The Supreme Court made a bad decision this month. That decision is called the Skrmetti Decision . This decision hurts our community. We’re going to explain what the Skrmetti decision is, and why it is a problem.

The U.S. Supreme Court is the highest national court in the United States. It has the final say. Sometimes the courts below the Supreme Court cannot agree on a case. Then, the Supreme Court may look at that court case. All the other courts in the United States follow the Supreme Court’s decisions. A Supreme Court decision can change how laws are put into action. A Supreme Court decision can change how policies are put into action.

Sometimes, people disagree about what a national law means. Sometimes, people disagree about what the United States Constitution means. A big part of the Supreme Court’s job is to decide who is right.

United States v. Skrmetti was a case about gender-affirming care that the Supreme Court chose to take. The Supreme Court shared its decision in this case.

Gender-affirming care is a type of health care. Gender-affirming care helps people’ bodies look and feel like the gender they want to be seen as. Gender-affirming care can be called GAC for short. Politicians have made gender-affirming care seem scary. They try to say that it hurts children. This is not true. Doctors know GAC is a safe and needed kind of medical care. It is a normal treatment for many medical conditions. We will explain more about this in the next section.

United States v. Skrmetti was the case to decide if Tennessee’s law about GAC is legal. Tennessee's law bans GAC for anyone under 18. The Skrmetti decision from the Supreme Court said that Tennessee’s law is legal. The Supreme Court talked about their reason for the Skrmetti Decision. The Tennessee law bans all GAC for people under 18. The Decision says that GAC for people under 18 is not about sex or gender. That’s why the Supreme Court says Tennessee’s law doesn’t discriminate against anyone. Discrimination is when a group gets treated unfairly because of who they are. As long as the law doesn’t discriminate, the Supreme Court says the law is okay. But the Skrmetti decision does discriminate against transgender people. Someone who is transgender has a gender different than people thought when the person was born. Many transgender kids get gender-affirming care. Tennessee’s law was made to stop transgender kids from getting GAC.

Cisgender means that your gender is the same as what people thought at birth. Sometimes, cisgender kids need gender-affirming care too. For example, cisgender girls who go through early puberty may need puberty blockers [[link removed]] . If cisgender kids can get gender-affirming care, transgender kids should also be able to get it. Saying that one group can get a medical treatment, but another group cannot, is discrimination.

The Supreme Court is supposed to make decisions based on good legal arguments. In the Skrmetti decision, they did not do this. In other recent Supreme Court decisions, they did not do this. Instead, they make bad arguments that let them do whatever they want.

Autistic people are more likely to be transgender [[link removed]]. The Skrmetti decision lets states stop giving lifesaving health care to transgender youth. Many of them are part of the autistic community.

The Skrmetti decision means that doctors in Tennessee can’t give GAC to trans kids. There are also other laws in 24 different states [[link removed]] that ban GAC for children under 18. United States v. Skrmetti says that all these laws can keep being laws for now. It’s likely that more states will pass even more laws like this one. This will harm trans youth, including autistic, trans youth, and people who love them.

Gender-Affirming Care is Lifesaving
Bans on GAC force transgender kids to go to other states to get GAC. Many transgender kids might not get care at all. This is dangerous. Transgender youth who can’t get GAC are more likely to try suicide [[link removed]]. This is why every big medical group in the US [[link removed]] says GAC is life-saving for all trans people.

Autistic people deserve GAC
There are many transgender autistic people. People sometimes talk about autistic transgender people in ableist ways. They say autistic people can’t decide for themselves if they are transgender. People sometimes say this is a reason to ban GAC.

Autistic people have the right to make our own choices about our medical care. We deserve to get the information we need to make medical decisions. We deserve to get the healthcare we want and need.

Autistic people know when we are transgender. We know this the same way that not-autistic people do. Transgender and autistic youth also try suicide when they can’t get GAC. They need to be able to get GAC just like non-autistic transgender kids.

Everyone should make their own healthcare choices
The government makes many laws. Some of those laws kept disabled people from making our own decisions. These laws also stopped us from making important choices about our health care. The Skrmetti decision does the same thing. The Supreme Court decided that state governments should make medical decisions for transgender children instead of parents or caregivers.When people’s rights get taken away, it affects everyone. The Skrmetti decision makes it harder for trans autistic kids to get the medical care they need.

The Skrmetti Decision hurts communities who need the most help.
Bans on gender-affirming care affect all kinds of people. But they affect some people more than others. Bans on gender-affirming care will be hardest for youth in poor households. They might not be able to afford to go to a different state to get GAC. Disabled trans people and trans people of color are more likely to not have a lot of money. They might rely on Medicaid to get the things they need. And moving states while on Medicaid can be very hard. Moving states could make someone lose their Medicaid.

What can we do?
The fight to protect GAC is not over. There are other policy ways that advocates can end bans.

There are still states that allow GAC for minors. This ruling does not change the rules in those states.

You can advocate for transgender rights in your state. Your local LGBTQ+ center or ACLU chapter may know where you can start. You can also donate to groups who help trans people, like:

* Advocates 4 Transgender Equality [[link removed]]
* Transgender Law Center [[link removed]]
* Lambda Legal [[link removed]]
* The ACLU [[link removed]]

Conclusion & Crisis Support
To our transgender community members, we are here for you. You do not deserve to be treated like this by the government. You deserve to be treated equally everywhere. That means at school, at work, in family life, in public places, and by your government. You deserve to get the health care you need without having to fight for it. The problems our communities’ face are all connected, and we will keep working to solve them. ASAN will continue to fight for the rights of autistic transgender people until we all are free.

If you are in crisis or thinking about trying suicide, you can call or text Trans Lifeline [[link removed]] at (877) 565-8860.


Autistic Self Advocacy Network
PO Box 66122
Washington, DC 20035
United States
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