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WARNINGS OF ‘UNTOLD HARM’ AFTER US SUPREME COURT RULES AGAINST
TRANS YOUTH
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Brett Wilkins
June 18, 2025
Common Dreams
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_ Dissenting Justice Sonia Sotomayor wrote that "there is no
constitutional justification" for the decision, and access to
gender-affirming care "can be a question of life or death." _
LGBTQ activists and supporters hold a rally outside the U.S. Supreme
Court., Photo by Jonathan Ernst/REUTERS
LGBTQ+ advocates decried Wednesday's U.S. Supreme Court decision
upholding Tennessee's prohibition on gender-affirming medical
treatments for minors as a dangerous green light for states to violate
personal privacy and ban healthcare that many transgender people say
saved their lives.
Writing for the 6-3 majority in _U.S. v. Skrmetti
[[link removed]]_, Chief
Justice John Roberts stated that S.B. 1
[[link removed]],
Tennessee's 2023 ban on gender-affirming care for people under age 18,
does not violate the equal protection clause of the 14th Amendment.
The majority concurred with a lower court's ruling that S.B. 1 is not
subject to heightened scrutiny
[[link removed]], a standard of
judicial review also known as intermediate scrutiny used to determine
a law's constitutionality, especially in cases involving
classifications based on sex or gender.
"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," Roberts wrote. "The voices in these
debates raise sincere concerns; the implications for all are profound.
The equal protection clause does not resolve these disagreements. Nor
does it afford us license to decide them as we see best."
"Our role is not 'to judge the wisdom, fairness, or logic' of the law
before us... but only to ensure that it does not violate the equal
protection guarantee of the 14th Amendment," the ruling adds. "Having
concluded it does not, we leave questions regarding its policy to the
people, their elected representatives, and the democratic process."
Roberts was joined in the majority by right-wing Justices Clarence
Thomas [[link removed]], Samuel
Alito, Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett. Liberal
Justices Sonia Sotomayor, Elena Kagan, and Ketanji Brown Jackson
dissented.
Sotomayor wrote in her dissent that "there is no constitutional
justification" for the decision, which "does irrevocable damage to the
equal protection clause and invites legislatures to engage in
discrimination by hiding blatant sex classifications in plain sight.
It also authorizes, without second thought, untold harm to transgender
children and the parents and families who love them."
She continued:
Transgender adolescents' access to hormones and puberty blockers... is
not a matter of mere cosmetic preference. To the contrary, access to
care can be a question of life or death. Some transgender adolescents
suffer from gender dysphoria, a medical condition characterized by
clinically significant and persistent distress resulting from
incongruence between a person's gender identity and sex identified at
birth. If left untreated, gender dysphoria can lead to severe anxiety,
depression, eating disorders, substance abuse, self-harm, and
suicidality. Suicide, in particular, is a major concern for parents of
transgender teenagers, as the lifetime prevalence of suicide attempts
among transgender individuals may be as high as 40%. Tragically,
studies suggest that as many as one-third of transgender high school
students attempt suicide in any given year.
S.B. 1—introduced by Tennessee state Sen. Jack Johnson (R-23)—who
was also behind the state's public drag ban
[[link removed]]—prohibits
[[link removed]]minors from
undergoing hormone therapy or taking prescribed puberty blockers.
Three transgender teens and their parents, as well as a Tennessee
doctor who treats trans youth, challenged the law, claiming it
violated the equal protection clause.
The plaintiffs were joined by the Biden administration along with the
national and state ACLU, Lambda Legal, and the law firm Akin Gump
Strauss Hauer & Feld LLP in asking
[[link removed]] the
Supreme Court to review the ban after the 6th U.S. Circuit Court of
Appeals upheld
[[link removed]] it
in September 2023.
Responding to Wednesday's ruling, Allison Scott of the Campaign for
Southern Equality—which manages the Trans Youth Emergency Project
[[link removed]] (TYEP)—said: "I am heartbroken
today. No one should be forced to leave their home state to access
healthcare—and it is outrageous to see the U.S. Supreme Court uphold
these bans and continue to allow the government to interfere with the
personal medical decisions of families."
Scott was alluding to the argument often made by proponents of bans on
not only trans healthcare but also abortion and other reproductive
rights that people seeking such care are free to go where it is
legal—even as some states pass laws banning
[[link removed]] such
travel.
There are approximately 300,000 people aged 13-17 and 1.3 million
adults in the United States who identify as transgender, according to
[[link removed]] the
Williams Institute at the University of California, Los Angeles School
of Law, which notes that more than two dozen states have passed laws
similar to S.B. 1.
(Image: Human Rights Campaign Foundation)
Transgender activist Alejandra Caraballo, a civil rights attorney and
instructor at the Harvard Law School Cyberlaw Clinic, said
[[link removed]] on the
social media site Bluesky, "I can't begin to tell you just how
incredibly fucked trans people are here."
