Courts take on cases about puberty blockers, hormone “therapy” for minors

According to an October 10, 2024 report from the Centers for Disease Control, “[i]n 2023, 3.3% of U.S. high school students identified as transgender, and 2.2% identified as questioning.”

This represents a significant increase since the release of a 2020 study by the Williams Institute in the School of Law at the University of California, Los Angeles, which describes itself as “[t]he leading research center on sexual orientation and gender identity law and public policy” indicating that “[a]mong youth ages 13 to 17 in the U.S., 1.4% (about 300,000 youth) identify as transgender.”

Amid ongoing controversy, with twenty-six states restricting or banning access to what is euphemistically referred to as “gender-affirming care” and at least another fourteen permitting it for the growing number of minors identifying as transgender or questioning, the Supreme Court has entered the fray. As I wrote earlier in Catholic World Report, on June 24, 2024, the Justices accepted an appeal in a case from Tennessee upholding a statutory ban on puberty blockers and hormone therapy for minors now named United States v. Skrmetti because the federal government intervened on behalf of the challengers.

Although Texas’ highest court rejected a challenge to a similar law in Texas v. Loe, on October 18, 2024, the Supreme Court announced it will hear oral arguments in only Skrmetti.

Originally known as L.W. v. Skrmetti, this dispute involved a sixteen-year-old “transgender female” who received puberty blockers and estrogen therapy; a thirteen-year-old “transgender male” who took puberty blockers; and a sixteen-year-old “transgender male” on puberty blockers plus testosterone therapy. The plaintiffs challenged Senate Bill 1’s ban against medical practitioners providing gender-affirming care to minors; individuals who violate the law are subject to $25,000 fines and liability for harm that minors experience due to the treatments they received.

A divided Sixth Circuit court, in a two-to-one judgment, recognizing the long-standing interests of states to regulate medical treatments, allowed the statute to take effect. The court reasoned that because puberty blockers and hormone therapy are novel medical developments, whether they can be used is best left to the judgment of legislatures rather than the judiciary. As noted, the Supreme Court agreed to review the Sixth Circuit’s order in United States v. Skrmetti.

Opponents of Tennessee’s law include Democrat Presidential nominee Kamala Harris and the federal Justice Department under President Biden (who continues to ignore Church teachings on transgender and other moral issues such as abortion despite professing to be a devout Catholic). The challengers claimed the law violated the equal protection clause of the Fourteenth Amendment by discriminating based on sex in enabling minors to use puberty blockers and hormone therapy to conform to their birth sexes, but impermissible denies them to youth identifying as transgender.

Conversely, twenty states joined the amicus curiae, or friend of the court brief, filed by Governor Kristi Noem of South Dakota with the Supreme Court supporting the Tennessee statute, hoping to influence its decision. Other amicus briefs will follow from interested parties on both sides.

Amid debates over gender-affirming care, a study from the Netherlands reveals that most young people expressing desires to transition outgrow these feelings, while 78% of people never experience gender dysphoria. In light of such evidence, combined with the growing number of European nations, notably Denmark, England, Finland, France, Sweden, limiting or cautioning against transitioning, even as Canada doubles down on these treatments, it is unclear why American parents, with the support of medical professionals hurry to subject their children to such procedures in light of their questionable benefits.

At the same time, as Alabama’s amicus brief points out, questions emerge over the good faith of some physicians who hasten to prescribe drugs while earning large fees as more than 14,000 children transitioned surgically or chemically at the cost of $120 million over five years in what is now a multibillion dollar industry with the abortion advocacy group Planned Parenthood also providing such procedures.

Minors experiencing gender dysphoria certainly deserve love, care, support, respect, and understanding. The status of students wishing to “transition” is unduly complicated in light of developments such as in California, though, which bans educators from informing parents whose children seeking to do so. Further, in Colorado at least one board adopted a policy permitting of children to change their names in school without informing their parents.

Moreover, advocacy groups interfere in familial relations when parents do not agree to having their children transition while activists continue to encourage minors to take medications and submit to life-altering procedures without fully understanding their long-term effects even as growing numbers of surgeons and doctors question the nonscientific bases behind such treatments.

Minors under eighteen cannot vote, purchase alcohol or cigarettes, typically enter contracts, and likely lack full awareness of what they are undergoing or will experience by taking medications and submitting to experimental life-altering procedures. With counseling and therapy for minors in conjunction with their families available, prudence dictates that youngsters and their parents should proceed cautiously, waiting for adulthood before undergoing serious surgeries or treatments, as they should have a better understanding of the impacts of their actions.

Should the Supreme Court uphold Tennessee’s right to regulate the health and well-being of highly vulnerable, impressionable minors who are constantly barraged by this gender-based ideological movement in many schools, on social media, and elsewhere, it would help to restore some much-needed sanity and balance in the face of this onslaught.

Given the originalist core of the Supreme Court, jurists who interpret the Constitution as they believe the Founders intended, rather than as activists who view it as subject to their own subjective opinions, there is reason to be optimistic.

The originalists, led by Justices Thomas and Alito, typically joined by Justices Gorsuch, Kavanaugh, Barrett, and often Chief Justice Roberts, support federalism, which recognizes states’ rights through their democratically elected representatives to set their own legislative paths as evidenced in Dobbs v. Jackson Women’s Health Organization, returning questions about abortion to individual states.

If the originalists follow their usual approach, they will defer to Tennessee’s legislature, and states with similar laws, acknowledging its authority to protect the health and well-being of some of its most vulnerable minors by establishing reasonable limits on untested procedures such as gender-affirming care for those experiencing gender dysphoria.

If the Supreme Court upholds Senate Bill 1 it would, however unintentionally, preserve the balance in nature God created as reflected in Genesis that God “created them male and female. When they were created, he blessed them and named them humankind.” By safeguarding the right of Tennessee’s democratically elected legislators to adopt laws they believe are in the best interest of their residents, the Justices would both ensure states’ rights or federalism and preserve God’s order in refusing to allow drugs and/or surgery to alter His creation.