Supreme Court Upholds Trans Healthcare Ban as Michigan Leaders Vow Protection, Decry ‘Attack on Children’
Rep. Pohutsky and Equality Michigan's Emme Zanotti respond to decision while reassuring state residents
Supreme Court Upholds Trans Healthcare Ban as Michigan Leaders Vow Protection, Decry 'Attack on Children'
Rep. Pohutsky and Equality Michigan's Emme Zanotti respond to decision while reassuring state residents
The U.S. Supreme Court dealt a devastating blow to transgender rights June 18, upholding Tennessee's ban on gender-affirming medical care for minors in a decision that could embolden similar restrictions nationwide and leave thousands of trans youth without access to evidence-based healthcare.
All six conservative justices joined at least part of the majority opinion in U.S. v. Skrmetti, rejecting arguments that the law constitutes sex-based discrimination under the 14th Amendment's equal protection clause. The Court's three liberal justices dissented.
"This is a devastating loss for families with transgender youth in Tennessee and in the other 24 states that have similar health care bans," said Jay Kaplan, staff attorney for the Nancy Katz and Margo Dichtelmiller LGBTQ+ Project at the ACLU of Michigan. "Over 100,000 transgender people under age 17 now live in states that ban medically necessary and in many cases life saving medical care. The Supreme Court majority twisted itself in knots in order to find that Tennessee's law did not constitute discrimination because of sex and was therefore not deserving of heightened constitutional scrutiny."
Responding to the ruling, Michigan State Rep. Laurie Pohutsky told Pride Source, "The most important thing I want folks in Michigan to know is we do not have a state law that prohibits gender-affirming care for anyone, including minors. So there is no reason that this court ruling should impact the availability of gender-affirming care for anyone in the state."
Pohutsky noted the broader emotional toll of the ruling, which serves as a reminder of intense anti-trans targeted at the highest levels of federal government. "The ruling is painful," she acknowledged. "The ruling is traumatic, whether it impacts our state or not. It does signal one more attack against the trans community, particularly trans children. And it's an isolating and fearful feeling to watch your government literally bully and harm children."
Roz Keith, executive director of the young adult trans advocacy organization Stand with Trans, told Pride Source the ruling is "devastating."
"The government should not be making decisions about anyone's medical care and certainly not about whether a trans person is 'entitled' to gender-affirming care such as hormones that allow one to live authentically and feel comfortable in their own skin," she noted. "If my son could not get what he needed. our conversation would be very different. This care is life saving."
Background: U.S. v. Skrmetti
The case before the Court represented one of the most significant challenges to LGBTQ+ healthcare protections in recent years, with implications extending far beyond Tennessee's borders.
U.S. v. Skrmetti centered on Tennessee's law banning gender-affirming medical care for transgender minors. The legislation prohibits treatments like puberty blockers and hormone therapy when used to support gender transition, while allowing the same medications for other conditions in cisgender children. Under the law, someone assigned female at birth cannot be prescribed testosterone, but someone assigned male at birth can receive those drugs.
The case was filed by three families of transgender children and a provider of gender-affirming care, who argued alongside the Biden administration that Tennessee's restrictions constituted clear sex discrimination. LGBTQ+ legal advocates contended the law violated the equal protection clause by singling out trans youth while ignoring established medical consensus.
In his majority opinion, Chief Justice John Roberts emphasized that the ruling rested primarily on the justices' finding that the law did not violate the equal protection clause, rather than ideological opposition to trans rights.
"This case carries with it the weight of fierce scientific and policy debates about the safety, efficacy and propriety of medical treatments in an evolving field. The voices in these debates raise sincere concerns; the implications for all are profound," Roberts wrote. "We leave questions regarding its policy to the people, their elected representatives, and the democratic process."
Justice Sonia Sotomayor authored a scathing dissent, joined by Justices Ketanji Brown Jackson and Elena Kagan, arguing that because the law discriminates on the basis of sex, it should face higher legal scrutiny than the majority applied.
"Male (but not female) adolescents can receive medicines that help them look like boys, and female (but not male) adolescents can receive medicines that help them look like girls," Sotomayor wrote. "By retreating from meaningful judicial review exactly where it matters most, the Court abandons transgender children and their families to political whims. In sadness, I dissent."
Tennessee defended the ban as necessary to protect children from what it termed "experimental" medical treatment, despite every major medical and mental health organization in the U.S. finding that gender-affirming care can be evidence-based and medically necessary. These groups also oppose political bans on such care.
The decision validates Tennessee's position and could set a precedent for dozens of other lawsuits involving transgender youth rights. Since 2021, 26 states have passed bans on gender-affirming care for minors, affecting nearly 40% of trans youth in the U.S. Many of these restrictions have been paused by court challenges, but today's Supreme Court decision could have vast implications for those lawsuits' futures.
A study by the Trevor Project found that anti-trans laws are linked to a 72% increase in suicide attempts among trans and nonbinary youth.
The case arrived at the Supreme Court amid an escalating campaign against LGBTQ+ rights under the Trump administration's second term. Just this week, House Republicans advanced a bill sponsored by Georgia Rep. Marjorie Taylor Greene that would criminalize gender-affirming care for minors nationwide.
"I completely disagree with the ruling," Pohutsky said. "I disagree with the methodology that was used to reach it. And I think that it's abhorrent that the Supreme Court is attempting to make a decision about what care is available for children and particularly to make it harder for parents to make those decisions."
"It's worth noting that that question was not actually answered," she added. "The ruling was not determined on the basis of the right for parents to make healthcare decisions for their children. But that doesn't help anyone who is no longer able to access gender-affirming care in the United States because their states already have laws banning it."
