Tennessee families, doctors ask Supreme Court to block state ban on gender confirmation in health care

Three Tennessee families with transgender children and a doctor asked the Supreme Court on Wednesday to intervene to prevent the state from enforcing a law that prevents transgender minors from accessing gender-affirming health care.

The case, if accepted, would be the first gender-affirming health care case to go before the Supreme Court.

The legislation, Senate Bill 1, prohibits health care providers from administering puberty blockers, hormones and surgeries to transgender youth under 18. Tennessee Republican Gov. Bill Lee signed the measure into law in March, along with the nation’s first law restricting drag performances.

Advocates including Lambda Legal and the American Civil Liberties Union sued the state in April on behalf of two anonymous plaintiffs, parents Samantha and Brian Williams and Dr. Susan Lacy, a Memphis-based physician.

District Judge Eli Richardson temporarily blocked the measure from taking effect in June. He cited preliminary injunctions issued by other courts in similar cases, writing in his opinion that “any court that has considered a preliminary injunction against the gender confirmation of care of minors has found that such a prohibition is likely to be unconstitutional .”

Gender-affirming health care bans enacted in Florida, Montana and Indiana are currently blocked by court orders. In June, a federal judge overturned the nation’s first ban in Arkansas, calling it unconstitutional.

In July, however, a panel of the 6th Circuit Court of Appeals granted a request by the Tennessee attorney general to overturn Richardson’s ban, becoming the first federal court to allow the ban on gender-affirming health care to go into effect. Six days later, the same court overturned Kentucky’s ban.

In August, Alabama became the third state to reinstate a previously blocked ban on gender-affirming health care when the 11th Circuit Court of Appeals struck down an injunction against its 2022 felony ban.

Attorneys for the plaintiffs in the Tennessee case wrote Wednesday that the district court’s conflicting rulings are “creating chaos across the country for teens, families and doctors.”

“Neither the wave of state bans on gender-affirming drugs, nor the lawsuits challenging them, are likely to abate in the near future,” they wrote. “Given the division among the courts of appeals over the appropriate level of scrutiny in these and related cases, any delay in this court’s review only risks subjecting transgender adolescents, their parents, and their physicians to a patchwork of inconsistent laws and legal standards, that impede their medical care.’

Until now, the Supreme Court has been hesitant to intervene in transgender health care disputes, although two of the court’s leading conservatives — Justices Samuel Alito and Clarence Thomas — appear eager to intervene in cases involving transgender protections.

When the court declined to step in to enforce West Virginia’s ban on transgender athletes in April, both justices publicly dissented. Alito wrote that the case involved “an important issue that this Court will likely have to address in the near future.”

In June, hours after ruling in favor of a Christian web designer who refused to make websites for same-sex weddings, the court upheld a lower court ruling that sided with a transgender woman deprived of hormone treatment while she was in a Virginia prison in 2018.

Both Alito and Thomas dissented, writing that the decision “will raise a host of important and sensitive issues regarding such issues as women’s and girls’ participation in sports, access to single-sex restrooms and housing, the use of traditional pronouns, and the administration of sex reassignment therapy (both surgery and hormone administration) by doctors and hospitals who object to such treatment on religious or moral grounds.’

In 2021, the court also declined to rule on a dispute over whether transgender students should be allowed to use school restrooms that align with their gender identity. Alito and Thomas said they would hear the case.

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