United States v. Skrmetti

United States v. Skrmetti
Supreme Court of the United States
Argued December 4, 2024
Full case nameUnited States of America v. Jonathan Thomas Skrmetti, Attorney General and Reporter for Tennessee, et al.
Docket no.23-477
ArgumentOral argument
Case history
Prior
  • Preliminary injunction granted in part and denied in part, L.W. v. Skrmetti, 679 F. Supp. 3d 668 (M.D. Tenn. 2023)
  • Preliminary injunction stayed, L.W. v. Skrmetti, 73 F.4th 408 (6th Cir. 2023)
  • Reversed and remanded, L.W. v. Skrmetti, 83 F.4th 460 (6th Cir. 2023)
Questions presented
Whether Tennessee Senate Bill 1 (SB1), which 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," Tenn. Code Ann. § 68-33-103(a)(1),[1] violates the Equal Protection Clause of the Fourteenth Amendment.
Court membership
Chief Justice
John Roberts
Associate Justices
Clarence Thomas · Samuel Alito
Sonia Sotomayor · Elena Kagan
Neil Gorsuch · Brett Kavanaugh
Amy Coney Barrett · Ketanji Brown Jackson

United States v. Skrmetti (Docket No. 23-477) is a pending United States Supreme Court case on whether bans on transgender medical procedures (including puberty blockers and hormone therapy) for minors under the age of 18 violate the Equal Protection Clause of the Fourteenth Amendment to the United States Constitution.[2]

Background

Main article: 2020s anti-LGBTQ movement in the United States

As a result of the culture war in the United States since the mid-2010s, transgender rights in the United States have come under attack from conservative groups including the Republican Party and evangelicals. Since 2020, many states with Republican-led legislatures introduced bathroom bills and bills to limit transgender schoolchildren from participating in sports, and while many were defeated or challenged legally, there was public support for these bills in those states, leading the Republicans to further their efforts to limit transgender rights as part of their platform as to draw in support from religious groups.[3][4]

Every major medical association in the United States has opposed these bans.[5] In June 2023 the Endocrine Society released a statement opposing such bans whose signatories included the American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American Urological Association, American Society for Reproductive Medicine, American College of Physicians, American Association of Clinical Endocrinology, and the American Medical Association (AMA).[6]

On March 22, 2023, the Tennessee House of Representatives passed HB1 amending the Tennessee Code prohibiting certain forms of gender-affirming care for transgender minors with a diagnosis of gender dysphoria.[7] This includes puberty blockers, hormone therapy, and surgeries (though the ban on the latter is not at issue in the case).[8] The bill does not restrain the use of puberty blockers and hormones for other medical purposes such as the treatment of precocious puberty.[8] As of December 2024, 23 other states had similar laws in place which could be affected by the Supreme Court's decision in this case (see List of legislation restricting transgender youth health care in the United States).[8]

Upon passage of the law, the Biden Department of Justice sought an injunction in the US District Court for the Middle District of Tennessee to prevent the law from going into effect on July 1, 2023.[9]

The District Court granted a preliminary injunction, preventing the ban on hormones and puberty blockers from going into effect. The court deemed the state ban as infringing on the "fundamental rights" of parents, while allowing for the ban on gender affirming surgery to remain.[10]

Plaintiffs

The suit was brought by three transgender teens and their families as well as a Tennessee doctor who treats youth with gender dysphoria.[8][11] The Biden administration joined the plaintiffs under a law which allows the federal government to join in private suits which allege violations of the Equal Protection Clause.[8] Among the plaintiffs is a 16-year old girl, identified only as "L.W.", and her parents, Brian and Samantha Williams, of Nashville, Tennessee.[12] L.W. is a recipient of gender-affirming hormone therapy, which she says has greatly improved her quality of life, describing the gender dysphoria she experienced before treatment as "real-life body horror",[13] and saying that her treatment allows her to "feel normal."[12][13] The Tennessee state ban forces the Williams family to travel out-of-state for L.W.'s hormone treatments.[12][13][14] Biden administration Solicitor General Elizabeth Prelogar has advocated for the plaintiff's right to be a girl in Tennessee.[15] Samantha Williams criticized the "hypocrisy" of Tennessee lawmakers, who championed "parental rights" with regards to COVID-19, only to infringe on those rights via HB1, saying, "They made this medical decision for our child."[14]

