The Supreme Court heard oral arguments Wednesday, Dec. 4, on a Tennessee law that bans the use of puberty blockers and hormone therapy for minors. The Tennessee law, known as SB1, states there is a compelling interest to protect children.
“These procedures can lead to the minor becoming irreversibly sterile, having increased risk of disease and illness, or suffering from adverse and sometimes fatal psychological consequences,” SB1 reads.
“Its application turns entirely on medical purpose, not a patient’s sex. That is not sex discrimination,” James Mathew Rice, Office of Tennessee Attorney General told the justices.
“Just as using morphine to manage pain differs from using it to assist suicide, using hormones and puberty blockers to address a physical condition is far different from using it to address psychological distress associated with one’s body,” Rice continued.
The American Civil Liberties Union (ACLU) and the Biden administration argued against the law’s categorical ban on children who identify differently than their birth sex.
“It doesn’t matter what parents decide is best for their children, it doesn’t matter what patients would choose for themselves, and it doesn’t matter if doctors believe this treatment is essential for individual patients,” U.S. Solicitor General Elizabeth Prelogar said.
This decision will impact transgender care nationwide because there are similar laws in 23 other states.
Justice Samuel Alito asked the ACLU attorney, who is transgender, about minors who transition and then change their mind.
“Are there not such people?” Alito asked.
“There are such people, I agree with that,” attorney Chase Strangio replied.
“So it’s not an immutable characteristic is it?”
“Well, I think people’s understanding of it shifts,” Strangio said. “I think the normative reason for that particular consideration is whether or not this is something that someone should or could change and whether they would have to change it in order to receive constitutional protections, and I think transgender status clearly fits within that.”
That was one of Tennessee’s main points: the changes to the body are permanent, but the child may one day seek to reverse them.
“They cannot eliminate the risk of detransitioners, so it becomes a pure exercise of weighing benefits versus risk,” Rice said. “And the question of how many minors have to have their bodies irreparably harmed for unproven benefits is one that is best left to the legislature.”
That’s when Justice Sonia Sotomayor jumped in.
“I’m sorry counselor, every medical treatment has a risk, even taking aspirin,” Sotomayor told Rice. “There’s always going to be a percentage of the population under any medical treatment that’s going to suffer a harm.”
Sotomayor said the case is really about sex-based differences. The law allows certain drugs to be used for children who have medical conditions like early puberty or delayed puberty but not those who want to change gender.
It could be months before the justices release a final decision, as they are still in the first half of their term, which won’t end until approximately June 2025.
