The United States Supreme Court has decided to take up a case on the constitutionality of state bans on gender-affirming care. Currently, the states are split on whether this care should be allowed for minors under the age of 18.
Gender-affirming care is used to treat gender dysmorphia, which occurs when people do not feel like their gender identity matches their biological sex. Care includes treatment such as puberty blockers, counseling, and hormone therapy that makes physical changes to the body. For transgender men, this care can cause periods to stop, voices to get lower, and to grow body hair. For transgender women, it could slow down the growth of body and facial hair, along with increasing breast size.
Another form of gender-affirming care is surgery, which can change chests and genitals. However, these operations are not often performed on minors.
The state in question before the High Court is Tennessee, which passed laws banning puberty blockers and hormone therapy for minors. Doctors who provide these types of care in contravention of the bans are subject to civil penalties. The gender-affirming care rules have been questioned in Kentucky as well, but the Supreme Court decided to only hear the case from Tennessee. The plaintiffs include two transgender boys, a transgender girl, and their parents who are fighting to “defend the treatments they have said improved their happiness and wellbeing,” according to Reuters. The U.S. Justice Department is joining the lawsuit to challenge the bans as well.
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 Supreme Court was always going to have to resolve how state bans on gender-affirming medical care can be reconciled with its approach to sex-based discrimination,” said Steve Vladeck, CNN Supreme Court analyst and professor at the University of Texas School of Law, when the Court accepted the case last Monday. “Today’s grant sets up this issue as one of the early blockbusters for the Court’s upcoming term.”
Proponents of bans on gender-affirming care say that people should wait until they are adults to make these decisions. Opponents say that these bans are a violation of civil rights.
“It’s simple: Everyone deserves access to the medical care that they need, and transgender and non-binary young people are no exception,” said Kelley Robinson, president of the Human Rights Campaign. “No politician should be able to interfere in decisions that are best made between families and doctors, particularly when that care is necessary and best practice.”
All major United States medical groups, including the American Academy of Pediatrics and the American Medical Association, oppose the bans. The AMA, for instance, says that gender-affirming care is medically necessary to treat gender dysphoria and gender incongruence according to generally accepted standards of medical and surgical practice.
The United States is not the only country without a national consensus on this issue. Some European countries say that there is an overdiagnosis of gender dysphoria. In England, the National Health Service commissioned a review of gender-affirming care for children and adolescents. Dr. Hilary Cass, a retired pediatrician, was appointed to lead this review. The review was released in April and concluded that there is “no good evidence on the long-term outcomes of interventions to manage gender-related distress.” Following Cass’s report, England’s health service has stopped giving puberty blockers to minors unless it is in a research setting, which was recommended in Cass’s report.
The World Professional Association for Transgender Health and its U.S. affiliate issued a statement in May regarding this review saying that it “deprives young trans and gender diverse people of the high-quality care they deserve and causes immense distress and harm to both young patients and their families.”
The Supreme Court case is set to be heard this fall, but a decision likely won’t be released until this time next year.
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