Sixth Circuit

The District Court's ruling was appealed to the US Court of Appeals for the Sixth Circuit. In a 2–1 decision in July 2023, the Sixth Circuit stayed the lower court's decision to grant a preliminary injunction, applying rational basis review.[11] Chief Judge Jeffrey Sutton wrote that the Tennessee state government was likely to succeed upon their appeal and that the right of parents to control the medical care of their children is not a fundamental right because it is not "deeply rooted in this Nation's history and tradition," a standard set by the Supreme Court in Washington v. Glucksberg (1997).[16] Judge Helene White concurred in part and dissented in part, arguing that the Tennessee law is "likely unconstitutional based on the Plaintiffs’ theory of sex discrimination" and that she would not stay the injunction but rather narrow its scope. However, she agreed that the "District Court abused its discretion in granting a statewide preliminary injunction."[16]

By a 2–1 vote in September 2023, the Sixth Circuit panel reversed the district court's preliminary injunction, with Sutton again writing for the majority and White again dissenting.[17]

The government advances two lines of argument by which Tennessee's HB1 violates the Equal Protection Clause of the Fourteenth Amendment: that it discriminates by sex, and that it discriminates by transgender status, which the government contends is a "suspect" (or "quasi-suspect") classification. Either of these forms of discrimination would trigger a heightened scrutiny standard of review which, the government argues, the law would not survive.[11][8] Gender discrimination has a lower standard of review than racial discrmination: namely, intermediate scrutiny since Craig v. Boren (1976).

A separate due process argument was raised before the lower courts but the Supreme Court declined to consider it.[11][8]

Sex discrimination

The government argues that the Tennessee law engages in facial sex discrimination. Because the law allows the use of puberty blockers and hormones for reasons unrelated to transition, the government argues, a patient's sex becomes a determining factor in deciding whether these treatments are permissible; for example, a male adolescent would be permitted to take testosterone as a treatment for delayed puberty, but the same medication would be disallowed for a patient whose birth sex is female (taking it for the purposes of inducing physical changes consistent with a masculine or nonbinary gender identity).[11][18] The government and families also pointed to the Supreme Court's decision in Bostock v. Clayton County (2020), which upheld that both sexual orientation and gender identity are protected classed covered by anti-discrimination laws under Title VII of the Civil Rights Act of 1964.[19]

Tennessee denies that the law draws classifications based on sex, arguing that it instead draws a distinction according to the purposes for which a treatment is given, distinguishing between "minors seeking drugs for gender transition and minors seeking drugs for other medical purposes".[11]

Discrimination on transgender status

The government further argues that the bill also warrants heightened scrutiny because it discriminates against transgender individuals who, the government argues, constitute at least a quasi-suspect class. In identifying whether a group constitutes a suspect or quasi-suspect class, the courts look to four criteria:

  • The group has historically been discriminated against or have been subject to prejudice, hostility, or stigma.
  • They possess an immutable or highly visible trait.
  • They lack political power.
  • The group's distinguishing characteristic does not inhibit it from contributing meaningfully to society.

The government argues that transgender people as a group meet all four criteria.[20]

Tennessee denies that the bill discriminates on transgender status, arguing again that it distinguishes only different medical uses, and pointing out that, for example, a transgender youth would be permitted to use puberty blockers for purposes unrelated to gender transition (such as to treat precocious puberty).[21] The state further argues that even if the bill were considered to discriminate on transgender status, the court should not "get back in the fraught business of creating suspect classes".[11][21]

Legal experts consider it very unlikely that the court will accept the government's argument in identifying transgender people as a quasi-suspect class, given that it has been decades since the court identified a new class as suspect or quasi-suspect.[18]

Supreme Court

On November 6, 2023, the United States petitioned the Supreme Court to hear this case on appeal.[20][22] The Supreme Court granted certiorari on June 24, 2024.[23] Whereas the government's petition alleged a violation of the Equal Protection Clause, the plaintiffs filed a separate petition for certiorari, which the court did not grant, which additionally presented the theory that the bill violated the Due Process Clause by denying parents the right to make medical decisions for their children.[11][8]

Amicus briefs

On November 21, 2024, it was discovered that four of the doctors that were testifying in favor of Tennessee's ban, namely Paul Hruz, Michael Laidlaw, James Cantor, and Stephen B. Levine, had previously been reprimanded by various courts across the country as "conspiratorial, deeply biased, far off and deserving very little weight", three of them had never provided healthcare to transgender youth, and who LGBTQ+ advocates and trans healthcare experts say repeatedly peddle misinformation about transgender health care.[24][25] Additionally, an analysis of the amicus briefs by SPLC found that 19% of them had been filed by designated anti-LGBTQ+ hate groups and another 10% had been filed by "groups and individuals associated with a network of anti-LGBTQ+ pseudoscience purveyors.[26]

