Tennessee families, doctor ask Supreme Court to block state's gender-affirming health care ban

Three Tennessee families with transgender children and a doctor on Wednesday asked the Supreme Court to step in to prevent the state from enforcing a law that prevents transgender minors from accessing gender-affirming health care.

The case, if accepted, would be the first gender-affirming health care case to go before the Supreme Court.

The law, Senate Bill 1, prohibits health care providers from administering puberty blockers, hormones and surgeries to transgender youths under 18. Tennessee’s Republican Gov. Bill Lee signed the measure in March, alongside the nation’s first law restricting drag performances.

Legal advocates including Lambda Legal and the American Civil Liberties Union sued the state in April on behalf of two anonymous plaintiffs, parents Samantha and Brian Williams and Dr. Susan Lacy, a Memphis-based physician.

District Judge Eli Richardson temporarily blocked the measure from taking effect in June. He referenced preliminary injunctions issued by other courts in similar cases, writing in his opinion that “every court to consider preliminarily enjoining a ban on gender-affirming care for minors has found that such a ban is likely unconstitutional.”

Gender-affirming health care bans enacted in Florida, Montana and Indiana are currently blocked by court orders. In June, a federal judge struck down Arkansas’s first-in-the-nation ban, ruling it unconstitutional.

In July, however, a panel of the 6th Circuit Court of Appeals accepted a request by Tennessee’s attorney general to lift Richardson’s injunction, becoming the first federal court to allow a ban on gender-affirming health care to take effect. Six days later, the same court lifted an injunction on Kentucky’s ban.

Alabama in August became the third state to have its previously blocked gender-affirming health care ban reinstated when the 11th Circuit Court of Appeals lifted an injunction against its 2022 felony ban.

Attorneys for the plaintiffs in the Tennessee case wrote Wednesday that conflicting district court decisions are “creating chaos across the country for adolescents, families, and doctors.”

“Neither the wave of state bans on gender-affirming medication nor the lawsuits challenging them are likely to abate in the near future,” they wrote. “Given the division among the courts of appeals on the appropriate level of scrutiny in these and related cases, any delay in this Court’s review only risks subjecting transgender adolescents, their parents, and their doctors to a patchwork of inconsistent laws and legal standards that obstruct their medical care.”

The Supreme Court has so far been hesitant to intervene in transgender health care disputes, although two of the court’s leading conservatives — Justices Samuel Alito and Clarence Thomas — appear eager to wade into cases implicating transgender protections.

When the court in April declined to step in to enforce West Virginia’s transgender athlete ban, both justices publicly dissented. Alito wrote that the case concerned “an important issue that this Court is likely to be required to address in the near future.”

In June, hours after ruling in favor of a Christian web designer who refused to make same-sex wedding websites, the court let a lower court ruling stand that sided with a transgender woman deprived of her hormone treatment while incarcerated in Virginia in 2018.

Both Alito and Thomas dissented, writing that the decision “will raise a host of important and sensitive questions regarding such matters as participation in women’s and girls’ sports, access to single-sex restrooms and housing, the use of traditional pronouns, and the administration of sex reassignment therapy (both the performance of surgery and the administration of hormones) by physicians and at hospitals that object to such treatment on religious or moral grounds.”

The court in 2021 also declined to weigh in on a dispute over whether transgender students should be allowed to use school restrooms that are consistent with their gender identity. Alito and Thomas said they would have heard the case.