Transgender Rights at SCOTUS: What’s at Stake for Bodily Autonomy in U.S. v. Skrmetti
Case could further embolden states to attack other privacy rights, including the right to birth control and more.
Bodily autonomy rights are back at the United States Supreme Court as it hears oral arguments December 4 in United States v. Skrmetti, a major case that will determine whether states may ban gender-affirming care for transgender minors. The stakes are high: the case has implications that go far beyond transgender health care, including for birth control, in vitro fertilization (IVF), and bodily autonomy at large.
At issue is Tennessee’s ban on gender-affirming care for young people, which took effect in July 2023. Families and health care providers challenged the law, which bans the use of hormone therapies and best practice surgical care for minors diagnosed with gender dysphoria. Importantly, the law does not ban these same treatments for non-transgender patients.
The question presented to the Supreme Court in Skrmetti is simple: whether Tennessee’s ban on gender-affirming care violates the Equal Protection Clause of the 14th Amendment.
The answer should be clear: prohibiting access to care based on the patient’s sex assigned at birth is sex discrimination under the 14th Amendment. That’s because the Equal Protection Clause prevents states from discriminating against people based on characteristics such as their race or sex—or targeting any group for hostile treatment.
Tennessee is also asking the Court to expand the application of its decision in the Dobbs case, which overturned Roe, eliminated the constitutional right to abortion, and weakened almost 50 years of precedent protecting bodily autonomy.
Although in Dobbs the Court expressly limited its decision to abortion, the Court could decide to apply the Dobbs reasoning to gender-affirming care. Such an expansion could further embolden states to attack some of our other most fundamental privacy rights—including the right to birth control, the right to intimacy, and the right to control our own bodies.
Oral Arguments: United States v. Skrmetti
Listen to the oral arguments presented at the U.S. Supreme Court on December 4 and view the transcript.
Gender-Affirming Care is Essential Health Care
Like abortion care, gender-affirming care is a human right and essential health care. Gender-affirming care has been endorsed as life-saving treatment by every major medical association in the United States, including the American Medical Association and the American Association of Pediatrics. Bans on gender-affirming care are not informed by research or medical expertise and instead perpetuate misinformation and instill fear about the safety of this form of health care—which has been used safely for decades.
For the past several years, these politically motivated attacks have begun eliminating access to essential health care for transgender youth, forcing thousands of families to travel across the country for this life-saving and life-affirming treatment. With 24 states already banning access to gender-affirming care for minors, and others poised to follow suit, the Supreme Court’s decision will undeniably impact hundreds of thousands of transgender youth.
Tactics Against Gender-Affirming Care Are Similar to Those Used Against Abortion Rights
The current attacks on gender-affirming care follow a familiar pattern. Like the attacks on abortion care that led to Dobbs, policymakers are chipping away at access to care state by state, targeting vulnerable communities first. History is repeating itself as extremist politicians target access to vital health care for minors.
Prior to Dobbs, anti-abortion advocates successfully limited abortion access for minors by passing a variety of parental involvement laws that severely hinder a minor’s ability to receive an abortion—a first step in a strategy to eventually ban abortion entirely. These same anti-abortion politicians are now attempting this strategy with gender-affirming care.
The Center for Reproductive Rights believes that government has no business telling people when and whether to have children, or whether they can access the life-saving and life-affirming health care they need. Everyone should have the freedom to feel safe, be treated equally, and be empowered to make decisions about their own health care without government interference. That’s the future the Center is fighting for.
Case Background: United States v. Skrmetti
The case was originally was brought by plaintiff families and health care providers in Tennessee and Kentucky, who sued their states for banning gender-affirming care for transgender minors. Those cases were later consolidated on appeal by the Sixth Circuit, which reversed the preliminary injunctions against the laws granted by the District Courts.
The United States then intervened and petitioned the U.S. Supreme Court to review the case.
