On Wednesday, the Supreme Court will hear oral arguments in a case that will determine whether or not transgender children in Tennessee have access to healthcare. Here’s what to expect from both sides and how we got here.
What’s at stake
L.W. v. Skrmetti arose out of a challenge to a 2023 Tennessee law banning gender-affirming care for transgender minors. Not only does the law ban surgery intended to cure gender dysphoria — an extremely rare procedure — it also forbids the prescription of hormone blockers, a practice major health organizations have cited as crucial to the health and well-being of minors who experience gender dysphoria.
Twenty-six states currently have laws banning gender-affirming care. According to the Human Rights Campaign, about 39 percent of the country’s trans kids live in those states. Research shows that these prohibitions have a severe negative impact on the mental health of trans kids.
The plaintiff’s argument
American Civil Liberties Union attorney Chase Strangio will argue on behalf of the plaintiffs in the case, three transgender adolescents, their families and a medical provider. The ACLU contends that Tennessee’s law violates the Equal Protection Clause of the Fourteenth Amendment of the U.S. Constitution, which requires that all people be treated equally.
“SB1 falls squarely within the heartland of sex-based classifications that arise from sex-based generalizations,” the ACLU’s brief reads. “It imposes differential treatment based on the sex an individual is assigned at birth.”
Under Tennessee Law, prescribing masculinizing treatments to a minor-assigned female at birth is prohibited, even though those same treatments can legally be prescribed to a minor-assigned male at birth. The ACLU argues this is discriminatory.
“SB1 enforces this sex-based rule for the express purpose of imposing a government preference that minors conform to overbroad sex-based generalizations,” the brief reads. “That is a classic sex classification, and it triggers heightened scrutiny.”
The state’s argument
Attorney General Jonathan Skrmetti’s office argues that the state has a right to make laws regulating medical practices.
“It is not unconstitutional discrimination to say that drugs can be prescribed for one reason but not another,” their brief reads. “Weighing risks and benefits, states (and the federal government) draw age and use-based distinctions for drugs all the time.”
The AG’s arguments largely depend on denying scientific evidence that gender-affirming care is necessary for the health and safety of trans children.
History in Court
In June 2023, U.S. District Court Judge Eli Richardson, a Donald Trump appointee, blocked Tennessee’s law. However, the next month, a three-judge panel in the Sixth Circuit Court of Appeals overturned his ruling, becoming the first federal court to allow a ban on gender-affirming care. The Supreme Court granted the case a hearing in June.
Following Tuesday’s arguments, a decision from the majority-conservative Supreme Court will be expected in the spring.