Oral arguments

Oral arguments were heard on December 4, 2024.[27][28] James Matthew Rice, Tennessee's Solicitor General, argued for the Respondents.[29] Prelogar represented the government,[30] and was joined by ACLU attorney Chase Strangio who argued for the private plaintiffs. Strangio is the first known transgender person to make oral arguments before the Supreme Court of the United States.[31][32][33]

From their lines of questioning, court observers opined that Justices Elena Kagan, Sonia Sotomayor and Ketanji Brown Jackson appeared to favor the arguments made by the plaintiffs whereas Justices Clarence Thomas, Samuel Alito, Brett Kavanaugh and John Roberts appeared to favor the arguments made by Tennessee. The putative tacks of Justices Amy Coney Barrett and Neil Gorsuch, were unclear; Gorsuch, who had written the majority opinion in Bostock, did not ask any questions during the session.[34][35] Barrett was described as seeming sympathetic to Tennessee's position, though was acknowledged as having been less direct in her questioning than Roberts, Thomas, Alito and Kavanaugh.[36]

Several of the conservative justices during the arguments signaled an openness to creating a carveout from sex discrimination protections, under which such discrimination via government authority would be constitutional in a medical context.[34]

Prognostication

In November 2024, the Yale Law School hosted a panel to discuss the medical and legal connotations of the case.[37] Legal experts predict that, should the Supreme Court uphold Tennessee's law, access to many other forms of healthcare for both children and adults could also be impacted including gender-affirming care for adults and abortion access.[38][37][39][40][41][42][43][44][45]

Legal experts expect that after Donald Trump is sworn in as president, his second administration will direct his Department of Justice to reverse their stance on the case and withdraw the government's request for the Supreme Court to hear the case.[46][24] Experts predict that with oral arguments having already taken place by then, this should have little impact on the case. The Supreme Court could decide to hold another hearing for the case, however.[47]

