Credit: Unsplash/CC0 Public Domain

US Supreme Court justices clashed Wednesday over gender-affirming medical treatments for transgender minors—an issue at the heart of the culture wars that have become a dominant feature of American political life.

At least four and possibly five of the conservative justices on the nine-member bench appeared to be leaning towards upholding a Tennessee law banning medical care for transgender people under the age of 18 such as puberty blockers or hormone therapy.

The three liberal justices expressed concern that the law was discriminatory while Justice Neil Gorsuch, a conservative considered a key vote, declined to ask any questions at all during two-and-a-half hours of oral arguments.

Gorsuch authored the majority opinion in a ruling four years ago that gay and transgender employees are protected from discrimination under federal law.

Two dozen Republican-led states have enacted laws restricting medical care for transgender youth and the case will have repercussions for the prohibitions across the country.

The Justice Department of Democratic President Joe Biden joined opponents of the Tennessee law, arguing that it violates the US Constitution's Equal Protection Clause since it denies transgender people access to medical treatments otherwise permitted to others.

US Solicitor General Elizabeth Prelogar said the law "bans treatment when and only when it's inconsistent with the patient's birth sex."

"The legislature didn't even take into account the significant health benefits that can come from providing gender-affirming care," Prelogar said.

"It doesn't matter what parents decide is best for their children," she said. "It doesn't matter what patients would choose for themselves. And it doesn't matter if doctors believe this treatment is essential for individual patients."

Chief Justice John Roberts and two other conservative justices—Samuel Alito and Brett Kavanaugh—expressed concerns that the medical science surrounding gender-affirming care for adolescents was still evolving.

"A lot of categorical statements have been made this morning in argument and in the briefs about medical questions that seem to me to be hotly disputed," Alito said.

Kavanaugh said the risks and benefits of medical treatments for minors suffering from gender dysphoria remain uncertain.

"England's pulling back and Sweden is pulling back," Kavanaugh said. "It strikes me as, you know, a pretty heavy yellow light, if not red light, for this court to come in, the nine of us, and to constitutionalize the whole area."

'Life-altering consequences'

Justice Sonia Sotomayor, a liberal, said the concerns about risks were being overblown.

"Every medical treatment has a risk, even taking aspirin," Sotomayor said.

Kavanaugh, touching on a hot-button issue for conservatives, asked what striking down the Tennessee law would mean for sports. "Would transgender athletes have a constitutional right, as you see it, to play in women's and girls sports?"

Tennessee Solicitor General Matthew Rice told the court the law was passed to "protect minors from risky, unproven medical interventions" with "often irreversible and life altering consequences."

"Its application turns entirely on medical purpose, not a patient's sex," he said. "That is not sex discrimination."

Chase Strangio, an attorney for the American Civil Liberties Union, which is representing three transgender adolescents, their parents, and a Memphis-based doctor, countered that the Tennessee law has "taken away the only treatment that relieved years of suffering" for the plaintiffs in the case.

"What they've done is impose a blunderbuss ban, overriding the very careful judgment of parents who love and care for their children and the doctors who have recommended the treatment," said Strangio, the first openly transgender lawyer to argue before the court.

Ahead of oral arguments, Strangio said the stakes are particularly high since President-elect Donald Trump has pledged to impose a federal ban on gender-affirming care for transgender minors and restrict it for transgender adults.

According to a study by UCLA's Williams Institute, an estimated 1.6 million people aged 13 and older in the United States identify as transgender.

© 2024 AFP