The Supreme Court on Wednesday will consider for the first time whether states can
ban certain gender transition medical treatments for young people — a closely watched case brought by three transgender teens, their parents and a doctor, all seeking to ensure health care access they say is critical.
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At issue is a Tennessee law barring transgender minors from using
puberty blockers and hormones, treatments the state characterizes as risky and unproven. Lawmakers said the state should instead encourage adolescents to “appreciate their sex, particularly as they undergo puberty.”
The court’s ruling might have implications for the more than 100,000 transgender adolescents living in Tennessee or one of
the 23 other states that has banned using the drugs to treat minors with gender dysphoria. The question of whether and how to medically treat young people whose gender identity is different than their sex assigned at birth has become a polarizing issue, one President-elect
Donald Trump seized on in advertisements targeting transgender people during his campaign.
Anti-trans bills have doubled since 2022. Our map shows
where states stand.
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The Supreme Court in 2020
extended employment protections to lesbian, gay, bisexual and transgender workers, but it has yet to rule on the constitutionality of lower court decisions involving bathroom access,
athletes and medical treatment for transgender minors like 16-year-old L.W., one of the Tennessee teens behind the case at the high court. Her parents, Brian and Samantha Williams, now drive her five hours to receive care in North Carolina.
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The teen started gender care treatments when she was 12 and said they have allowed her to “get to be myself a little bit more.”
“It took a huge stressor off my back,” L.W. said in an interview. “I have more friends now because I’m more confident, and I’m more able to socialize.”
The Biden administration and the American Civil Liberties Union are representing the parents and teens, who are referred to in court filings by their initials or a pseudonym to protect their identity. The families say the Tennessee law amounts to unconstitutional sex discrimination and a broad restriction on treatments that nearly every major medical association says are appropriate and effective for minors. ACLU attorney Chase Strangio, who is arguing on behalf of the families, will be the first openly transgender lawyer to present a case before the Supreme Court.
Tennessee’s attorney general Jonathan Skrmetti (R) says in court filings that states have long had the power to regulate medicine and that there is nothing unconstitutional about restricting the use of a drug for certain purposes, even when it can be used for treating other conditions, or imposing age limits for health treatments when the risks and rewards are too uncertain.
One potential wild card in the resolution of the case is the incoming Trump administration and the possibility that the next solicitor general will flip the federal government’s position to align with Tennessee’s view. If that were to happen, the court could allow the ACLU to continue challenging the law on its own, which would keep the justices on track to issue a ruling by the end of June.
Trump transition officials did not immediately respond to questions about the case before the court, but his team has said Trump intends to fulfill his campaign promises, which included a crackdown on gender transition care for minors.
Patients and lawmakers clash
L.W. said she began to suspect she was trans in 2019, when she was 11. She’d long felt as if she were “drowning,” but she didn’t understand why. She wore baggy clothes to obscure her body, and she panicked the first time she saw a few facial hairs above her lip. She was so uncomfortable in boys bathrooms, she avoided ever using one at school. Eventually, she developed urinary tract infections.
After a cousin came out as trans, L.W. began researching on YouTube and Google. But she was scared, so she didn’t tell her parents she thought she was trans until just after Thanksgiving in 2020, more than a year after she’d first put a name to her feelings.
Brian and Samantha Williams both had gay friends, and they told L.W. they supported her, but neither felt comfortable immediately taking her to a doctor. L.W. was 12, and Brian worried the distress she felt might be normal puberty angst.
“It’s not like we took this thing lightly and just did it,” Brian said.
The family went to a progressive church, and the church had a therapist on staff who specialized in trans youth, so Samantha and Brian signed L.W. up for counseling. After roughly six months, the therapist diagnosed L.W. with gender dysphoria and recommended a team of doctors at Vanderbilt Children’s Hospital.
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At Vanderbilt, L.W. underwent tests, then, in the summer of 2021, her doctors prescribed the drug Lupron to stop her body from going through male puberty. The medication, which has been used for at least 30 years on patients who start puberty too early, is largely reversible, but it can affect a young person’s bone density if taken long term without hormone therapy.
The teen said she felt instantly relieved. To her, the benefits “strongly outweighed” any side effects.
At the time, no state had banned trans adolescents from receiving the kind of care Vanderbilt’s team offered. Doctors nationwide had been treating a few thousand young people a year with hormones and puberty blockers, according to data compiled for Reuters — a tiny fraction of America’s adolescent population. They faced little pushback. Multiple peer-reviewed studies have found that a majority of trans adolescents experience “
satisfaction,” “confidence” and “
improvements in psychosocial functioning” after such treatment.
https://www.washingtonpost.com/politics/2024/12/03/supreme-court-trans-minors-health-care/
