Supreme Court to weigh in on regulating puberty blockers, hormone therapy

Recent litigation suggests that a return to sanity may be in the offing over puberty blockers and hormone therapy for minors wanting “gender-affirming care” as they seek to transition.

On June 24, 2024, shortly after South Carolina became the twenty-fifth state to restrict or ban gender-affirming care for minors, the Supreme Court entered the fray, even as at least fourteen states adopted laws permitting such practices. The Justices will hear an appeal of a case from the Sixth Circuit upholding a law from Tennessee banning the use of puberty blockers and hormone therapy for minors.

Four days after that Sixth Circuit decision, the Supreme Court of Texas rejected a challenge to a state law limiting these therapies.

Supreme Court to review

In a consolidated appeal, including a dispute over a similar statute from Kentucky on which it did not act directly, the Supreme Court agreed to review the Sixth Circuit’s order in L.W. v. Skrmetti leaving the Tennessee law in place. The laws in both states banned the use of puberty blockers and hormone therapy by minors.

Skrmetti was filed on behalf of a sixteen-year-old “transgender” girl who received puberty blockers and estrogen therapy; a thirteen-year-old “transgender” boy who took puberty blockers; and a sixteen-year-old “transgender” boy who received puberty blockers plus testosterone therapy.

A divided court, in a two-to-one judgment, ruled the law could take effect. The court acknowledged that states have a long-standing interest in regulating medical treatments consistent with the due process clause. Accordingly, recognizing that puberty blockers and hormone therapy are novel medical developments whose treatment is best left to the judgment of legislatures, the court refused to block the statute’s enforcement.

Opponents of both laws, including the administration of President Biden, which continues to ignore Church teachings regarding transgenderism, challenged the statutes. Critics claimed the laws violated the equal protection clause of the Fourteenth Amendment by infringing on parents’ rights to make medical decisions for their minor children.

The Court will likely hear oral arguments during its 2024-2025 Term, with a judgment due late in spring or early summer 2025, in what promises to have significant ramifications.

Developments in Texas

Four days later, on June 28, the Supreme Court of Texas rebuffed a challenge filed by “parents of children with gender dysphoria, together with physicians and groups that would be affected by the law.”

In an eight-to-one ruling in Texas v. Loe, the court refused to enjoin Senate Bill 14’s bans on specified medical treatments for children if administered “[f]or the purpose of transitioning a child’s biological sex” or “affirming the child’s perception of the child’s sex if that perception is inconsistent with the child’s biological sex.”

Among the procedures Senate Bill 14 bans are surgery to sterilize children and to remove otherwise healthy or non-diseased body parts or tissues.

Further, the law prohibits health care professionals from providing, prescribing, administering, or dispensing specified drugs to induce transient or permanent infertility, including puberty suppression or blocking prescription drugs to stop or delay normal puberty.

The court reasoned that the “[l]egislature made a permissible, rational policy choice to limit the types of available medical procedures for children, particularly in light of the relative nascency of both gender dysphoria and its various modes of treatment and the Legislature’s express constitutional authority to regulate the practice of medicine.”

Some considerations

Before reflecting on recent judicial developments, it is worth noting a study from the Netherlands about being “transgender”. The report demonstrated that most young people experiencing gender dysphoria who express desires to transition their sexes not only experience personal unhappiness, in the form of poor self-concept, but also outgrow these feelings.

The study also reported that seventy-eight percent of people never experienced feelings of gender dysphoria. In light of such evidence, it is unclear why parents, with the support of medical professionals (who can earn large fees for surgery and other treatments in what has rapidly become a multibillion dollar industry) are in such a rush to enable minors who cannot vote, purchase alcohol or cigarettes, and likely lack full understandings of what they are going through or will experience, among other limitations, to engage in such significant life-altering medical treatments.

Even more troubling, but in line with the Biden administration’s ideological perspective, is the treatment of medical professionals who disagree with the radical pro-transgender agenda amid recent reports it has actively attempted to remove age limits for transition surgeries.

In the first of two related developments, the Department of Justice filed four felony charges against a Dr. Ethan Haim. Haim faces ten-years in prison for exposing Texas Children’s Hospital based on his claims that at least three physicians continued to perform transitioning procedures on minors despite claiming otherwise.

Meanwhile, two FBI agents visited the home of Vanessa Sivadge, a registered nurse at the same hospital who claimed that staff engaged in Medicaid fraud in subjecting children to illicit transgender procedures. Whatever happened to government neutrality in caring for patients, let alone the Hippocratic Oath’s dictum of doing no harm?

Moreover, as part of its unwavering support for the transgender movement, two years ago the Biden administration condemned a Texas policy under which parents who facilitated gender transition medical treatments for their young can be investigated for child abuse.

Minors undergoing gender dysphoria certainly need and deserve love, care, and support, along with understanding, as states such as California and advocacy groups seek to interfere in familial relations if parents do not agree to having their children transition. Yet, even as growing numbers of doctors raise caution flags about the nonscientific bases behind the headlong rush into promoting “gender affirming care,” activists, such as those opposed to the laws in Kentucky, Tennessee, and Texas, continue to encourage minors to take prescription medicines and undergo life altering procedures without fully understanding their long-term effects.

With counseling and therapy for minors and their families, why not have young people wait until reaching adulthood before embarking on such dramatic changes at which times they should have better understandings of what they wish to do?

The Supreme Court will hopefully uphold the rights of states seeking to regulate the health and well-being of highly vulnerable and impressionable minors, let alone their parents, who are constantly barraged by an ideological movement in schools, on social media, and elsewhere. The Court could help restore some much needed sanity and balance in response to ideological arguments proponents of the transgender movement advance by acknowledging the legislative authority of states to protect the health and well-being of their residents by establishing reasonable limits on heretofore untested gender affirming procedures for minors experiencing gender dysphoria.