"This will pour gasoline on the Trump administration's attacks on
trans people and they will get even harsher and more cruel," Caraballo
added. "The Supreme Court is green-lighting the eradication of trans
people from society."
Caraballo and others including the ACLU and trans rights activist Erin
Reed noted [[link removed]] that the
decision is somewhat limited because it leaves previous rulings
[[link removed]] against
anti-trans laws intact. However, Caraballo warned that "while the
decision didn't explicitly say heightened scrutiny doesn't apply to
all contexts involving trans people, it held that it was on the basis
of medical diagnosis."
Therefore, "the government could just do whatever it wants to trans
people based on gender dysphoria," she wrote. "For instance, they
could strip everyone with gender dysphoria of security clearance in
the government. Declare everyone with gender dysphoria a national
security threat and purge them from the government entirely. The trans
military ban will be upheld under this."
"Most importantly, states can now just ban gender-affirming care for
everyone, including adults," Caraballo added. "We'll likely see that
coming soon in addition to federal government efforts to eliminate
access for all trans people."will pour gasoline on the Trump
administration's attacks on trans people."
U.S. President Donald Trump
[[link removed]] has renewed and
expanded his first-term attacks on transgender people, including by
issuing a day one executive order
[[link removed]] declaring
that only two genders exist, another order
[[link removed]] advocating
action against educators who "facilitate the social transition of a
minor," and yet another directing the Department of Education—which
he has vowed to abolish—to notify school districts that allowing
transgender girls and women to compete on female teams violates Title
IX, the federal law prohibiting discrimination on the basis of sex in
education.
Trump also appointed a transphobe
[[link removed]] to head the
Justice Department's civil rights office, ordered the removal
transgender people and issues from federal agency websites,
and reinstated
[[link removed]] his
first-term ban on new military enlistment by trans people,
who—according to the White House—cannot lead an "honorable,
truthful, and disciplined lifestyle."
"Every day I speak with families of transgender youth who are worried
about the future," TYEP patient navigator Van Bailey said after
Wednesday's ruling. "Many are panicking, unsure of where or when
they'll get the medicine that their child needs to continue leading a
healthy, happy life. These laws are cruelly thrusting families into
impossible choices, and it is deeply unfair."
ACLU LGBTQ & HIV Project co-director Chase Strangio—the first openly
trans attorney to argue before the Supreme Court—said
[[link removed]] that
"today's ruling is a devastating loss for transgender people, our
families, and everyone who cares about the Constitution."
However, Strangio also noted that "the court left undisturbed Supreme
Court and lower court precedent that other examples of discrimination
against transgender people are unlawful."
"We are as determined as ever to fight for the dignity and equality of
every transgender person and we will continue to do so with defiant
strength, a restless resolve, and a lasting commitment to our
families, our communities, and the freedom we all deserve," he added.
Jennifer Levi, senior director of transgender and queer rights at GLAD
Law, said in a statement
[[link removed]] that
"the court today failed to do its job."
"When the political system breaks down and legislatures bow to popular
hostility, the judiciary must be the Constitution's backbone," Levi
added. "Instead, it chose to look away, abandoning both vulnerable
children and the parents who love them. No parent should be forced to
watch their child suffer while proven medical care sits beyond their
reach because of politics."
National Center for LGBTQ Rights legal director Shannon Minter
asserted: "The court's ruling abandons transgender youth and their
families to political attacks. It ignored clear discrimination and
disregarded its own legal precedent by letting lawmakers target young
people for being transgender."
"Healthcare decisions belong with families, not politicians," Minter
added. "This decision will cause real harm."
Sasha Buchert, counsel and director of the Nonbinary and Transgender
Rights Project at Lambda Legal, called the ruling "heartbreaking" and
contended it will make it "more difficult for transgender youth to
escape the danger and trauma of being denied their ability to live and
thrive."
"But we will continue to fight fiercely to protect them," Buchert
added. "Make no mistake, gender-affirming care is often lifesaving
care, and all major medical associations have determined it to be
safe, appropriate, and effective. This is a sad day, and the
implications will reverberate for years and across the country, but it
does not shake our resolve to continue fighting."
Human Rights Campaign (HRC), Lambda Legal, and other advocacy
organizations are planning to hold a "decision day" rally
[[link removed]] at noon Wednesday outside
the Supreme Court in Washington, D.C.
HRC lamented that _Skrmetti_ "sets a dangerous precedent and
threatens access to care for trans people across the country."
"We are showing up loud and clear: We will not go back," HRC said. "We
will not be erased."
_Brett Wilkins is a staff writer for Common Dreams._
* Transgender Rights
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* Supreme Court Decision
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* Imminent Danger
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