Supreme Court agrees to review Tennessee law banning sex grooming of minors

Washington – The Supreme Court said Monday it will consider whether a Tennessee law banning gender-affirming health care for transgender minors violates the Constitution, setting the stage for a major decision on transgender rights in its next term.

The justices agreed to review a lower court ruling upholding Tennessee’s ban, which was appealed by the Justice Department and transgender youth, who argue the laws are outside the bounds of the 14th Amendment.

The case will be heard in the Supreme Court’s next term, which begins in October, with a possible decision by the end of June 2025. The dispute puts the Supreme Court at the center of a politically charged case that has sparked a wave of legislative actions by state legislators.

The outcome of the case could have a nationwide impact, as more than 20 states have passed laws in recent years restricting treatments such as puberty-blocking drugs, hormone therapy or surgery for minors experiencing gender dysphoria.

The Supreme Court has never directly weighed in on the constitutionality of these bans, and the justices intervened in a case involving an Idaho law on an emergency basis. In April, the court agreed to let Idaho officials enforce the state’s ban on gender-affirming medical care for nearly all transgender minors nationwide and narrowed the scope of a lower court order that blocked the law from taking effect.

According to the Supreme Court’s order, Idaho’s law did not apply to two transgender teenagers who challenged the restrictions.

In a separate case involving a West Virginia law barring transgender athletes from competing on female sports teams, the Supreme Court refused to allow state officials to enforce the law while legal proceedings continue.

Tennessee law

The Tennessee law, known as SB1 and passed in March 2023, prohibits health care providers from “prescribing, administering or dispensing any puberty blockers or hormones” if the treatment is to “enable a minor to identify or live as an assumed identity inconsistent with the minor’s sex” or address “alleged concern or distress from a discrepancy between the minor’s sex and the asserted identity.

While the law also prohibits surgical procedures undertaken for the same purpose, that restriction is not at issue in this case. Puberty blockers or hormones may be administered to treat conditions such as precocious puberty, disease, a birth defect, or physical injury.

Violators of the Tennessee law can face civil penalties of up to $25,000, professional discipline and possible civil liability. While the law took effect on July 1, 2023, it allowed prohibited treatments that began previously to continue until March 31.

A transgender girl and two transgender boys, who were all diagnosed with gender dysphoria, challenged the ban along with a doctor in the state who works with transgender patients, arguing in part that it violates the Equal Protection Clause of the 14th Amendment . In this case, the Department of Justice intervened.

A federal district court blocked state officials from enforcing the law, finding it likely to be unconstitutional. The ban, the court said, “expressly and exclusively targets transgender persons” and found that “the benefits of medical procedures prohibited by [the law] are well placed”.

But a divided panel, a judge on the US Court of Appeals for the 6th Circuit overturned the order. The 6th Circuit’s decision upheld not only the Tennessee law, but a similar ban in Kentucky. The court did not act on a request to review the Kentucky law.

“This is a relatively new diagnosis with ever-changing approaches to care over the past decade or two. Under these circumstances, it is difficult for anyone to be certain about predicting the long-term consequences of abandoning the age limits of any type for these treatments,” wrote Chief Judge Jeffrey Sutton of the 6th Circuit.

He continued: “This is exactly the kind of situation in which life-tenured judges interpreting a Constitution difficult to change should be humble and wary of declaring new due process or rights equal protections that limit elected officials from addressing these medical, social and political challenges.”

The Department of Justice and the transgender teenagers appealed to the Supreme Court. The justices agreed to accept the challenge from the Biden administration.

In a filing with the justices, the Biden administration pointed to a flurry of legislative activity in nearly half of the states that have barred transgender teenagers from receiving medical care “in accordance with evidence-based standards that reflect the overwhelming consensus of the medical community.”

“Absent this court’s review, families in Tennessee and other states where laws like SB1 have taken effect will face the loss of essential medical care,” Attorney General Elizabeth Prelogar wrote. “Those who have the resources to do so can leave their homes, jobs, schools and communities to go to a state where needed treatment remains available. Others will not even have that option.”

Represented by the ACLU, transgender teens and their families noted that appellate courts are split on the constitutionality of laws banning gender-based care for transgender teens, as well as the appropriate level of scrutiny to enforce bans aimed at transgender individuals for medical treatment. .

“The legal uncertainty surrounding this medical care is creating chaos across the country for teenagers, families and doctors,” their lawyers told the Supreme Court in a filing.

But attorneys for the state of Tennessee said hormonal and surgical interventions for minors diagnosed with gender dysphoria “carry serious and potentially irreversible side effects.” They argued that the ban on gender-affirming care seeks to ensure that young people from Tennessee will not receive these treatments “until they fully understand the lifelong consequences or until the science develops to the point that Tennessee can have a view different for their efficiency”.

The state argued that the question of whether Tennessee can enact regulations on medical interventions for minors is a matter of public policy and should be left to elected representatives of voters.

“Tennessee acted rationally, reasonably and compassionately to protect its children, and the Act survives every level of scrutiny,” state attorneys wrote in a brief. “Nothing in the Constitution supersedes petitioners to override the legislature’s judgment and seek a policy they believe is most favorable.”