The US Supreme Court agreed on Monday to decide the legality of a Republican-backed ban in Tennessee on gender-affirming medical care for transgender minors, as the justices waded into another contentious issue implicating LGBT rights.
They took up an appeal by Democratic President Joe Biden's administration of a lower court's decision upholding a ban on medical treatments including hormones and surgeries for minors experiencing gender dysphoria in Tennessee. The court will hear the case in its next term, which begins in October.
The challengers contend that banning care for transgender youth violates the US Constitution's 14th Amendment's equal protection and due process guarantees by discriminating against these adolescents based on sex and transgender status, and undermining parents' fundamental right to access and make decisions concerning the medical care for their children.
Republican-led states have passed numerous similar measures in recent years targeting medications or surgical interventions for adolescents with gender dysphoria - the clinical diagnosis for significant distress that can result from an incongruence between a person's gender identity and the sex they were assigned at birth.
Lawmakers supporting the restrictions have cast doubt on the treatments, calling them experimental and potentially harmful. Medical associations, noting that gender dysphoria is associated with higher rates of suicide, have said gender-affirming care can be life-saving and that long-term studies show its effectiveness.
Tennessee's law bans healthcare workers from administering puberty blockers and hormones for purposes "inconsistent with the minor's sex," but allows treatments for congenital conditions or early puberty. Providers can be sued and face fines and professional discipline for violations.
Several plaintiffs sued in Tennessee
Several plaintiffs, including two transgender boys and a transgender girl, and their parents, sued in Tennessee to defend the treatments they say have improved their happiness and wellbeing. Biden's administration intervened in the lawsuit to also challenge the law.
A federal judge blocked the law in Tennessee in 2023, finding that it likely violates the 14th Amendment.
In a 2-1 decision in September 2023, the Cincinnati, Ohio-based 6th Circuit Court of Appeals reversed the judge's preliminary injunctions.
"Prohibiting citizens and legislatures from offering their perspectives on high-stakes medical policies, in which compassion for the child points in both directions, is not something life-tenured federal judges should do," the 6th Circuit's ruling stated.
Biden's administration urged the Supreme Court to take up the matter, saying state bans "inflict profound harms on transgender adolescents and their families by denying medical treatments that the affected adolescents, their parents and their doctors have all concluded are appropriate and necessary to treat a serious medical condition."
The law was among numerous measures pursued by Republicans at the state level to restrict LGBT rights. Such measures also have included bans on discussion of gender identity in schools, clampdowns on drag shows and blocking transgender participation in sports.
The Supreme Court has confronted several cases in the past decade implicating LGBT rights. In 2015, it legalized same-sex marriage nationwide. In 2020, it ruled that a landmark federal law forbidding workplace discrimination protects gay and transgender employees.
But in 2018, the justices ruled in favor of a Denver-area baker who refused based on his Christian views to make a wedding cake for a gay couple. In 2023, they ruled in a case from Washington state that the constitutional right to free speech allows certain businesses to refuse to provide services for same-sex weddings.