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Supreme Court to weigh in on laws banning treatments for trans minors

The Supreme Court of the United States.
Liam James Doyle
/
NPR
The Supreme Court of the United States.

The U.S. Supreme Court waded back into the culture wars on Monday, agreeing to hear a challenge to a Tennessee law that bans gender affirming hormone treatments for patients under the age of 18. The justices will not hear the case until next fall, with a decision expected in 2025.

The challengers are three teenagers ranging in age from 13 to 16 who have received puberty blockers as they transition away from their sex assigned at birth. The youngsters and their parents contend that the law violates the constitutional guarantee to equal protection of the law, and that parents have the right to determine their children’s medical treatment.

The justices have agreed to hear only the claim that Tennessee’s law denies trans minors the equal protection of the law. Specifically, that it allows the use of hormone treatments for some minors, such as those who begin puberty too early, but forbids the treatment for trans patients under 18. The Biden administration, in a separate suit, urged the court to consider only that more limited question. Specifically, whether such laws should be subjected to more rigorous judicial scrutiny.

The Sixth Circuit Court of Appeals, ruling in the Tennessee case, applied the lowest level of scrutiny, holding that the legislature had a “rational basis” for enacting the law. There is “no reason to apply skeptical, rigorous, or any other form of heightened scrutiny to these laws,” wrote Chief Judge Jeffrey Sutton for a divided panel. The Biden administration and the ACLU, representing the trans patients, counter that the law should be subjected to “heightened scrutiny” because the statute explicitly treats trans minors differently, and less favorably, than minors receiving hormone treatment for other reasons.

The Supreme Court has only ruled on transgender issues three times. Most recently, in 2020, the justices ruled that The 1964 Civil Rights Act banning discrimination in employment applies to gay, lesbian, and transgender employees.

Currently some 25 Republican-led states have enacted various bans on gender affirming hormone treatments for minors. Tennessee’s law, like many others, also bans surgeries . But the surgery question is not at issue in this case.

The laws banning gender-affirming hormone treatments for minors are strongly opposed to major medical groups, including the American Academy of Pediatrics and the American Medical Association. The AMA, for instance, in 2021 sent a letter a letter to the National Governors Association citing evidence showing that gender affirming care can lead to “dramatic reductions in suicide attempts as well as decreased rates of depression and anxiety” among young people.”

In addition to the Sixth Circuit Court of Appeals, the Eleventh Circuit, has also rejected legal challenges to the bans. The Supreme Court has declined to block those rulings while it considers the issue in the upcoming term.

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Nina Totenberg is NPR's award-winning legal affairs correspondent. Her reports air regularly on NPR's critically acclaimed newsmagazines All Things Considered, Morning Edition, and Weekend Edition.
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