In a landmark 6-3 ruling earlier this week in United States v. Skrmetti, the United States Supreme Court ruled that a Tennessee law banning gender-affirming care for minors does not violate the Equal Protection Clause of the 14th Amendment.
Writing for the court, Chief Justice John Roberts said that the Tennessee law — Senate Bill 1 — prohibits all such treatments for all minors. It is not discriminatory on the basis of sex.
“SB1 does not exclude any individual from medical treatments on the basis of transgender status but rather removes one set of diagnoses — gender dysphoria, gender identity disorder, and gender incongruence — from the range of treatable conditions,” Roberts wrote. “SB1 divides minors into two groups: those who might seek puberty blockers or hormones to treat the excluded diagnoses, and those who might seek puberty blockers or hormones to treat other conditions.”
The Tennessee statute does permit the use of puberty blockers for other conditions, such as precocious puberty.
Roberts also rejected the plaintiffs’ invitation to second-guess the lines that SB1 draws.
“It may be true, as the plaintiffs contend, that puberty blockers and hormones carry comparable risks for minors no matter the purposes for which they are administered,” Roberts wrote. “But it may also be true, as Tennessee determined, that those drugs carry greater risks when administered to treat gender dysphoria, gender identity disorder, and gender incongruence. We afford States ‘wide discretion to pass legislation in areas where there is medical and scientific uncertainty.'”
Roberts concluded that this is a policy issue, not a constitutional one, which is not a matter for the court to decide.
“This case carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field,” Roberts wrote. “The voices in these debates raise sincere concerns; the implications for all are profound. The Equal Protection Clause does not resolve these disagreements. Nor does it afford us license to decide them as we see best. Our role is not ‘to judge the wisdom, fairness, or logic’ of the law before us, but only to ensure that it does not violate the equal protection guarantee of the Fourteenth Amendment. Having concluded it does not, we leave questions regarding its policy to the people, their elected representatives, and the democratic process.”
Associate Justice Clarence Thomas wrote a scathing concurrence, particularly taking aim at the “expert class” who asserted there was “medical consensus” that so-called “gender-affirming care” was required for children — and despite the Cass Study in the United Kingdom, among others, which cast deep doubt on such “consensus.”
“Notwithstanding the alleged experts’ view that young children can provide informed consent to irreversible sex-transition treatments, whether such consent is possible is a question of medical ethics that States must decide for themselves,” Thomas wrote. “There are particularly good reasons to question the expert class here, as recent revelations suggest that leading voices in this area have relied on questionable evidence, and have allowed ideology to influence their medical guidance.
“States are never required to substitute expert opinion for their legislative judgment, and, when the experts appear to have compromised their credibility, it makes good sense to chart a different course,” Thomas continued. “The views of self-proclaimed experts do not ‘shed light on the meaning of the Constitution.’ Thus, whether ‘major medical organizations’ agree with the
result of Tennessee’s democratic process is irrelevant. To hold otherwise would permit elite sentiment to distort and stifle democratic debate under the guise of scientific judgment, and would reduce judges to mere ‘spectators . . . in construing our Constitution.'”
Kansas law also prevents gender-affirming care for minors
Earlier this year, Kansas state lawmakers overrode Governor Laura Kelly’s veto of a similar bill, which also outlaws “gender-affirming care” for minors.
SB 63, the “Help Not Harm Act,” outlaws healthcare providers treating a child whose gender identity is inconsistent with the child’s sex at birth with puberty blockers or surgery.
Meanwhile, as recently as March of this year, the Daily Caller found multiple hospitals across the country are continuing to provide so-called “gender-affirming care” for minors, despite an executive order removing federal funding for such “care.”
Indeed, the Daily Caller reports that dozens of federally funded hospitals, including one in Kansas, continue to provide gender-affirming care to children.
“More than three dozen hospitals that offer sex changes to minors and also receive federal funding told the Daily Caller that they are still providing services including puberty blockers, hormone replacement therapy, or surgeries to people under the age of 18,” Senior Editor Amber Duke wrote.
The University of Kansas Health System is one of those hospitals.
A member of the Daily Caller’s staff called pretending to be a parent looking for “gender-affirming care” for their minor and spoke with a staff member.
Duke provided the Sentinel with a transcript of that call in which a staff member stated such care was, indeed, available.
“My name is [Redacted]. How may I help you?” the transcript reads.
The Caller’s staff member then asked, “I was just wondering if you guys offer gender-affirming care services for trans youth, like things like hormone therapy or hormone blockers or surgeries.”
The employee replied, “Yes, we do.”