Looking ahead
The June 18 ruling represents a devastating setback for transgender youth and their families in states where transgender healthcare bans are in effect or had been pending while the Supreme Court was decided. Thousands of families live in states with legal restrictions that advocates argue ignore medical consensus and endanger vulnerable young people. The decision will likely embolden other states to enact or defend similar bans, while legal challenges to existing restrictions may face an uphill battle given the Supreme Court's precedent.
However, Kaplan emphasized that the decision has important limitations. "It's important to understand what the decision did not do," he said. "It does not mandate a ban on gender affirming care and it does not change the law in states like Michigan where such care remains legal, or the bans that ACLU has overturned in state courts."
Kaplan also noted several key aspects the Court left unresolved. "The Supreme Court majority did not decide whether transgender people are a suspect class for heightened constitutional scrutiny and left the door open about whether other forms of discrimination against transgender people could be challenged under this tougher standard (which makes it more difficult for government to justify discrimination)," he said.
"The Court majority did not overturn the Bostock decision, which recognizes that employment discrimination against transgender people is sex discrimination, which means that trans employees continue to be protected under federal civil rights laws (Title VII)," Kaplan added.
The Supreme Court has yet to rule on Kennedy v. Braidwood Management, another case with significant implications for LGBTQ+ healthcare access. That case challenges the authority of the U.S. Preventive Services Task Force to recommend preventive services that insurers must cover without cost-sharing under the Affordable Care Act, including PrEP for HIV prevention. A decision in that case could affect millions of Americans' access to no-cost preventive health services.
Michigan advocates quickly moved to reassure families that the Skrmetti ruling doesn't immediately impact access to care in the state. Emme Zanotti, senior director of movement building & political affairs at Equality Michigan Action Network, wrote in a moving statement that the organization "condemns this decision in the strongest possible terms."
"Today's decision, as you've all heard, is an unfortunate one," Zanotti's statement begins. "Most unfortunate about this decision, though, is that at the true heart of it, you had the plaintiffs, Samantha and Brian Williams, pleading to keep their 16-year-old daughter's medical care available. Pleading the way any parent would; trying to move heaven and earth the way any parent would; making sure they can legally do what's best for their child, which was maintaining access to the health care that they and their doctors determined was necessary for her to thrive."
She emphasized that Michigan will not follow Tennessee's path: "Some politicians in Michigan, who are not doctors, who do not have transgender kids and who don't even have the decency or regard for keeping the children of our state fed while they are at school, who have already tried to emulate the style of ban we saw in this case, want to turn our state into Tennessee, who ranks in the bottom 10 of all U.S. states as it relates to healthcare. Let me be clear for them. Michigan does not go backward."
"The Supreme Court has failed to protect families' freedoms and opened the floodgates for politicians trying to ban transgender health care, abortion and more," Zanotti continued. "We know that politicians' assault on our freedom doesn't end here."
However, Zanotti emphasized that because Michigan has no law banning transgender healthcare, "this decision does not impact health care for transgender youth in Michigan. For youth and families in Michigan, this decision should have no impact on your continued access to health care."
Kaplan highlighted Michigan's additional protections. "In addition, in Michigan we have explicit civil rights protections on the basis of gender identity and expression and those are additional tools to be used to challenge any efforts in our state to single out transgender people for discrimination," he said.
Pohutsky sought to reassure Michigan's transgender community: "I know it's a really frightening time, but I do want people to know that they have people willing to fight for them who are holding power, who are holding office, and that's not going to change," she said. "I want people to know that there are folks in your government who are not cowed by a very, very vocal minority of people who are doing the dangerous work to harm trans people. There are people who want to defend the trans community, protect them and make sure that they don't just have rights, but they can flourish the way that everyone else can and they aren't being persecuted by their government."
Kaplan emphasized the broader movement's commitment to continuing the fight. "To quote Chase Strangio, ACLU National Attorney who argued the Skrmetti case before the Supreme Court (becoming the first transgender attorney to do so): 'We are determined as ever to fight for the dignity and equality of every transgender person and we will continue to do so with defiant strength, a restless resolve, and a lasting commitment to our families, our communities and the freedom we all deserve,'" he said.
"The path to justice is not linear and a setback like this is a blow," Kaplan added. "But they will not deter us from fighting for what is right and to continue our fight until we realize a world where trans people belong and are valued."
Zanotti, a trans woman, directly addressed Michigan families in her statement. "To the transgender young people and the parents and families of transgender young people in Michigan: While the U.S. Supreme Court has failed today to protect the fundamental freedoms of your peers in hostile states, this decision should have no legal bearing on yours or your kid's ability to access this evidence-based, essential medical care. You should experience no interruptions in your care."
"Transgender health care is safe, essential and legal here in Michigan," Zanotti wrote. "We will fight like hell to keep it that way. And it's Pride Month. So, it's important for you to learn and remember that our ancestors fought against unjust laws and unjust systems to obtain the rights we have today. In their brave shadows, your true spirit lies."
"In your heart, there exists an angel that's capable of a degree of love, compassion and empathy that this country has not reciprocated today," she continued. "In your heart also exists a warrior, who I know will grow up strong, despite any setbacks, and carry our community's torch to liberty and justice when it's time. And no matter what any person, politician or otherwise tells you, please don't ever forget that."
Equality Michigan Action Network and the ACLU of Michigan are hosting a statewide virtual webinar on June 26 to discuss the decision's details and how it impacts Michiganders, including a Q&A session addressing questions about the case and other relevant issues facing Michigan's LGBTQ+ community. Sign up here to take part in the webinar.
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