Psychologists are battling it out ahead of Wednesday’s Supreme Court hearing on a legal challenge to a state ban on medical treatment for transgender youth.
At issue is Tennessee’s law, known as S.B.1, which prohibits medical treatment for transgender youth, banning the use of puberty blockers and surgeries. It was enacted in 2023.
Some mental health experts say providers need access to these treatments for their clients who are suffering from gender dysphoria, while another expert says he’s seen the harm done to patients who later decide to detransition.
Erica E. Anderson and Laura Edwards-Leeper are two clinical psychologist experts who treat transgender youth suffering from gender dysphoria and oppose the state law.
They said in a brief supporting challengers to the state law that Tennessee’s outright ban on treating youth who are suffering from gender distress is harmful because the categorical approach runs afoul of the standards of medical care, which requires each patient having an individualized clinical assessment that could yield different treatment options.
“While medical interventions are not appropriate for all patients, they are extremely beneficial for some patients. Thorough and proper individualized assessments play an essential role — ensuring that only young people who will most likely benefit from medical interventions will be treated with them,” reads their brief submitted to the high court.
They say Tennessee’s law “requires health professionals to disregard these established standards by barring them from providing critical treatments even when properly determined to be clinically indicated.”
“Such a state-imposed prohibition on medical care is untenable. For patients denied access to critical care, serious adverse health consequences may result,” they said, referencing long-term distress and mental health as concerns.
But Joseph Burgo, a clinical psychologist and psychoanalyst, says he has had to counsel clients who have decided to detransition after receiving medical treatment for gender dysphoria.
Many of his clients are men who detransitioned from living as a woman after realizing they were gay.
“Dr. Burgo’s clinical experience demonstrates that gender affirming medical care fails to address internalized homophobia in teenage boys, and he respectfully aims to assist the Court by explaining this phenomenon,” his filing in support of the state law reads. “Internalized homophobia and feelings of gender incongruity are mental health issues, and SB1 properly protects children from irreversible and harmful medical interventions before they come of age.”
Mr. Burgo’s argument is based on his experience and research, which suggests that young gay boys are bullied and feel immense shame. They look to escape that shame in one way or another, where some choose to accept the narrative that they were born in the wrong male body, according to his filing.
The justices will dive into the weighty topic Wednesday with oral arguments. They will decide if Tennessee’s law runs afoul of the Equal Protection Clause of the 14th Amendment, which requires governments to treat all individuals equally.
It’s the first major trans-rights case that the justices have agreed to hear since 2020, when they decided a civil rights case in favor of LGBTQ challengers, granting them protection from workplace discrimination.
The dispute over Tennessee’s law was brought by the American Civil Liberties Union and the Justice Department.
Courts have rejected similar bans on medical treatment for transgender minors in other states like Alabama, Arkansas, Florida, Georgia, Idaho, Indiana and Kentucky, according to the ACLU.
But the 6th U.S. Circuit Court of Appeals let Tennessee’s ban take effect.
Three transgender minors, their parents and a doctor who has transgender youths as patients challenged the state law.
Represented by the ACLU, they argue the children received puberty-delaying medicine and hormone treatment which has allowed them to become happy and healthy.
“Every major medical association in the United States supports the use of the Guidelines for treating gender dysphoria in adolescents and recognizes that puberty-delaying medication and hormone therapy are safe and effective treatments for adolescents,” their filing reads. “Indeed, those medical treatments are the only evidence-based treatment shown to be effective at alleviating gender dysphoria in adolescents.”
The Biden Justice Department agrees, saying in its filing that the law is discriminatory because it allows certain treatments for some patients, but would ban it for others based on their sex.
“A teenager whose sex assigned at birth is male can be prescribed testosterone to conform to a male gender identity, but a teenager assigned female at birth cannot,” U.S. Solicitor General Elizabeth Prelogar wrote in the government’s filing.
Meanwhile, Tennessee Attorney General Jonathan Skrmetti said the state has an interest in protecting the health and welfare of its residents, including minors. He said the state legislature heard from people who have detransitioned, and did research before passing the state ban.
He said the state law does not run afoul of the Equal Protection Clause of the 14th Amendment because it does not classify boys and girls differently.
“SB1 includes no sex classification. It draws a line between minors seeking drugs for gender transition and minors seeking drugs for other medical purposes. And boys and girls fall on both sides of that line,” Mr. Skrmetti said in his filing.
One percent of Americans are transgender, according to the Justice Department filing. Roughly 22 other states have moved to pass laws similar to Tennessee.
But the debate on transgender care is worldwide. European nations have adopted a more conservative approach but not outright bans.
The case likely will become one of the blockbusters of the court’s term, which began in October and runs through June 2025.
The dispute even drew the attention of Elliot Page, a Hollywood transgender actor who used to go by the name Ellen Page. Mr. Page has won several Academy Award nominations and a Golden Globe Award.
In his brief that was filed in support of the groups challenging the state law, he was joined by 63 other transgender individuals. They come from various industries like scientists, lawyers, artists and actors. In the court filing, the transgender individuals accompanied by Mr. Page said medical treatment for gender dysphoria improved their lives.
“Without such care, their suffering would have continued,” their filing read.
A decision is not expected right away, but will likely come by the end of June.
The case is U.S. v. Skrmetti.
• Stephen Dinan contributed to this report.
• Alex Swoyer can be reached at aswoyer@washingtontimes.com.