On December 4, 2024, the United States Supreme Court (Supreme Court or SCOTUS) heard oral arguments in United States v. Skyrmetti.[1] Three families are challenging SB1, a Tennessee law that bans surgery, hormone therapy, and puberty blockers for children under 18, only when those treatments are prescribed to individuals seeking to change their gender identity.[i] (This case is not about gender-affirming surgery.) The medications used in the treatment of gender-affirming care are allowed under the law for minors in other cases—such as for endometriosis or early or late onset puberty —but the law specifically bans its use in gender-affirming care. Therefore, these families and their children are contesting that the law is unconstitutional because it discriminates based on sex, therefore violating the Fourteenth Amendment’s Equal Protection Clause.
The penalties for doctors who prescribe hormone therapy or puberty blockers for reasons banned under the law, can be stripped of their license and subject to civil enforcement penalties.
An American Civil Liberties Union attorney, Chase Strangio, represented the plaintiffs—transgender adolescents, their parents, and a doctor who initially filed the lawsuit after the state’s ban. With this case, Strangio became the first openly transgender attorney to argue in front of the Supreme Court.
The outcome of the case has implications beyond the transgender community—as it also determines the extent to which the government can interfere in the private medical decisions of individual citizens.
Two years ago, in the 2022 decision, Dobbs v. Jackson Women’s Health Organization, the Supreme Court allowed state governments to place limits on individuals’ medical decisions based on the state’s interests.
Other important and notable information for the case background (as determined by the National Center for Disability, Equity, and Intersectionality):
In May 2024, under the Biden Administration, the Department of Health and Human Services adopted a new final rule including ‘gender dysphoria’ under the definition of ‘disability’ under Section 504 of the Rehabilitation Act of 1973.
Gender dysphoria is protected under the Americans with Disabilities Act (ADA): In June 2023, the Supreme Court declined to review a federal appeals case that found people with gender dysphoria are entitled to protections under the ADA—therefore implicitly acknowledging that the ADA protects people who experience gender dysphoria.[2]
[i] The case was originally brought by the parents of a 15-year-old trans girl, along with two other trans youths. The plaintiffs are represented by the ACLU and others; the Justice Department later joined; and Tennessee Attorney General (in charge of defending state’s laws) Jonathan Skrmetti is the named defendant.
Writing about disability on a global scale feels a bit like being asked to map the stars while navigating a ship through stormy seas. The constellations are there—glimmering stories of resilience, exclusion, and progress—but the winds of politics, economics, and cultural norms blow unpredictably, often sending the conversation into uncharted waters. And here I am, your queer, autistic pirate captain, attempting to make sense of it all with a kaleidoscope in one hand and a compass in the other.
Let’s start with this: the world loves a good story about disability—but only the kind where the disabled person is “overcoming” something. These tales are neatly packaged, tied with a bow of inspiration, and sprinkled with the requisite tear-jerking soundtrack. Think, The Autistic Genius Who Solved World Hunger! or How a Blind Woman Conquered Mount Everest (While Babysitting a Toddler). While these stories have their place, they often sideline the messy, everyday truths of disability: the bureaucratic battles for accommodations, the sensory minefields of public spaces, and the constant negotiation between authenticity and survival in a world designed for the neurotypical and able-bodied.
Globally, the realities of disability are a tale of haves and have-nots, with geography playing a starring role. In wealthier nations, disability rights have seen some progress, albeit unevenly. Access to education, healthcare, and employment is improving in places with robust legal protections, but even there, the barriers remain high. The office ramps might exist, but the metaphorical ones—the attitudes, the biases—are still steep and slippery. Meanwhile, in lower-income countries, the very idea of disability rights often competes with the urgent demands of basic survival. For millions, the question isn’t whether a workplace can provide accommodations but whether they’ll eat that day.
Take South Africa, my homeland, where apartheid’s scars still linger, slicing through every system and structure. Disability in this context becomes another layer of marginalization in a society still grappling with the legacy of systemic oppression. Public resources are sparse, stretched thin, and unevenly distributed. Specialized education or therapeutic support? A fantasy for most. Disabled children are often hidden away or excluded entirely from formal education, their futures dimmed by a lack of opportunity before they even have a chance to begin. If you’re disabled in South Africa, particularly if you’re poor, the systems designed to support you are likely to fail—or not exist at all.
