United States v. Skyrmetti
By Tracy Waller, MPH, Esq.
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]
[1] https://www.msnbc.com/opinion/msnbc-opinion/supreme-court-transgender-minors-tennessee-rcna182449
[2] https://apnews.com/article/gender-dysphoria-americans-with-disabilities-act-kesha-williams-978eb6090baa78653d9c31309de17100
[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.
