Supreme Court upholds state bans on transgender care for minors

In a decision that plunged the Supreme Court into yet another culture war feud, the justices on Wednesday upheld a Tennessee law banning all gender affirming care for minors. In the last few years, fully half the states have adopted similar bans, leaving the other half, so far, allowing gender affirming care in the form of at minimum, hormone treatments prior to a teenager turning 18.

The vote was 6-to-3, along conservative/liberal lines.

Supporters of the bill were predictably elated over the win. As state Sen. Jack Johnson, the sponsor of the bill, put it in an interview with NPR late last year, the state bars minors from getting tattoos, smoking or drinking, and, as he observed, "We regulate a number of different types of [medical] procedures, and we felt like this was the best public policy to prevent kids from suffering from irreversible consequences, things that cannot be undone."

The court fight over access to puberty blockers and other treatments for gender dysphoria was brought by three teenagers and their parents in Tennessee. They claimed that the ban on these treatments violated the constitutional guarantee to equal protection of the law by barring certain treatments only for kids who want to transition from their sex assigned at birth, while at the same time allowing the same medications to treat minors suffering from other conditions, everything from endometriosis to delaying the early onset of puberty.

The ACLU, which represented the challengers in the case, countered that the treatments that were at issue in Wednesday's case were endorsed as appropriate for teenagers by the major medical associations that deal with gender dysphoria, including the American Medical Association, the American Academy of Pediatrics, the American Association of Clinical Endocrinology, and the American Psychological Association.

But state Sen. Johnson points out that many countries in Western Europe have been dealing with this issue for much longer than the United States, and many of them in recent years have pulled back "because they're seeing that the adverse effects of some of these medications far outweigh any benefit they have."

Wednesday's Supreme Court decision was a big win for Tennessee and 24 other states, but there are many questions that remain unanswered. Can doctors continue previous treatments if taking kids off the medications is deemed too risky? And what about all the issues that have roiled institutions ranging from school boards to team sports? None of those has been resolved, so far anyway. Nor has the court yet tackled the question of parental rights to determine treatments for their kids.

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