The U.S. Supreme Court on Monday agreed to decide whether a Tennessee law restricting puberty blockers and hormone therapy for children is unconstitutional, in a closely watched case that is almost certain to affect similar laws in Florida and more than a dozen other states.
Justices will hear the case in the fall, with a decision likely coming in June or July 2025.
The Biden administration in November filed a petition asking the court to consider whether the Tennessee law, which blocks doctors from ordering puberty blockers and hormone therapy for minors diagnosed with gender dysphoria, violates equal protection rights and is sex-based discrimination because the treatments are available for other purposes.
The “court’s intervention is urgently needed because Tennessee’s law is part of a wave of similar bans preventing transgender adolescents from obtaining medical care that they, their parents, and their doctors have all concluded is necessary,” U.S. Department of Justice lawyers wrote in the petition.
Monday’s decision to take up the case, known as United States v. Skrmetti, comes amid conflicting lower-court decisions over similar restrictions enacted in Republican-led states, including Florida.
U.S. District Judge Robert Hinkle this month ruled that a 2023 Florida law and regulations prohibiting the use of puberty blockers and hormone therapy to treat children for gender dysphoria and making it harder for trans adults to access care are unconstitutionally discriminatory and were motivated by “animus” toward transgender people.
Hinkle permanently barred Florida health officials from enforcing the law, which also carried heavy sanctions and potential jail time for doctors who violated the restrictions.
In a 101-page ruling, the judge wrote that “gender identity is real” and likened opposition to transgender people to racism and misogyny.
“The state of Florida can regulate as needed but cannot flatly deny transgender individuals safe and effective medical treatment — treatment with medications routinely provided to others with the state’s full approval so long as the purpose is not to support the patient’s transgender identity,” Hinkle’s June 11 ruling said.
Lawyers for the state last week asked the 11th U.S. Circuit Court of Appeals to put a hold on Hinkle’s ruling while Florida’s appeal plays out. A June 18 notice of appeal, as is common, did not detail arguments the state will make at the Atlanta-based appeals court. But the motion for a stay raised a series of arguments, including that putting the ruling on hold would prevent “irreparable harm” to the state and be in the “public interest.”
The state’s motion also pointed to debate about transgender treatment for minors at appellate courts in other parts of the country.
“At the very least, all must agree that the legal issues aren’t clearcut,” the motion said.
Shannon Minter, an attorney who represents plaintiffs in the Florida lawsuit, called the Supreme Court’s decision to rule on the issue a “huge victory.”
“They don’t take very many cases. It’s an indication of how important this issue is, and it should give hope to families across the country. Our nation’s highest court recognizes the significance of this issue. Now is our chance to let them hear from these families,” Minter, legal director for the National Center for Lesbian Rights, told The News Service of Florida in a phone interview.
The Florida lawsuit, filed last year by the parents of two children and a transgender man, almost certainly will be put on hold until the Supreme Court decides the Tennessee case, Minter predicted.
The Tennessee law, which focuses only on children, prohibits all medical treatments intended to allow “a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex” or to treat “purported discomfort or distress from a discordance between the minor’s sex and asserted identity.”
U.S. District Judge Eli Richardson, who was appointed to the bench by former President Donald Trump, last year blocked the part of the Tennessee law that banned puberty blockers or hormone therapy. Richardson found that the ban violates constitutional guarantees of equal protection for people in similar situations, because it prohibits treatment for transgender adolescents that would be allowed for other adolescents.
But a split 6th U.S. Circuit Court of Appeals reversed Richardson’s ruling and reinstated Tennessee’s law and a similar prohibition in Kentucky. Plaintiffs in both cases, which the appeals court consolidated, and the Biden administration asked the Supreme Court to take up the issue.
The Supreme Court’s review “will bring much-needed clarity to whether the Constitution contains special protections for gender identity,” Tennessee Attorney General Jonathan Skrmetti said in a prepared statement.
"We fought hard to defend Tennessee's law protecting kids from irreversible gender treatments and secured a thoughtful and well-reasoned opinion from the Sixth Circuit. I look forward to finishing the fight in the United States Supreme Court,” he said.
The court’s decision to consider the case immediately drew widespread attention. But the pending review also created divisions within the LGBTQ legal community, especially among people wary of the conservative-leaning court.
Alejandra Caraballo, a transgender attorney who teaches at the Harvard Law School Cyberlaw Clinic, posted on X, that she thinks asking the Supreme Court to take up the issue “will turn out to be a generationally bad strategic mistake akin to Bowers v Hardwick,” referring to a 1986 Supreme Court ruling that said sodomy is not a constitutionally protected right and allowed states to outlaw it.
But Minter, who also represents plaintiffs in Kentucky’s lawsuit, said the issue is urgent and needs to be settled.
“We can’t let these incredibly harmful laws stay on the books, so really there’s no choice about the timing,” Minter told the News Service. “These laws are so damaging, so extreme, we have to challenge them and we’re doing so all across the country, generally with a lot of success, and when those victories are reversed by these appellate courts, we have to seek review.”
Minter also pointed to a 2020 decision by the Supreme Court in a case known as Bostock v. Clayton County establishing that discrimination against LGBTQ workers is unconstitutional.
“I am extremely optimistic about our chances in the Supreme Court. Yes, it is a conservative court. They have done many alarming things. At the same time, this is essentially the same court that decided the Bostock case very recently, and Bostock recognized that discrimination because a person is transgender is sex discrimination, and that is the main issue in this case,” he said.
