Christina Lee, Head Photography Editor

This Tuesday, the Yale Law School held a panel to discuss the United States Supreme Court case United States v. Skrmetti, involving the state of Tennessee’s blanket ban on gender-affirming care for transgender minors. 

The Yale Law School Solomon Center for Health Law and Policy held a panel on Tuesday with legal scholars and litigators from various backgrounds, giving a holistic view of the “legal landscape” surrounding United States v. Skrmetti. This panel mainly focused on the implications of the Court’s decision on this case for not only transgender youth, but also medical practice and sex-based discrimination. 

“It’s hard to see a path where the challengers lose this case, that there is another trans restriction that they can win,” said Michael Ulrich, professor of law at Boston University and former senior fellow in health law and lecturer at Yale Law School.

This case comes from Tennessee Senate Bill 1, a law enacted in March 2023 to ban gender-affirming medical care when provided to transgender adolescents, but not cisgender adolescents. The American Civil Liberties Union sued the state on behalf of parents of L.W., a transgender girl in Tennessee, and two other families with transgender children and a Memphis-based medical doctor. This case, then L.W. v. Skrmetti, was then argued in front of the U.S. 6th Circuit Court of Appeals, which upheld the ban in their decision. 

In June 2024, the Supreme Court announced that they would review the legal challenge of the 6th Circuit Court decision. SCOTUS has scheduled the oral arguments for this case for Dec. 4, 2024. 

United States v. Skrmetti will be argued by Chase Strangio, deputy director for transgender justice at the ACLU’s LGBTQ and HIV Project, who stated that “The future of countless transgender youth in this and future generations rests on this Court adhering to the facts, the Constitution, and its own modern precedent,” in a press release by the ACLU. 

The case will argue that the Tennessee law violates the Equal Protection Clause in the 14th Amendment because the law discriminates against transgender youth on the basis of sex. 

The panel hosted on Tuesday by the Solomon Center and other sponsoring organizations began to discuss what potential outcomes of the case could be once oral arguments are heard in early December.

According to Julie Veroff LAW ’15, one of the panelists and deputy solicitor general of the California Department of Justice, there are three potential outcomes of this case. 

“One option is that we get a decision affirming the 6th Circuit’s application of rational basis [a test determining whether a law violates the Equal Protection Clause], and the court can say that this bill does discriminate based on sex,” Veroff said.

Alternatively, Veroff explained that SCOTUS could also agree that there is discrimination based on sex and that it violates the Equal Protection Clause which would make the law unconstitutional and strike it down. The third option is that SCOTUS agrees that there is discrimination based on transgender status, but that that does not fit within the definition of discrimination based on sex, which would do significant damage to any future case regarding transgender rights. 

The panel then began to discuss the implications of the outcome of United States v. Skrmetti that reaches beyond solely transgender rights. 

“The court really can’t find against the transgender plaintiffs without doing violence to other aspects of Equal Protection doctrine,” Katie Eyer LAW ’04, professor of law at Rutgers Law School, said. “[This] would not just affect transgender folk, but would affect sex discrimination across the board.”

According to Ulrich, potentially the most dangerous implication of this court case has nothing to do with trans and LGBTQ+ rights at all. 

He instead highlighted the grave implications this could have on the practice of medicine. 

“This is a state that is saying, ‘here is this treatment that is available, that pretty much all medical associations support, but we don’t agree [so] we’re banning it because we think it is being harmful,’” Ulrich told the audience.

He explained that this would allow states to regulate which medical treatments the state does or does not agree with, regardless of what major medical organizations say about the benefits or risks of treatments. 

Gender-affirming care for minors, for example, is not a contentious treatment in the medical community. All major medical organizations, including the American Medical Association, the American Academy of Pediatrics and the American Psychiatric Association, support this treatment. 

Veroff stated that “this kind of categorical ban, where you can prevent an entire population from accessing care irrespective of any individual’s considerations contrary to the universal recommendation of major medical groups, that’s an unheard of kind of state regulation of the practice of medicine.”

Joshua Block, another panelist and senior staff attorney at the ACLU LGBT and HIV Project, has worked on transgender and LGBTQ+ rights and cases for more than a decade. He is also a member of the legal team arguing on behalf of the plaintiffs in United States v. Skrmetti. 

Following Veroff’s statement, he began to discuss how greatly things have changed in how both the public and medical professionals view and discuss gender-affirming care in his time working in the space. 

“With the assistance of people in the media, there has been a type of laser focus on this one type of medicine, completely decontextualizing how the same sort of risks and benefits play out across the medical field. One of the struggles, in this case, is that sure, there are risks and benefits, but that is true for all types of medicine,” Block said.

Therefore, the panel made it clear that gender-affirming care is not unique in terms of medical treatment. Hormone therapy, one of the key treatments used and scrutinized in gender-affirming care, is actually more commonly used by cis-gendered people for a variety of medical conditions, including cancer treatment. 

The panel closed by highlighting once again to the audience that the implications of the SCOTUS decision on United States v. Skrmetti will be vast, with far-reaching consequences if the decision affirms the 6th Circuit and upholds the Tennessee ban. 

The Solomon Center for Health Law and Policy at Yale Law School is the first of its kind to focus on the intersection of law and the governance, practice and business of healthcare.