US Supreme Court to decide legality of Tennessee ban on gender-affirming care for minors

Republican-led states have passed numerous measures in recent years targeting medications or surgical interventions for adolescents

The challengers contend that banning care for transgender youth violates the US constitution’s 14th amendment. Photograph: Andrew Harnik/Getty Images

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 US president Joe Biden’s administration of a lower court’s decision upholding Tennessee’s ban on medical treatments including hormones and surgeries for minors experiencing gender dysphoria. 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.

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.

Several plaintiffs – including two transgender boys, a transgender girl and their parents – sued in Tennessee to defend the treatments they have said improved their happiness and wellbeing. The US justice department intervened in the lawsuit to also challenge the law.

Tennessee Attorney General Jonathan Skrmetti said the law is “protecting kids from irreversible gender treatments” and that he was looking forward to “finishing the fight in the United States Supreme Court.”

The 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.

Lawyers representing the plaintiffs said they were grateful these youths and their families will have their day in the highest US court. The Supreme Court has “historically rejected efforts to uphold discriminatory laws, and without similar action here, 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,” said Tara Borelli of Lambda Legal, an LGBT legal group.

American Civil Liberties Union lawyer Chase Strangio said bans like the one in Tennessee represent a “dangerous and discriminatory affront to the wellbeing of transgender youth across the country” and are “the result of an openly political effort to wage war on a marginalised group and our most fundamental freedoms”.

The justice department declined to comment on Monday.

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 injunction.

“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 supreme court on Monday did not act on a separate appeal of the 6th circuit’s decision also upholding a similar law in Kentucky.

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. – Reuters

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