At its core, this case is about whether transgender minors in Tennessee can access the same medical care that is commonly provided to nontransgender minors and whether their families can make healthcare decisions in consultation with their doctors without the interference of politicians. This law violates the Equal Protection Clause of the U.S. Constitution because it unfairly discriminates against transgender youth by denying them the same care that is available to other youth, such as hormone therapy or puberty blockers.

This is about transgender or nonbinary youth having access to medically necessary care services and treatments commonly provided to cisgender youth, that their doctors have prescribed them to treat their gender dysphoria and improve their physical, mental, and emotional well-being. Not having this care can result in devastating consequences for their health and wellbeing. This lifesaving care has been approved by all the major medical associations and has been scientifically proven to be safe, and effective. 

Tennessee passed a law banning certain health care treatments when provided to transgender youth (and only transgender youth) if it allows them to live as who they are in March 2023. One month later, in April 2023, Lambda Legal, the ACLU, the ACLU of Tennessee, and Akin Gump Strauss Hauer & Feld LLP filed our lawsuit, arguing the law was discriminatory and harmful. The ban violates the U.S. Constitution by denying the same treatments for transgender youth that are commonly provided to cisgender youth. Decisions about medical care properly lie with families and their doctors, and politicians shouldn’t be inserting themselves in these personal and private discussions. The United States District Court for the Middle District of Tennessee agreed, issuing a well-reasoned preliminary injunction blocking enforcement of the law in June 2023. However, in September 2023, the U.S. Court of Appeals for the Sixth Circuit reversed the lower court ruling and allowed the law to go into effect. In November we filed a petition for certiorari asking the Supreme Court to review the ruling, and in June 2024 the Court granted that review. 

There are three families involved in U.S. v. Skrmetti case, each with a transgender child currently impacted by the Tennessee healthcare ban. In addition to L.W., identified by her initials as she is a minor, the other two anonymous plaintiffs are 15-year-old Ryan Roe and 12-year-old John Doe. These families are challenging the ban because it denies their children access to essential medical care and threatens their well-being. Also, a plaintiff in the case is Memphis-based gynecologist who works with transgender youth and their families.

The Supreme Court has set a hearing date for oral argument on Wednesday, December 4, 2024. The Court might take until June 2025 to issue its ruling. 

There are a range of different outcomes that are foreseeable in a final ruling. A ruling in favor of the families would return the case to the lower courts to apply the appropriate standard of review for improper sex-based classifications. If the Court upholds the ban, the Tennessee law would remain in effect, depriving trans minors from receiving hormone therapy, greenlighting similar bans already enacted in other states, and potentially emboldening even more states to pass similarly restrictive laws and perhaps even more draconian bans. However the case is decided, it is likely to have a significant impact on how much deference courts give to bans on medical care to treat gender dysphoria.  

Beyond this case, the Supreme Court may soon address other issues affecting transgender rights. For example, West Virginia and North Carolina have recently asked the U.S. Supreme Court to review rulings out of the U.S. Court of Appeals for the Fourth Circuit in two successful lawsuits brought by Lambda Legal challenging each state’s policies denying medical care for transgender people, specifically transgender state employees in North Carolina and transgender Medicaid beneficiaries in West Virginia. West Virginia has also asked the Court to review another ruling out of the Fourth Circuit where Lambda Legal, the ACLU, the ACLU of West Virginia and Cooley LLP successfully challenged West Virginia’s law barring transgender girls from participating in interscholastic athletics. 

There is a lot at stake for trans and nonbinary people in the upcoming cases and Lambda Legal is working around the clock to represent our trans and nonbinary community and fight back against these attacks

Since 2021, 26 states have banned hormone therapies for transgender youth. These are all similar cases introduced by conservative state legislatures targeting trans youth and their families pushed by conservative and far-right groups using copy-cat legislation and peddling misinformation and conspiracy theories. 

First, we need all the visibility and support possible and need folks to show up in solidarity to the community rally “Freedom to Be” in front of the Supreme Court in Washington, D.C., on Wednesday, Dec. 4 from 10 a.m. – 1 p.m. ET. If you are able to attend, please RSVP in this link. If not, please support by amplifying our social media content and uplifting this event locally. 

Also, you can stay informed, spread the word, and show support as a visible ally for the trans community and organizations fighting for their rights. 

Follow us on social media, donate, and get involved by contacting elected officials or attending events, which can also help raise awareness and show there’s widespread support for transgender rights.