The United States Supreme Court recently heard United States v. Skrmetti, a case with monumental implications for transgender rights and anti-discrimination laws. This pivotal case centers on whether discrimination against transgender individuals violates the Constitution. Early indications suggest that a majority of justices may rule in favor of upholding bans on gender-affirming care, not just for minors but potentially for adults as well. This decision could fundamentally reshape anti-discrimination protections in the United States.
A Critical Moment for Trans Rights and Sex Discrimination Laws
At the heart of the case is a 2023 Tennessee law that bans gender-affirming care—such as puberty blockers and hormone therapy—for minors, explicitly aiming to “encourage minors to appreciate their sex.” This law draws a clear line based on sex assigned at birth: treatments permissible for one sex are prohibited for another.
The case raises critical questions about whether such laws violate the constitutional prohibition against sex-based discrimination. Historically, cases like United States v. Virginia (1996) have required that any law drawing distinctions based on sex must pass "heightened scrutiny," a rigorous legal test that presumes such laws to be unconstitutional unless the state can provide a compelling justification.
Yet, during oral arguments, several justices appeared ready to abandon this precedent. Chief Justice John Roberts proposed a carveout that could grant states greater leeway to impose sex-based restrictions in medical contexts, raising concerns about broader impacts on anti-discrimination laws.
The Court’s Divided Stance
While the Court’s three liberal justices—Sonia Sotomayor, Elena Kagan, and Ketanji Brown Jackson—vigorously defended traditional anti-discrimination principles, the six conservative justices largely signaled support for Tennessee’s position:
Chief Justice John Roberts suggested that medical issues require unique deference to state lawmakers, arguing that judges are ill-equipped to resolve “medical nuances.”
Justice Brett Kavanaugh echoed this sentiment, framing the case as a “medical and policy debate” outside the Constitution’s purview.
Justice Amy Coney Barrett expressed skepticism about applying heightened scrutiny in medical cases, questioning whether courts have historically done so.
Justices Clarence Thomas and Samuel Alito offered consistently hostile questioning to the lawyers defending transgender rights. One notable absence from the conversation was Justice Neil Gorsuch, who in 2020 authored the landmark Bostock v. Clayton County opinion affirming protections for LGBTQ workers. His silence leaves his stance uncertain.
Potential Ramifications Beyond Trans Rights
A ruling in favor of Tennessee would mark a significant departure from longstanding legal principles. It could undermine the precedent set by Virginia, which requires heightened scrutiny for all laws drawing sex-based distinctions. If the Court allows medical carveouts to this rule, it could pave the way for other exceptions—potentially weakening anti-discrimination protections for women, transgender individuals, and other marginalized groups.
Justice Jackson voiced alarm, warning that such carveouts could have far-reaching implications. She compared Tennessee’s arguments to those made in Loving v. Virginia (1967), where the Court struck down bans on interracial marriage, underscoring the dangers of eroding constitutional protections.
A Politicized Legal Landscape
The case comes amidst a politically charged environment, with anti-trans rhetoric becoming a centerpiece of Republican campaigns. President-elect Donald Trump’s recent campaign spent hundreds of millions of dollars portraying transgender people as societal threats, and the Supreme Court’s conservative majority seems aligned with this political agenda.
This alignment raises concerns about the Court’s impartiality in cases involving marginalized groups. While the liberal justices argue for a strict adherence to constitutional principles, the conservative majority’s willingness to consider carveouts suggests a shift toward prioritizing states’ rights and political ideology over individual protections.
What’s at Stake?
The Court is expected to deliver its decision in Skrmetti by June 2025. If the ruling upholds Tennessee’s law, it would not only restrict access to gender-affirming care but also weaken the broader framework of anti-discrimination laws.
Such a decision could embolden states to enact further restrictions on transgender rights and other forms of sex-based discrimination. Moreover, the legal reasoning used in this case could set a precedent for challenges to protections against race, gender, and other forms of discrimination.
The stakes in United States v. Skrmetti extend far beyond transgender rights. A ruling favoring Tennessee could signal a fundamental shift in how the Court interprets constitutional protections against discrimination. As Justice Jackson warned, the implications could unravel decades of progress in anti-discrimination law, threatening the rights of all individuals who rely on constitutional protections against unequal treatment.
This case demands close attention, as its outcome will shape the future of civil rights in the United States for generations to come.