The U.S. Supreme Court on Wednesday upheld an appeal's court decision that allows Tennessee to ban types of gender-affirming care for transgender minors. The ruling marks a significant blow for transgender rights advocates.
The court ruled 6-3, with the bench's conservatives ruling in the majority.
The ACLU was among groups suing the state of Tennessee on behalf of Samantha and Brian Williams and their 15-year-old transgender daughter. They claim Tennessee's law bans doctors from providing "medically necessary care to trans youth." Two anonymous families are also plaintiffs in the lawsuit.
Tennessee was among 24 states that have some sort of restrictions on gender-affirming care for minors as of the time of oral arguments.
The majority opinion was authored by Chief Justice John Roberts, who addressed the science of gender-affirming care.
"This case carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field," he wrote, adding that the Constitution's Equal Protect Clause does not settle those differences.
"Questions regarding the law’s policy are thus appropriately left to the people, their elected representatives, and the democratic process," Roberts added.
Justice Sonia Sotomayor, wrote a dissent, saying that there was no constitutional justification for the majority's ruling.
"The majority refuses to call a spade a spade," she said. "Instead, it obfuscates a sex classification that is plain on the face of this statute, all to avoid the mere possibility that a different court could strike down SB1, or categorical healthcare bans like it. The Court’s willingness to do so here does irrevocable damage to the Equal Protection Clause and invites legislatures to engage in discrimination by hiding blatant sex classifications in plain sight. It also authorizes, without second thought, untold harm to transgender children and the parents and families who love them."
What is gender-affirming care?
An American Medical Association letter sent to state governors says, “Accepted medically necessary services that affirm gender or treat gender dysphoria may include mental health counseling, non-medical social transition, gender-affirming hormone therapy, and/or gender-affirming surgeries.”
RELATED STORY | Supreme Court will take up state bans on gender-affirming care for minors
In a 2020 amicus brief filed in a federal court case by various medical organizations, it says surgery is “appropriate and medically necessary” for some patients.
“These procedures could include chest reconstruction surgery for transgender men, breast augmentation for transgender women, or genital surgeries, including removal of the testicles, the primary source of testosterone production, in women who are transgender,” the brief said.