But let’s zoom out. On a global scale, disability rights are a patchwork quilt stitched together with uneven threads of advocacy, policy, and cultural perception. In Sweden, for instance, universal design is a national mantra, and people with disabilities benefit from some of the most comprehensive support systems in the world. Contrast that with countries where disability is still viewed as a punishment for moral failings or as a family’s “shame,” hidden away to protect their social standing. The kaleidoscope shifts, the patterns change, and the experience of disability morphs depending on where you stand.
And then there’s the curious case of autism. In the global conversation on disability, autism occupies a strange space, often veering between fetishization and complete invisibility. In wealthier nations, autistic voices are increasingly being amplified, but even there, the narrative tends to revolve around “autism as a superpower” or “autism as a tragedy,” leaving little room for the messy, complicated middle ground. Meanwhile, in many parts of the world, autism remains misunderstood, underdiagnosed, or entirely unrecognized. For autistic girls, the situation is even more precarious, as gender biases in diagnostic criteria mean that their struggles are often misinterpreted or ignored altogether.
Here’s the thing: the world loves binaries. We adore neat categories, clear lines, and unambiguous truths. You’re either disabled or abled, autistic or neurotypical, functional or non-functional. But the lived experience of disability, like everything else in life, is gloriously, maddeningly complex. It’s the brilliant chaos of a kaleidoscope, not the rigid order of a spreadsheet. And yet, global systems continue to treat disability as something to be fixed, cured, or accommodated in the simplest, most cost-effective way possible.
The truth is, disability is a political issue as much as it is a personal one. It’s shaped by laws, policies, and cultural norms that decide who gets to participate fully in society and who doesn’t. Globally, disabled people are disproportionately represented among the poor and unemployed. In many countries, they’re excluded from education and healthcare, denied the tools and opportunities needed to thrive. And this exclusion isn’t just a moral failing—it’s an economic one. Studies consistently show that inclusion benefits everyone. When disabled people have access to education and employment, they contribute to the economy, enrich communities, and drive innovation. The world’s obsession with exclusion isn’t just unjust; it’s shoddy math.
But let’s talk solutions, because no one boards a pirate ship just to dwell on the storm. The path forward begins with shifting our perspective. Disability isn’t a problem to be solved; it’s a natural part of human diversity, as fundamental as race, gender, sexuality or culture. By designing systems, spaces, and policies with disabled people in mind from the outset, we create a world that works better for everyone. It’s the difference between building a ramp and waiting for someone to ask for one.
Education is another key. Globally, we need to invest in inclusive education systems that don’t just accommodate disabled students but actively celebrate their strengths. Representation matters too. When disabled people are visible in every sphere of life—politics, media, science, art—it changes the narrative from pity to power.
And let’s not forget the importance of listening. The global conversation on disability often excludes the very people it claims to represent. Autistic voices, for instance, are frequently drowned out by organizations speaking about autism rather than with autistic individuals. If we’re serious about inclusion, we need to amplify the voices of disabled people, particularly those from marginalized communities.
As an autistic, queer, rebellious pirate navigating the high seas of global disability politics, I’ve learned this: the horizon is not an endpoint but a beginning. The journey toward a more inclusive world is ongoing, and it’s one we all have a role in shaping. So, to those who still see disability as a deficit, I offer my kaleidoscope and say, “Look again. You’re missing the beauty of the patterns.”
Here’s to the misfits and rebels, the dreamers and outliers, and everyone charting a course through a world not designed for them. Let’s rewrite the maps, redraw the boundaries, and hoist the sails toward a future where diversity isn’t just tolerated—it’s celebrated.
Lara Hindle is a South African-born American and full-time chaos wrangler, currently pursuing a Master’s in Cybersecurity at Harvard. By day, she torments hackers; by night, she forgets her own passwords. She started in systems and cryptocurrency, thinking she was building the future—until she realized it was just a high-tech scheme to turn the Earth into a baked potato. With a background in computer science, political science, and space engineering, Lara’s expertise lies in building things, arguing about why we built them, and launching them into space when all else fails. When she’s not plotting solutions, she’s obsessing over Emily Dickinson, rescuing animals, or trying—and failing—to explain her career to bewildered dinner party guests. Her mission: prove that chaos, creativity, and a little poetry can save the planet.
