Key events that led to SCOTUS case on gender-affirming care
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Bans on gender-affirming care for youth went from being a political nonstarter to a top priority for GOP legislators with the Supreme Court hearing oral arguments on Wednesday in a pivotal case on the issue.
The big picture: In the three years since the first state legislative ban on youth gender-affirming care was passed in 2021, such legislation has taken effect in 26 states, per the Human Rights Campaign.
- The Supreme Court heard arguments on U.S. v. Skrmetti, which challenges Tennessee's 2023 law that prohibits health care providers from providing or offering puberty blockers, hormones or surgery to minors.
- It could be the biggest case of the high court's term, and the court seems likely to uphold Tennessee's ban, Axios' Sam Baker reported. Conservative justices indicated via their questioning that they don't want to overrule the state law.
- Major medical groups including the American Medical Association, the American Academy of Pediatrics and the American Psychiatric Association concur that gender-affirming care is lifesaving medical care.
By the numbers: More than a third of transgender youth live in states that have enacted bans on access to gender-affirming care, according to UCLA Law's Williams Institute.
- More than three-quarters of trans youth between 13 and 17 years old live in states where such a law was introduced or pending in the 2024 legislative session.
What they're saying: "While the day-to-day lives of transgender and nonbinary people have become increasingly politicized, our ability to access the medicine we need to lead healthy lives should not be up for debate," Jaymes Black, CEO at The Trevor Project, said in a statement Wednesday.
Here are some key events that led to this moment:
2020: Anti-trans movement emboldens
The Supreme Court in 2020 ruled in Bostock v. Clayton County that employers can't fire employees based on their sexual orientation or gender identity.
- Conservative Justices Neil Gorsuch and John Roberts sided with the court's more liberal justices in the decision.
The Biden administration, during President Biden's first month in office, used this as a basis for a wide-ranging LGBTQ+ anti-discrimination executive order.
Yes, but: Political attacks against trans youth increased in 2020 with a "new energy of frenetic assaults on trans life focused on beginnings of sports, bathrooms and health care," Chase Strangio, co-director of the ACLU'S LGBT and HIV Project, said recently on the Vibe Check podcast.
- The bans on health care, at that point, didn't seem politically viable, said Strangio, who delivered the ACLU's argument before the Supreme Court on Wednesday.
2021: First youth gender-affirming care ban
Arkansas was the first state to ban gender-affirming care for patients under 18.
- The Republican-led state house overrode a veto from Republican Gov. Asa Hutchinson, who said it was a "vast government overreach." (That same year, Hutchinson signed a bill banning transgender women and girls from participating in sports consistent with their gender identity.)
2022: "Increasingly draconian" bills
- Across 13 states, 26 anti-trans bills were passed in 2022. Proposed legislation became "increasingly draconian," per the Trans Legislation tracker.
- "Don't Say Gay" bills proposed in more than a dozen states prohibited classroom discussion about LGBTQ+ identities and issues.
- Alabama and Arizona passed legislation limiting youth access to gender affirming care. In Texas, Gov. Greg Abbott (R) also issued a directive defining certain gender-affirming services as child abuse, per KFF.
2023: Anti-trans legislation booms
- 90 anti-LGBTQ+ bills were passed in 2023, half of which were anti-trans.
- Challenges to the bans are also making their way through the courts: In June 2023, a federal judge overturned Arkansas' ban on gender-affirming care for youth — later appealed by the state's attorney general.
Tennessee Gov. Bill Lee (R) signed a bill banning transition-related medical care for trans youth in March 2023 — the legislation that would eventually make it to the Supreme Court as U.S. v. Skrmetti. It was the first bill proposed during that year's legislative session.
- The following month, the ACLU of Tennessee along with other organizations sued Tennessee to block the ban on behalf of three families and a doctor. A district court sided with the plaintiffs, but an appeals court subsequently sided with the state.
- "Radical gender ideology has captured an entire alphabet of American medical organizations," the defense said in a court filing.
Between the lines: "These decisions were catastrophic because not only did they let these laws go into effect but they, in essence, gave governments the green light to discriminate against trans people in a host of contexts," Strangio said.
2024: Trans issues soar within GOP presidential campaign
- 2024 marks the fifth consecutive record-breaking year for the total number of anti-trans bills considered in the U.S., per the Trans Legislation Tracker.
Zoom out: Republicans have continued to target trans rights following the presidential campaign, where President-elect Trump released anti-trans campaign ads and suggested that he'd ban trans athletes from competing in sports according to their gender identity.
- House GOP members launched immediate attacks on Sarah McBride, the first trans person elected to Congress by banning transgender people from accessing House bathrooms that correspond to their gender identity.
Go deeper: Trump win emboldens GOP's anti-trans blitz
Editor's note: This story has been updated with details from Wednesday's oral arguments.
