The US Supreme Court on Wednesday upheld a state law banning gender-affirming medical treatments for transgender minors – an issue at the heart of the culture wars that have become a dominant feature of American political life. The top court voted 6-3 to uphold a law in the southern state of Tennessee, which bans hormone therapy, puberty blockers and gender transition surgery for those under the age of 18.
The six conservative justices on the court rejected a challenge to the law while the three liberals dissented. Two dozen Republican-led states have enacted laws restricting medical care for transgender youth and the case will have repercussions for the prohibitions across the country.
"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," wrote Chief Justice John Roberts, author of the majority opinion.
"The Court's role is not 'to judge the wisdom, fairness, or logic' (of the law) but only to ensure that the law does not violate equal protection guarantees," Roberts said. "It does not. Questions regarding the law's policy are thus appropriately left to the people, their elected representatives and the democratic process," he said.
The Supreme Court heard arguments in the case in December, and the Justice Department of then president Joe Biden joined opponents of the Tennessee law, arguing that it violated the US Constitution's Equal Protection Clause since it denies transgender people access to medical treatments otherwise permitted to others.
Republican President Donald Trump has since taken office, and he signed an executive order in January restricting gender transition procedures for people under the age of 19. While there is no US-wide law against gender-affirming medical treatments for transgender youth, the Trump order ended any federal backing for such procedures.
'Must end'
During oral arguments in December, Tennessee Solicitor General Matthew Rice told the court the law was passed to "protect minors from risky, unproven medical interventions" with "often irreversible and life altering consequences."
Chase Strangio, an attorney for the American Civil Liberties Union, representing three transgender adolescents, their parents and a Memphis-based doctor, countered that the Tennessee law has "taken away the only treatment that relieved years of suffering" for the plaintiffs in the case.
"What they've done is impose a blunderbuss ban, overriding the very careful judgment of parents who love and care for their children and the doctors who have recommended the treatment," said Strangio, the first openly transgender lawyer to argue before the court.
Trump, in his inauguration speech, said his government would henceforth only recognize two genders, male and female, and he signed an executive order on January 28 restricting gender transition procedures for minors.
"Across the country today, medical professionals are maiming and sterilizing a growing number of impressionable children," the executive order said. "This dangerous trend will be a stain on our Nation's history, and it must end."
Trump's order said it would now be US policy that it would "not fund, sponsor, promote, assist, or support the so-called 'transition' of a child from one sex to another."
The order barred funding for gender transitions under the Medicaid health insurance program for poor families, the Medicare scheme used by retirees, and Defense Department health insurance that covers some two million children.