What You Absolutely Need to Know About U.S. v Skrmetti

 

What you need to know and what the mainstream media may not tell you about the case.

 
 

by Valorie Van-Dieman

What is U.S. v Skrmetti?

It’s a case before the U.S. Supreme Court that will decide whether bans on necessary medical treatments for transgender youths, such as hormone therapy and puberty blockers, violate the equal protection clause of the U.S. Constitution. The question before the court is whether the bans discriminate on the basis of sex by making some medications available to natal males unavailable to natal females, and vice versa.

What is happening with the case on Wednesday?

The nine justices will hear oral arguments from the petitioners (who are challenging the constitutionality of Tennessee’s ban on trans youth health care on behalf of families with transgender children), and the respondents (who represent the state of Tennessee, its health care ban and, more broadly, state health care bans in general).

Outside the court, trans youth, their families and representatives, and the larger trans community will rally to support their right to health care that is free of discrimination. Anti-trans protesters, representing conservative groups who believe transgender identities are illegitimate and that trans people represent a danger to traditional gender hierarchies, are also expected.

When are oral arguments happening? How long will they take?

Oral arguments start at 10 a.m. ET, and each side will have 30 minutes. During the presentations, justices typically ask questions of the lawyers for each side.* The questions may give hints about the way the justices are viewing the case, although no decision is expected until May or June 2025.

Because the Justice Department has joined the case, the presentation time for the petitioners’ side will be split, with Solicitor General Elizabeth B. Prelogar and the A.C.L.U.’s Chase Strangio each making a 15-minute presentation. Strangio will be the first openly trans person in history to argue a case before the high court. 

Who are the parties in U.S. v Skrmetti?

Brian and Samantha Williams, parents of a trans girl identified by the initials L.W., have sued the attorney general of Tennessee, Jonathan Skrmetti, in his official capacity as the enforcer of Tennessee’s health care ban. Two other families of trans youth (who have not been identified to the public) are also parties to the lawsuit. The families are represented by the A.C.L.U. and the LGBTQ+ legal organization Lambda Legal.

Under President Joe Biden, the Department of Justice joined the case on the side of the families in April 2023. The department is widely expected to withdraw once Donald Trump, a harsh opponent of trans rights, returns to the White House.

What is trans youth health care?

Often called “gender-affirming care,” it encompasses a range of potential treatment options for young people struggling with gender dysphoria. The treatments seek to halt the permanent effects of a puberty the transgender person sees as wrong, and they seek to help the trans person achieve an appearance more typical for the gender in which they live.

Medical evidence has clearly shown these treatments are safe and effective, despite an environment of rampant misinformation that has sought to confuse and mislead the public. Recent studies further show that laws targeting trans youth, including care bans, have led to a drastic increase in calls to suicide hotlines from trans youths..

What is gender dysphoria?

Gender dysphoria is a diagnosis given by a doctor, psychologist, or other medical professional when a trans person’s discomfort with their birth-assigned sex or gender role is acute enough to interfere with their daily living. 

The only interventions shown to successfully address gender dysphoria – and improve the lives of the trans people who experience it –  involve transitioning. These treatments are supported by every major medical association in America and are considered life-saving by doctors, patients and families who rely on them.

How many states have banned trans youth health care, and what do these bans do in practice?

Twenty-four states have banned doctors from prescribing puberty blocking and hormonal medication to trans youth, or from performing surgery to align a trans young person’s appearance with their gender. Two additional states have banned surgery for transgender minors only. (Such surgeries are rare. In many cases they had never been available in states that banned them.)

Where the bans have gone into effect, some families have been forced to uproot their lives and move to states where medical care is available, while others have been compelled to travel great distances to receive care out of state.

While many politicians and pundits have falsely labeled trans youth care as “experimental,” the banned medications are considered a safe and effective part of mainstream medicine. The legislative bans themselves acknowledge this fact. The bans explicitly single out gender dysphoria as a condition that cannot be treated by these means, but allow the same drugs and surgeries to be performed on minors for all other potential purposes. 

The decision will affect every state that has banned this care. You can find out more about which states have bans and the specifics of each state’s ban on the website of the nonpartisan health policy organization KFF.

Who opposes trans youth health care bans?

Bans on gender dysphoria treatment are opposed by the families of trans youth who need such care, by transgender adults, and by every major medical organization.

The bans have been driven by highly partisan politics. Every state that has instituted such a ban is dominated by Republicans. The Biden administration opposes the bans. Many Democratic-led states have sought to protect doctors and patients by crafting legislation shielding providers of trans health care.

Who supports trans youth health care bans?

In recent years, Republicans have tried to turn the very existence of trans people into a political wedge issue. They have sought to exploit the general public’s lack of knowledge about trans people to make false claims about treatments being unsafe or experimental.

The evidence does not in any way support this. Hormone therapy has been used to treat transgender minors since the 1960s, and the current mainline treatment of adding puberty blockers has a 20+ year history. Affirming care in 2024 is safe and effective.

Tennessee’s law includes false statements about the risks of trans youth healthcare and claims that one of the reasons for the ban is the state’s interest in “prohibiting medical procedures that… might encourage minors to become disdainful of their sex.” 

The phrase seems to reflect not simply an interest in public health, but also an interest in promoting a negative view of transgender identities.

*UPDATE: The original version of the sentence was unclear about when justices post questions to attorneys during oral arguments. Questions are posed during the lawyers’ presentations, not separately from them.


Valorie Van-Dieman (she/her) is the editorial assistant at Assigned Media. @valorievandieman.bsky.social

 
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