State Limits on “Gender-Affirming” Meds for Kids on the SCOTUS Docket

The Supreme Court is set to consider the constitutionality of state restrictions on certain forms of “gender-affirming care” for minors.

It was announced Monday that the justices granted cert to a case out of Tennessee concerning recently approved regulations preventing medical professionals from giving children medication or surgery to treat expressed discomfort with their gender.

Approved in 2023, the policy at the center of this case bans health care providers from giving children under the age of 18 “any puberty blocker or hormone” for the purpose of “enabl[ing] a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex” or treating “purported discomfort or distress from a discordance between the minor’s sex and asserted identity.”

Under this law, violators may be subject to a $25,000 fine, professional discipline, and potential civil liability.

The state’s restrictions on “gender-affirming” surgeries are not being challenged in the case that is now before the Court, only the limitations on prescribing certain medications to minors who identify as transgender, such as cross-sex hormones and puberty blockers.

This case may mark the first time that the Supreme Court will weigh in on the issue of providing transgender-related medical treatment to minors.

Earlier this year, the Court agreed to lift a temporary injunction imposed by an Idaho court on a similar law, allowing the policy to be generally enforced except against the two teenagers directly involved in the case, but refrained from offering pointed insight on its constitutionality.

Over the course of the past few years, nearly half the states in the country have passed laws limiting the legality of these surgeries and medications for children, twenty of which are currently in full effect.

In the remaining states, these laws have either been blocked or have not yet been implemented.

In this case, the Justice Department has argued that Tennessee’s ban on providing “gender-affirming” medications to minors violates the Equal Protection Clause of the 14th Amendment for allegedly discriminating against transgender individuals since the same prescriptions remain available to minors as treatments for other conditions.

This interpretation proffered by the government is largely in agreement with the reasoning provided by the federal district court in its decision for this case.

The 6th Circuit Court of Appeals, however, went on to reverse their ruling, citing the relative-newness of “gender dysphoria” as a diagnosis and the uncertainty regarding the long-term impact of these treatments.

“This is a relatively new diagnosis with ever-shifting approaches to care over the last decade or two. Under these circumstances, it is difficult for anyone to be sure about predicting the long-term consequences of abandoning age limits of any sort for these treatments,” Chief Judge Jeffrey Sutton of the 6th Circuit wrote.

“That is precisely the kind of situation in which life-tenured judges construing a difficult-to-amend Constitution should be humble and careful about announcing new substantive due process or equal protection rights that limit accountable elected officials from sorting out these medical, social, and policy challenges,” the Chief Judge concluded.

Following this, the Justice Department and transgender-identifying teenagers that brought this case appealed the ruling to the Supreme Court.

“Absent this court’s review, families in Tennessee and other states where laws like [this] have taken effect will face the loss of essential medical care,” Solicitor General Elizabeth Prelogar wrote. “Those with the resources to do so may abandon their homes, jobs, schools, and communities to move to a State where the needed treatment remains available. Others will not have even that option.”

Lawyers for the State of Tennessee, however, have noted concerns similar to those raised by the 6th Circuit, explaining that the medical interventions encompassed by the state law “carry serious and potentially irreversible side effects” and should not be available to individuals “until they can fully understand the lifelong consequences or until the science is developed to the point that Tennessee might take a different view of their efficacy.”

Click Here to Read Tennessee’s Brief and Here to Read the Government’s Brief

Oral arguments in this case are set to take place this fall, and a decision can be expected by June of 2025.

Click Here for More Information on This Case