the Ohio-based 6th Circuit Court in a 2-1 decision became the first appeals court to rule such a law may go into effect.

The state’s lawmakers had questioned the safety and effectiveness of hormone treatments for teens, and they "may reasonably exercise caution in these circumstances," wrote Chief Judge Jeffrey Sutton for the 6th Circuit Court. He said there is genuine disagreement over hormone treatments for young people and "life-tenured federal judges should be wary of removing a vexing and novel topic of medical debate from the ebbs and flows of democracy."

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This story originally appeared in Los Angeles Times.