Over the past three years, a rash of bans on best-practice medical care has swept the country. Now, more than three-quarters of transgender youth live in states that have introduced bans on their medical care, and more than one-third of trans youth live in states where these bans have been enacted. Civil rights lawyers have challenged these bans in more than a dozen lawsuits on behalf of trans youth and their families. Due to their litigation efforts and the support of the U.S. Department of Justice, trans youth will have their day in court on December 4, 2024, when the U.S. Supreme Court hears oral arguments in United States v. Skrmetti. Skrmetti will make history as the first time that an openly transgender lawyer will argue before the Supreme Court.
This case is about reinstating access to lifesaving care for trans youth in more than two dozen states. More so, this case is about the bodily autonomy of all patients. If the justices reject the arguments for equal protection of trans people under law in this case, the decision could be yet another encroachment of the government into doctor’s offices nationwide. An outcome harming the trans community would further evidence far-right efforts to capture the judiciary to advance their extreme political preferences.
How did we get here?
In March 2023, Tennessee Gov. Bill Lee (R) signed S.B. 1 into law, banning transition-related medical care for transgender youth.
That same year, 19 other states passed similar bans on best-practice medical care for transgender youth. As of publication, 26 states ban best-practice medical care for trans youth—although two of these states only ban surgical care and not the provision of hormones. These bans have had a negative impact on trans youth, and families have been forced to travel or move across state lines to access necessary care.
Skrmetti is one of 17 cases challenging these bans that have been filed by trans youth, their families, and medical providers. The cases largely make two arguments: that the bans discriminate based on sex and transgender status, violating the equal protection clause, and that they infringe on parent’s rights to guide their children’s medical care, violating their due process rights.
The Department of Justice has filed five amicus briefs in support of trans youth in cases that have made it to the U.S. Courts of Appeals. Judges in the 6th and 7th circuits have allowed medical bans to remain in effect by wrongfully asserting that these medical bans do not discriminate against transgender youth. In the 8th and 9th circuits, the courts refused to overturn the injunctions against similar bans in Arkansas and Idaho. Given the circuit split, Skrmetti will determine whether the existing state bans remain in place or whether the rights of transgender youth to receive the medical care they need will be protected.
The fight for trans rights is a fight for bodily autonomy
When the Supreme Court overturned the right to abortion in Dobbs v. Jackson Women’s Health Organization, it also weakened equal protection safeguards for targeted communities by preventing courts from applying heightened scrutiny to sex-based discrimination. The fight for transgender medical care is clearly linked to the fight for abortion rights, and Skrmetti shows how the far right is using the courts to challenge bodily autonomy at every turn. Skrmetti is an opportunity to thwart some of these challenges and, possibly, reset the conversations about both transgender and abortion health care in the courts.
Misinformation is central to the Tennessee attorney general’s legal argument. Their brief cites discredited theories and reports from anti-trans actors in the United States and abroad to reject transgender people’s very existence and misrepresent medical facts about the history, safety, and efficacy of transgender health care. This means, unfortunately, that anti-trans misinformation will be given a platform during oral arguments. While some courts have been swayed by misinformation such as this, judges in lower courts have challenged this misinformation and sided with transgender communities. For example, judges have affirmed trans youth’s equal protection rights by properly applying the protections against discrimination based on sexual orientation or gender identity that were codified in Bostock v. Clayton County, Georgia.
The argument in the Skrmetti case is clear: These bans discriminate against transgender youth on the basis of sex and transgender status, and they must be overturned. The court must side with the families of trans youth and with civil rights advocates. In doing so, it has the ability to overturn all bans on best-practice transgender medical care. However, if the court decides to reject its own logic in Bostock and deny transgender youth equal protection under the Constitution, the bans on transgender medical care will remain in place.
Conclusion
Bans on transgender health care are part of a larger attack on sex discrimination protections that will harm bodily autonomy by restricting reproductive rights and access to medical care—all of which are a part of the far right’s attempts to redefine sex and gender. The fallout of this decision, which likely won’t be released until the summer of 2025, is something that everyone concerned about bodily autonomy should be worried about.