It’s October, which means SCOTUS is back. Over this term, the Supreme Court of the United States will hear numerous cases on a broad range of issues impacting our communities’ safety and wellbeing.
One case we have our eyes on is U.S. v. Skrmetti. In Skrmetti, the Court will decide if bans on access to gender-affirming hormone care for transgender youth violate protections under the Equal Protection Clause of the Fourteenth Amendment of the Constitution. This is the first time the Supreme Court will hear arguments on whether transgender youth and their families can make their own medical decisions.
What’s at Stake?
U.S. vs. Skrmetti began as an action by three transgender youth and their parents against Tennessee’s Attorney General to challenge SB 1—a ban on gender-affirming hormone care for young people in the state of Tennessee. The Department of Justice joined the lawsuit shortly after in support of the young people and their families. The district court in Tennessee temporarily blocked SB 1, but the state successfully appealed to the Sixth Circuit. While the Supreme Court agreed to hear Skrmetti this term, SB 1 is currently in effect and threatening the health and safety of trans youth in Tennessee.
SB1 prohibits the use of puberty blockers and hormone therapies only if the care is intended for a young person to live in accordance with their gender identity. And of course, the hallmark of any awful law restricting health care, SB 1 allows individuals to sue health care providers for providing safe, necessary, lifesaving health care to transgender youth. This tactic copies the Texas abortion ban that empowers any person to sue any Texas physician for providing abortion care or referring a person for abortion care.
Gender-affirming care encompasses a range of social, psychological, behavioral, and medical care designed to support and affirm a person’s gender identity. For transgender youth, this often includes treatment like hormone therapy. Tennessee’s ban on gender-affirming hormone care for transgender youth is disrupting medically necessary care. Unfortunately, it is not just Tennessee taking extreme action to deny young people and their families the dignity to keep medical decisions private and non-politicized.
In just the last three years, 24 states banned hormone therapy for young transgender people. Over 100,000 transgender youth have already lost or are at risk of losing hormone therapy. Not only do these bans upset the routine and health of transgender youth, but there are far-reaching legal implications. Parents and caregivers risk becoming the target of a family policing investigation for seeking care for their child. Health care providers risk civil liability and professional sanctions for continuing medically necessary care.
These bills have a devastating impact on young people. Discrimination based on gender is damaging to the developmental well-being of children. Banning access to gender-affirming care can lead to negative health outcomes, such as depression and anxiety. This is especially true for transgender youth of color who experience disproportionately higher rates of violence and are more likely to experience limited access to health care.
Reproductive Justice & Trans Justice
Now that Skrmetti is at the Court, the outcome will set a legal precedent that determines the legitimacy of similar anti-LGBTQ+ bills across the country. This legal tactic should sound familiar. Tennessee is relying on the Court’s ruling in Dobbs v. Jackson Whole Women’s Health to justify the ban on gender-affirming hormone care for transgender youth. The same attacks that overturned Roe are used to target transgender youth’s autonomy over their bodies and futures.
Transgender, non-binary, and gender-diverse people—regardless of age—should have access to all available care that affirms their gender identity. Beginning gender-affirming care is a personal decision with no place for political interference, just like abortion care (and all health care!).
Protecting gender-affirming care is protecting bodily autonomy. Freedom to access the full range of health care options that allow you to express your gender and sexuality free from discrimination, violence, and criminalization is fundamental to reproductive justice.
Anti-trans health care legislation—like anti-reproductive health care legislation—is deeply rooted in white supremacy and works to uphold the same systems of oppression that control those disproportionately affected by these bans. The architects of these bills work overtime to undermine what we know is true—gender-affirming hormone therapy is essential and lifesaving care.
The Court scheduled oral arguments in Skrmetti for December 4. Once again, our right to control our bodies, lives, and futures is in the hands of nine Justices.
Let’s work together and uplift each other as we get ready to tackle yet another Supreme Court term.
Natasha Rappazzo
Reproductive Justice Fellow