Transgender care argument pits Tennessee lawmakers against LGBTQ+ supporters

WASHINGTON — The scene outside the U.S. Supreme Court where the nation’s justices debated equal protection for transgender young people on Wednesday turned chaotic.

As hundreds of people rallied in support of transgender rights, dozens shouted at Tennessee lawmakers, and at least one called them “homophobes.”

The lawmakers who passed Senate Bill 1 in 2023 prohibiting puberty blockers and hormone therapy for minors appeared unfazed.

House Majority Leader William Lamberth said the state’s attorney, Matt Rice, did a “great job” of arguing that the law contains nothing that approaches sex discrimination. Lamberth, the Republican who sponsored the bill, said there is no need to remand the case back to the lower court where a ruling striking down the law was overturned.

“We simply prohibited experimental medical procedures on our children in Tennessee. That is something every single state has the right to do. If a different state wants to allow these type of barbaric practices on their children, they can certainly do that,” Lamberth said. 

Gender-affirming surgeries on minors are rare nationally. Vanderbilt University Medical Center in Tennessee halted such surgeries for people under 18 in October 2022. At the time, Deputy CEO and Chief Health System Officer Dr. C. Wright Pinson said the hospital’s Transgender Health Clinic performed an average of five annually for patients at least 16-years-old, and no genital surgeries.

Vanderbilt pauses gender affirmation surgeries on minors, says genital surgeries not performed

Outside the Supreme Court on Wednesday afternoon, Lamberth said he has met people who regretted undergoing gender affirming care as children, an argument considered by justices earlier in the day.

“We’re not going to let their lives be destroyed in Tennessee no matter what these crazy folks over here say,” Lamberth said.

A study published in JAMA Pediatrics showed “high levels of satisfaction” and little regret among young people who access nonsurgical gender affirming medical care. National research shows that less than 1% of people who undergo gender affirming surgery report regret.

Chase Strangio, co-director of the American Civil Liberty Union’s LGBTQ & HIV Project, became the first openly transgender person to argue a case in the U.S. Supreme Court Wednesday. He told a throng of rallygoers they would not give up if they lose the case, which could be decided in early summer next year.

“My heart — and the heart of every transgender advocate fighting this fight — is heavy with the weight of what these laws mean for people’s everyday lives,” Strangio said in a statement afterward. “But I also know that every out trans person has embraced the unknown in the name of living free from shame or the limits of other people’s expectations. By virtue of being a trans person, each of us has chosen hope over despair. And as all parents know, when your child is suffering, you are suffering.”

Tennessee Attorney General Jonathan Skrmetti said his office presented a “robust legal and evidence-based defense” of the law to the high court. 

“Our arguments were ultimately about constitutional clarity and common sense,” Skrmetti said. “Our founders guaranteed states the right and responsibility to protect children, regulate the medical profession, and independently evaluate the evidence of the risks and benefits of practices to be regulated.”

Skrmetti called on the Supreme Court in a brief to expand its Dobbs v. Jackson Women’s Health Organization ruling that ended nearly 50 years of federal abortion rights protections, and to allow states to ban gender affirming care for minors.

Karen Loewy of Lambda Legal said the plaintiffs’ attorney made a strong argument about the harm Tennessee’s law against transgender health care will cause tens of thousands of young people.

“No court should be allowed to disregard the overwhelming evidence supporting both the safety and efficacy of this health care for transgender youth simply because a state legislature passed a mean-spirited bill,” Loewy said. “We look forward to this court understanding that a wholesale ban on treatments solely because they are prescribed to help transgender youth live as their authentic selves is discrimination, plain and simple.”