Supreme Court to Decide on Hormone Therapy for Transgender Youth: United States v. Skrmetti

Here’s what you need to know ahead of the Supreme Court’s oral argument in United States v. Skrmetti on December 4.

What is this case about?

The plaintiffs, a group of families and doctors represented by the American Civil Liberties Union, the ACLU of Tennessee, Lambda Legal, and Akin Gump Strauss Hauer & Feld LLP, have sued to challenge the state of Tennessee’s discriminatory ban on hormone therapy for transgender youth. Tennessee’s law would not only ban best practice medical care for trans youth up to age 18, but it would also require trans youth currently receiving this kind of gender-affirming care to end that care within nine months of the law’s effective date of July 1, 2023, or by March 31, 2024. The law also establishes a private right of action against medical providers providing medically necessary care to trans youth. The plaintiffs in this case have asked the Supreme Court to strike down Tennessee’s ban on hormone therapy for transgender youth.

What is gender-affirming care?

Gender-affirming care is generally understood to be medical care that many transgender and nonbinary people need as part of their gender transition. More broadly, gender-affirming care is any kind of medical care that people receive to bring their bodies into alignment with their sense of gender. Tennessee’s law outlaws a broad range of medical care, but in this case, the families and doctors are specifically challenging the law’s ban on hormone therapy for transgender youth.

Why is access to this care important?

Every family should have the freedom to love and support their child and to help them flourish and thrive. Medical care and decisions should stay between families and their doctors, not politicians, to allow all children the freedom to live happy and healthy lives. Bans like Tennessee’s law deny that right to families of transgender youth.

Hormone therapy is safe and effective, and it is a lifeline for many transgender people. Transgender young people who are affirmed in their gender by their families do better in school, feel safer in their communities, and create healthier relationships with their parents and classmates. Medical and mental health treatment for transgender youth is guided by providers who follow evidence-based clinical guidelines determined by the individual needs of each patient. Blanket bans on treatment disrupt medically necessary care and lead to negative health outcomes, including anxiety, depression, and suicidality.

What have the courts said so far?

In April 2023, a group of families and doctors sued the state of Tennessee to block its discriminatory law. Following a decision by the Sixth Circuit Court of Appeals, Tennessee’s law took effect in July 2023. On June 24, the U.S. Supreme Court granted certiorari in response to the petition for review filed by the U.S. Department of Justice.

What will happen in the Supreme Court?

Oral arguments will take place on December 4. The Supreme Court will consider whether to strike down Tennessee’s ban on hormone therapy for transgender youth.

What happens if the Supreme Court rules against the families and doctors?

A ruling that fails to block this cruel and discriminatory law would be a failure to preserve basic rights for transgender people across the country. The Court has an opportunity to reaffirm long-standing precedent and the fundamental principle that medical care should stay between families and their doctors. 

What is The Leadership Conference’s take on the case?

We believe access to medically necessary care is a civil rights issue. These bans deny families the dignity and freedom to support their transgender children in leading healthy and happy lives and to access the care that is right for them. Transgender youth and their families must be trusted to make these private medical decisions with their doctors — without being attacked by politicians who want to control their bodies, their families, and their lives.