Gender-Affirming Care for Minors Argued at U.S. Supreme Court

The Supreme Court of the United States (SCOTUS) heard a historic case Wednesday regarding gender-affirming care for minors. Although U.S. v. Skrmetti originated in the Tennessee State House, the ruling is expected to reverberate throughout the nation.

In April 2023, the American Civil Liberties Union (ACLU), the ACLU of Tennessee, Lambda Legal, and Akin Gump Strauss Hauer & Feld LLP sued the State of Tennessee to block the state’s ban on medically necessary gender-affirming care for Tennessee’s transgender youth.

“It was incredibly painful watching my child struggle before we were able to get her the life-saving healthcare she needed. We have a confident, happy daughter now, who is free to be herself and she is thriving,” said plaintiff Samantha Williams.

“I am so afraid of what this law will mean for her. We don’t want to leave Tennessee, but this legislation would force us to either routinely leave our state to get our daughter the medical care she desperately needs or to uproot our entire lives and leave Tennessee altogether,” Williams added. “No family should have to make this kind of choice.”

This is the first major trans-related case to arrive at SCOTUS since the decision in Bostock v. Clayton County in 2020. That decision banned workplace discrimination against LGBTQ people.

While key conservative Justice Neil Gorsuch was silent, Chief Justice John Roberts, Justice Amy Coney Barrett, and Justice Brett Kavanaugh saddled the conservative line.

“You say there are benefits from allowing these treatments, but there are also harms, right, from allowing these treatments,” Kavanaugh argued. “At least the state says so – including lost fertility, the physical and psychological effects on those who later change their mind and want to detransition, which I don’t think we can ignore.”

A December 2022 study from The Netherlands tracked their subjects’ treatment with puberty suppression for transgender adolescents younger than 18 years old. Researchers studied the proportion of people who continued gender-affirming hormone treatment at follow-up after having started puberty suppression and gender-affirming hormone treatment in adolescence.

“Most participants who started gender-affirming hormones in adolescence continued this treatment into adulthood,” the study revealed. “The continuation of treatment is reassuring considering the worries that people who started treatment in adolescence might discontinue gender-affirming treatment.”

MSNBC columnist Katelyn Burns wrote: “American Civil Liberties Union attorney Chase Strangio will become the first openly trans lawyer to make oral arguments before the Supreme Court on Wednesday. As historic a moment as that is, Strangio’s appearance before a court with a 6-3 conservative super majority will come with an overwhelming sense of impending doom for trans people like me.”

“My heart — and the heart of every transgender advocate fighting this fight — is heavy with the weight of what these laws mean for people’s everyday lives,” said Strangio. “…My heart aches for the parents who spent years watching their children in distress and eventually found relief in the medical care that Tennessee now overrides their judgment to ban. Whatever happens today, tomorrow, and in the months and years to come, I trust that we will come together to fight for the realized promise of our Constitution’s guarantee of equal protection for all.”

A decision is expected in U.S. v. Skrmetti in the spring or early summer of 2025.

This case is a part of the ACLU’s Joan and Irwin Jacobs Supreme Court Docket.

Sarah Toce

Screenwriter & Journalist | Sarah Brusig (Toce) is an appointed member of the King County Women's Advisory Board and an elected precinct committee officer (PCO) in Burien, WA. As a healthcare worker, Sarah is represented by SEIU 1199NW. In 2010, Sarah created the online news source The Seattle Lesbian, LLC, which still receives upward of 100,000 readers per month. A recipient of McCormick's New Media Women Entrepreneur Award in 2012, Sarah was invited to the White House by President Barack Obama in 2015. That same year, GO Mag recognized Sarah as one of their Red-Hot Entrepreneurs in media.​ In 2016, the National Diversity Council honored Sarah with their LGBT Leadership Award. Congresswoman Pramila Jayapal (D-WA) recognized Sarah's advocacy work with the Community Builder Award in 2017, the same year Curve Magazine named Sarah one of their Top Women in Media & Publishing. Sarah served a two-year term as president of the Society of Professional Journalists - Western Washington Chapter beginning in 2018 and was elected Communications Vice Chair of the King County Democrats in 2021.

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