Washington — The Supreme Court on Wednesday considered for the first time whether States can restrict access Gender-affirming care for minors experiencing gender dysphoria, stepping into the politically charged debate over health care for transgender youth.
Nearly half of the states have enacted laws that ban puberty blockers or hormone therapy for people under 18, and the dispute brought by the Biden administration, three families and a doctor tests whether states should protect transgender people. Cross a constitutional line when regulating medical care. Teenagers argue that this is important for their well-being.
The case before the Supreme Court, US v. Scrametti, involves a Tennessee law known as SB1 which was Adopted in 2023It prohibits health care providers from administering puberty blockers or hormone therapy if their purpose is to “enable the minor to identify with or live as a perceived identity inconsistent with his or her gender.” The state argued that it has a strong interest in “encouraging minors to appreciate their gender, especially as they are going through puberty” and in prohibiting treatments that “could cause minors to be contemptuous of their gender.” Can encourage for.”
Tennessee's law is part of a series of measures passed by GOP-led states in recent years that prohibit gender-affirming care for minors experiencing gender dysphoria. Newly elected President Donald Trump also pledged to ban Medical treatment for transgender teenagers and barring transgender athletes from competing in women's sports, another area where states have Enacted restrictions,
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During oral arguments, several of the court's conservative justices cast doubt on the government's argument that Tennessee's ban should be ruled unconstitutional because it discriminates on the basis of gender. He also raised concerns about the evidence surrounding the treatment's efficacy and questioned whether courts should second-guess state lawmakers on this issue.
Liberals on the court highlighted the potentially serious consequences of gender dysphoria and the role of gender-affirming care in addressing them, and compared Tennessee's ban to state laws that have discriminated on the basis of race in the past. She bombarded the lawyer appearing for the state with questions aimed at showing that the state law constituted gender-based discrimination.
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State lawmakers have argued that they are trying to protect young people from “the life-altering risks of uncertain gender-transition interventions” and have said the treatments are “risky” and “unproven.” Tennessee officials told the Supreme Court in filings that the law sets age- and utilization-based limits on Medicare care, and is a routine exercise of the state's authority to regulate Medicare.
“The government second-guesses the decisions of elected lawmakers and asks this court to do the same,” Tennessee Attorney General Jonathan Scermetti said in a plea. filed With the High Court. “But this Court should not stifle legislative development in an emerging field by enshrining a distorted science of government into the Constitution.”
But the Biden administration, along with three Tennessee families and a Memphis doctor, say the state's ban draws gender-based lines and discriminates based on transgender status, a violation of the Constitution's guarantee of equal protection.
“A female assigned a teenage boy at birth cannot get puberty blockers or testosterone to remain and present as male, but a male assigned a teenage boy at birth cannot get puberty blockers or testosterone. And conversely, an adolescent assigned male at birth may not receive puberty blockers or estrogen to survive and present as a female, but an adolescent assigned female at birth may,” Solicitor General Elizabeth Preloger wrote in the brief. “This is gender discrimination.”
Shortly before Tennessee's law took effect, families with transgender children and Dr. Susan Lacey, who provided gender-affirming care to patients suffering from gender dysphoria, challenged the ban in federal court, arguing that it was unconstitutional. Is. After this the Biden administration intervened.
a federal district court blocked the lawFinding that it discriminates on the basis of gender and transgender status and is potentially unconstitutional. The judge ruled that “the benefits of the medical procedures prohibited by SB1 are well established,” and said that the law “prohibits the treatments for a small portion of minors, while leaving them available to all other minors (which would be subject to the same risks the state claims SB1 intends to eliminate).”
A divided panel of judges of the U.S. Court of Appeals for the Sixth Circuit overturned that decision. Tennessee's ban allowed To be effective while the legal proceedings continue. The Court found that the measure regulates gender-affirming care for all minors, regardless of gender.
Chief Justice Jeffrey Sutton wrote, “Lifetime federal judges should be wary of removing a complex and novel topic of medical debate from the vicissitudes of democracy by occupying this area with a largely unamendable Constitution. “
Both the Biden administration and the families represented by the ACLU separately asked the Supreme Court to review the 6th Circuit's decision. High Court in June agreed to do soBut only considered the Biden administration's appeal, which asked the judges to decide whether Tennessee's law violated the Equal Protection Clause. Parents had argued that the law violates their due process rights to make decisions about their children's medical care, but the judge is not considering that question.
The issues the Biden administration has asked the Supreme Court to consider include whether the Sixth Circuit applied the wrong standard when evaluating the constitutionality of Tennessee's law. The lower court held that the ban is subject to review on rational grounds, the most deferential of the three levels of scrutiny. But Preloger has argued that the law should be subject to a more rigorous level of judicial review, known as heightened scrutiny, because it classifies on the basis of sex and discriminates on the basis of transgender status.
If the Supreme Court agrees with the Biden administration, it could send the case back to a lower court to apply that more demanding standard, as Preloger is asking it to do.
Preloger argued on behalf of the US on Wednesday, and he shared time with the ACLU's Chase Strangio, who made history as the first openly transgender person to argue before the Supreme Court. Tennessee Solicitor General Matthew Rice is presenting the state's case to the justices.
The case is the most significant case involving transgender rights that the Supreme Court, now with a 6-3 conservative majority, has heard in years. High Court in 2020 divided 6-3 Finding that Title VII protections from discrimination in the workplace extend to gay and transgender employees. Justice Neil Gorsuch wrote the majority opinion, joined by Chief Justice John Roberts and four liberal members.
A decision in this matter is expected from the Supreme Court by the end of June.