Democrats urge Supreme Court to strike down Tennessee gender-affirming care ban

More than 160 House and Senate Democrats on Tuesday called on the Supreme Court to protect access to gender-affirming health care for transgender minors by striking down a Tennessee law that bans treatment for youths younger than 18 when the justices review the law this fall. 

The Supreme Court in June agreed to review the constitutionality of Tennessee’s law, which transgender rights advocates and families have argued discriminates against transgender youths and infringes on the right of parents to make medical decisions on behalf of their children. 

The justices’ decision to hear the case marks the first time the high court will weigh in on the issue, setting the stage for a blockbuster showdown over transgender rights that is likely to impact laws passed in nearly half the nation banning transition-related care for transgender children and teens. 

Legal challenges mounted by transgender youths, their families and medical providers have been met with mixed results, and federal appeals courts have split over whether laws that ban gender-affirming care are constitutional. The Justice Department in a November filing said the Supreme Court’s intervention is “urgently needed,” arguing that conflicting court rulings have created “profound uncertainty” for transgender people. 

Democratic lawmakers in Tuesday’s brief pointed to a 2006 Supreme Court ruling in a case involving a state attorney general’s attempt to forbid physicians from prescribing certain medications for physician-assisted suicide. The court in that case ruled that Congress had rightly denied the attorney general’s “authority to make quintessentially medical judgments” and questioned whether political actors without medical expertise should insert themselves into medical decision-making. 

“The Court should afford the same skepticism to legislation banning a politically marginalized group from choosing to undergo certain treatments—particularly where a law has been passed in spite of the available science,” lawmakers wrote in Tuesday’s filing. “Every major medical association agrees that gender-affirming care—including hormone therapy—is safe, effective, and necessary to treat certain conditions.” 

“Yet despite knowing this, Tennessee has banned it,” 164 lawmakers wrote in the 27-page brief. “That puts the government exactly where it should hesitate to be: between a patient seeking critical care and the health care providers seeking to treat that patient.” 

Twenty-four Republican-led states since 2021 have passed laws that heavily restrict or ban access to gender-affirming care for transgender minors, though several of those laws are blocked by federal court orders. 

“Decisions about healthcare belong to patients, their doctors, and their families—not politicians,” said Rep. Mark Pocan (D-Wis.), who led Tuesday’s brief with Democratic Reps. Jerry Nadler (N.Y.) and Frank Pallone (N.J.) and Sens. Ed Markey (Mass.) and Jeff Merkley (Ore.), in a statement.

“The law at issue in this case is motivated by an animus towards the trans community and is part of a cruel, coordinated attack on trans rights by anti-equality extremists,” said Pocan, chair of the Congressional Equality Caucus, which works to advance LGBTQ rights in Congress.

“We strongly urge the Supreme Court to uphold the Constitution’s promise of equal protection under the law and strike down Tennessee’s harmful ban,” Pocan said.