US Supreme Court upholds Tennessee ban on youth gender-affirming care

Nothing says "freedom" like preventing teenagers from feeling okay about themselves!

Seriously worried this helps pave the way for a national ban, maybe even for adults. It's obviously what the red team is aiming for, and it really sucks to watch them inch closer and closer.

I've been holding out hope that midterm elections will flip the senate/house and we'll be okay but it's starting to feel like that's too far off.

Something that's been on my mind recently, and no idea where else to talk about it but it's a bit relevant here.

I met a kid while volunteering at a camp this week, and I and another volunteer happened to see them go in the men's bathroom. We thought the kid was a girl so another worker went in to let him know, and upon returning told us he said he was a boy. Another volunteer who knew him better was passing by and quickly confirmed he was a boy. The first volunteer and I looked at each other and shrugged. "Oh, guess he's trans, maybe...?" No big deal to us, but I was a little worried because we're in a red state and I knew some people might not react so well.

After he left the bathroom and we all returned to the main camp area, he came up to me to comment about the worker saying he was in tbe bathroom. He wasn't angry or upset, just kind of bemused it happened at all. And talking to him, I realized he was cis.

This kid is barely at the start of puberty so his voice hasn't dropped yet, with shoulder-length hair and a bit overweight to the point he himself acknowledged that his chest could be mistaken for breasts. Part of our confusion stemmed from his name, which is usually a female variant of a fairly common name. Turns out it was a combination of his first and last names because his class had multiple kids with his first name. Think something like Nick E, which we thought was Nikki.

All of that combined to make him one of the most androgynous people I've ever met, through no effort or intention on his part. Even his shirt was a pinkish color with some pink graphics, just adding to the impression. From our conversation, he's been mistaken for a girl before and he was kind of mystified by it. Again, not in a bad way, just kind of bemused and wondering why in a light-hearted way.

And my thoughts keep going back to that initial concern when I saw him go into a bathroom. I was worried this innocent kid could walk into the bathroom in front of a raging bigot, because we do live in a red state, and I'd had the fleeting thought that maybe I should warn him to be careful in the future. I wouldn't, because it isn't my place to have that conversation with a strange kid, but the thought still passed my mind for a half-second.

The concern that spurred that fleeting thought is still there, but in some ways it kind of feels worse now. This kid is a kid. He has no clue this is a concern, because it shouldn't be a concern. I will probably never see him again, but I think I'll be worrying for a long time that this kid who's not even a teenager yet might someday encounter some raging bigot spewing vile hatred at him. Hatred towards a group he doesn't even belong to, because he doesn't fit the "standard" image of a boy. And how many other kids are at that precarious point pre-puberty where they're highly androgynous, and easily mistaken for the opposite sex? Little girls with short hair and undeveloped chests, and little boys with long hair and still-high voices?

Bigotry like this hurts far more than the intended targets. And there's something extra sick that I'm more concerned about random adults being transphobic bigots than his fellow kids bullying him for looking like a girl.

Tennessee, meanwhile, has argued that the ban is necessary to protect children from what it termed “experimental” medical treatment.

I would have expected that in the case of HRT this would have been easy to scientifically disprove as experimental to the Supreme Court. Isn’t it widely proven to be safe and also critically important to the health of trans kids?

I know that the goal isn't actually to use logic in a lot of these cases...but I find it baffling that the argument to "let people decide what to do with their own bodies" doesn't work here. If the child and parents/guardian decide they want to do this, especially with support from a doctor, why can't they? If we allow people to skip vaccines even though there is measurable risk to their communities, why the hell is it ok to ban care if the parents/guardian and children want it? (I believe children should be allowed to have agency in their own care, but parents/guardians have legal rights here that also get considered with minors, which is why I've included them here.)

Here's a long read from the New York Times on the politics leading up to the Supreme Court decision:

How the Transgender Rights Movement Bet on the Supreme Court and Lost

The politics seem very complicated, but here are a few quotes from the middle:

The demands set off a furious debate within WPATH. Conservative politicians might attack WPATH for recommending medical intervention at younger ages than before. But Bowers, the group’s president-elect, pointed out that without specific age requirements, “insurers may not grant authorization” for pediatric care. Others worried about capitulating to political pressures in what WPATH intended to present as an “evidence-based” document.

Just as WPATH’s internal emails began trickling into public view, the Supreme Court announced that it would hear Skrmetti. Not long after, Levine’s requests to WPATH were reported by The Times. White House officials were blindsided, several told me. Though Levine would later tell Biden aides that she had been trying to protect the president, the West Wing saw it differently: Her request could suggest that the administration thought there should be no minimum ages at all. “Everyone was like, holy cow — did Rachel Levine really go out and lobby for 9-year-olds to get surgery?” one former Biden aide told me. (Levine’s spokesman says she based “all policy recommendations on the best available science.”)

...

Cass’s report sent shock waves across the Atlantic. There was “no evidence” that gender-affirming treatments reduced the risk that trans teenagers would die by suicide, her review found. SOC-8’s adolescent chapter lacked “developmental rigor.” And the much-cited consensus of medical associations was a mirage. Few of the groups endorsing gender-affirming care had actually conducted their own in-depth evidence reviews, her team found; instead, nearly all had relied on older Endocrine Society and WPATH guidelines as the basis for their own recommendations.

There was now a dawning awareness within the administration, another Biden aide told me, that its allies in the L.G.B.T.Q. movement had overstated the medical case for pediatric gender-affirming care. Unwilling to abandon the broader cause of trans rights, and wary of arbitrating a contentious medical debate, aides drafted statements clarifying that Levine didn’t speak for the administration. “We believe these surgeries should be limited to adults,” the White House told one outlet.

Tennessee’s ban on surgery was not before the justices in Skrmetti. (That provision of Tennessee’s law had remained intact in 2023, after the trial judge ruled that L.W. and other plaintiffs did not have standing to challenge it.) But the Biden administration had now put itself on both sides of a different question before the Supreme Court. As a matter of policy, the White House was now on record opposing part of WPATH’s new standards of care. But in court, Justice Department lawyers had held up WPATH’s recommendations, and those of other medical associations, as reliable guidelines for care. If the federal government could pick and choose from among WPATH’s recommendations, Alabama’s attorney general later argued in a blistering amicus brief in Skrmetti, why couldn’t states? The White House understood its dilemma, two of the aides told me, but concluded that it was more important to prevent Trump from being re-elected.

There was also growing tension between the A.C.L.U. and the Justice Department, three former government officials told me. (The A.C.L.U. and a spokeswoman for Prelogar denied this account.) In later briefs to the court, the administration would brush off the Alabama revelations as “out-of-context excerpts” from “a different case.” In private, though, some administration lawyers worried that their allies had pushed them onto thin scientific ice.