References

  1. ^ "Section 68-33-103 - Prohibitions, Tenn. Code § 68-33-103 | Casetext Search + Citator". casetext.com.
  2. ^ Howe, Amy (June 24, 2024). "Supreme Court takes up challenge to ban on gender-affirming care". SCOTUSblog. Retrieved June 24, 2024.
  3. ^ Burke, Kelsy; Kazyak, Emily (November 8, 2022). "Americans' support for transgender rights has declined. Here's why". The Washington Post. Retrieved November 6, 2024.
  4. ^ Sosin, Kate (May 20, 2022). "Why is the GOP escalating attacks on trans rights? Experts say the goal is to make sure evangelicals vote". PBS Newshour. Retrieved December 6, 2024.
  5. ^ Stern, Mark Joseph (December 3, 2024). "The Hidden Danger of the Supreme Court's New Trans Rights Case". Slate. ISSN 1091-2339. Retrieved December 13, 2024.
  6. ^ "AMA strengthens its policy on protecting access to gender-affirming care" (Press release). Endocrine Society. June 12, 2023.
  7. ^ "Tennessee SB0001 | 2023-2024 | 113th General Assembly". LegiScan. Retrieved June 24, 2024.
  8. ^ a b c d e f g h Howe, Amy (December 3, 2024). "Supreme Court to hear challenge to ban on transgender health care for minors". SCOTUSblog.
  9. ^ "Justice Department Challenges Tennessee Law that Bans Critical, Medically Necessary Care for Transgender Youth" (Press release). United States Department of Justice. April 26, 2023. Retrieved June 24, 2024.
  10. ^ L. W. v. Skrmetti, 3:23-cv-00376 (M.D. Tenn. June 28, 2023).
  11. ^ a b c d e f g h Schwinn, Steven D. (December 4, 2024). "United States v. Skrmetti". American Bar Association.
  12. ^ a b c "Landmark Supreme Court case weighs gender-affirming care for trans kids". ABC News. December 4, 2024. Retrieved December 4, 2024.
  13. ^ a b c "US v. Skrmetti: Trans Teens Like L.W. Just Want to Have a Normal Childhood". Retrieved December 4, 2024.
  14. ^ a b "Trans teen pleads with SCOTUS to strike down Tennessee's gender-affirming care ban ahead of landmark hearing". December 2, 2024. Retrieved December 5, 2024.
  15. ^ "Highlights from the Supreme Court's hearing on health care ban for transgender minors". Associated Press. Retrieved December 5, 2024.
  16. ^ a b "L. W. v. Skrmetti, No. 23-5600 (6th Cir. 2023)". Justia Law. Retrieved June 24, 2024.
  17. ^ L.W. v. Skrmetti, 83 F.4d 460 (6th Cir. 2023).
  18. ^ a b Liptak, Adam (December 4, 2024). "What is 'heightened scrutiny,' and why does it matter?". New York Times.
  19. ^ Howe, Amy (December 3, 2024). "Supreme Court to hear challenge to ban on transgender health care for minors". SCOTUSblog. Retrieved December 7, 2024.
  20. ^ a b "Petition for Writ of Certiorari in the case United States v. Skrmetti" (PDF). Supreme Court of the United States. November 2023.
  21. ^ a b Skrmetti, Jonathan Thomas (October 8, 2024). "Brief for Respondents" (PDF).
  22. ^ "United States v. Skrmetti". SCOTUSblog.
  23. ^ Sherman, Mark (June 24, 2024). "Supreme Court will take up state bans on gender-affirming care for minors". AP News. Retrieved June 24, 2024.
  24. ^ a b Levin, Sam (November 21, 2024). "Revealed: trans rights case at US supreme court features doctors previously discredited by judges". The Guardian.
  25. ^ Riedel, Samantha (November 22, 2024). "Slew of Discredited, Anti-Trans Doctors to Testify In Upcoming SCOTUS Case on Trans Health Care". Them.us.
  26. ^ "Anti-LGBTQ+ hate groups support Supreme Court case to ban gender-affirming care". SPLC. October 30, 2024.
  27. ^ "Supreme Court skeptical of challenge to Tennessee ban on transgender youth treatments". NBC News. December 4, 2024.
  28. ^ Greve, Joan E. (December 4, 2024). "US supreme court hears arguments in pivotal trans youth healthcare case". The Guardian. Retrieved December 4, 2024.
  29. ^ "Ex-Baseball Minor Leaguer Makes SCOTUS Debut in Transgender Case". December 2, 2024.
  30. ^ Walsh, Mark (December 4, 2024). "Inside the Supreme Court arguments on transgender care". SCOTUSblog.
  31. ^ Bailey, Chelsea (December 1, 2024). "He's set to be the first known transgender lawyer to argue before Supreme Court. For Chase Strangio, the mission 'is not lost on me'". CNN. Retrieved December 4, 2024.
  32. ^ Groppe, Maureen. "Transgender lawyer makes history, takes case on puberty blockers and hormone therapy to Supreme Court". USA TODAY.
  33. ^ Stein, Chris (December 4, 2024). "Supreme court begins hearing major case on trans youth healthcare ban – live". The Guardian. Retrieved December 4, 2024.
  34. ^ a b "The horrifying implications of today's Supreme Court argument on trans rights". December 4, 2024.
  35. ^ Wheeler, Lydia (December 4, 2024). "Gorsuch Stays Quiet at High Court Transgender Rights Argument". Bloomberg Law. Retrieved December 7, 2024.
  36. ^ Milhiser, Ian. "The horrifying implications of today's Supreme Court argument on trans rights". Vox. Voxdotcom. Retrieved December 14, 2024.
  37. ^ a b Lokanadham, Rohan (November 18, 2024). "Law School hosts panel on how United States v. Skrmetti puts transgender healthcare on the line". Yale News Daily.
  38. ^ Rummler, Orion (October 31, 2024). "How the Supreme Court case on trans youth could affect health care for all Americans". The 19th.
  39. ^ Carmon, Irin (November 27, 2024). "The Trans-Rights Showdown at the Supreme Court". New York Magazine.
  40. ^ Rummler, Orion (October 31, 2024). "Why This Supreme Court Case on Trans Health Care Is "Really Dangerous" for All Americans". Them.us.
  41. ^ Riga, Kate (November 29, 2024). "The Supreme Court Gets Its Shot At Trans Kids As The Right Ramps Up Attacks". Talking Points Memo.
  42. ^ Ring, Trudy (November 22, 2024). "What is U.S. v. Skrmetti, the Supreme Court case that could change gender-affirming care forever?". The Advocate.
  43. ^ "A new Supreme Court case threatens to gut the Court's one good trans rights decision". Vox Media. July 26, 2024.
  44. ^ "How a Supreme Court decision on health care bans for transgender youth could impact trans people nationwide". CNN. December 3, 2024.
  45. ^ "Supreme Court to Hear Case about Bans on Gender-Affirming Care for Transgender Youth on Wednesday". Boston University. December 3, 2024.
  46. ^ Millhiser, Ian (November 15, 2024). "A GOP Supreme Court will now decide the fate of transgender Americans". Vox.
  47. ^ Burga, Solcyré (December 2, 2024). "The Stakes of the Supreme Court's Major Trans Rights Case". Time.

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