Wednesday, June 18, 2025

The Supreme Court's terrible 6-3 decision in United States v. Skrmetti

We need to work toward a society in which people are not so afraid, or ignorant, of differences that they will countenance cruelty to families and children.

Today the U.S. Supreme Court issued its decision in United States v. SkrmettiThe 6-3 decision written by Chief Justice Roberts permits the State of Tennessee to ban the use of medical treatments for transgender adolescents diagnosed with gender dysphoria.  This decision essentially tells families of transgender minors (and their physicians) that they must either (1) condemn their children to dangers that have all-to-often led to extreme distress and even suicide or (2) choose exile to states that do not have such laws.  And it opens the possibility that if the Republican MAGA majority in the House continues and if the Republican MAGA majority in the Senate dispenses with the filibuster, then such laws could be enacted by the Congress and signed by the President, meaning that such families would have to leave their homes in the United States altogether in order to do right by their children.

This is cruel and unacceptable, as Justice Sotomayor (joined by Justices Jackson and Kagan) explained in her dissent:

Transgender adolescents’ access to hormones and pu-

berty blockers (known as gender-affirming care) is not a

matter of mere cosmetic preference. To the contrary, access

to care can be a question of life or death. Some transgender

adolescents suffer from gender dysphoria, a medical condi-

tion characterized by clinically significant and persistent

distress resulting from incongruence between a person’s

gender identity and sex identified at birth. App. to Pet. for

Cert. 251a–252a. If left untreated, gender dysphoria can

lead to severe anxiety, depression, eating disorders, sub-

stance abuse, self-harm, and suicidality. See, e.g., Cole-

man, 23 Int’l J. Transgender Health, at S62. Suicide, in

particular, is a major concern for parents of transgender

teenagers, as the lifetime prevalence of suicide attempts

among transgender individuals may be as high as 40%.

App. to Pet. for Cert. 264a. Tragically, studies suggest that

as many as one-third of transgender high school students

attempt suicide in any given year.


When provided in appropriate cases, gender-affirming

medical care can meaningfully improve the health and well-

being of transgender adolescents, reducing anxiety, depres-

sion, suicidal ideation, and (for some patients) the need for

more invasive surgical treatments later in life.4 That is why

the American Academy of Pediatrics, American Medical As-

sociation, American Psychiatric Association, American Psy-

chological Association, and American Academy of Child Ad-

olescent Psychiatry all agree that hormones and puberty

blockers are “appropriate and medically necessary” to treat

gender dysphoria when clinically indicated. Id., at 285a.

https://www.supremecourt.gov/opinions/24pdf/23-477_2cp3.pdf (pp. 88-89 of the PDF, pp. 4-5 of Justice Sotomayor's dissent)

Justice Sotomayor also criticizes the linguistic gymnastics used by the majority to reach its right-wing ideological result.  But I will leave that to others to discuss.

It is important for the general public to understand how cruel such statutes are.  May the one-third of the electorate which has chosen to opt out of voting altogether understand this cruelty and join the other one-third who oppose the MAGA agenda to elect representatives who will reject this cruelty.   Parents should not have to choose exile to protect their children.  We need to work toward a society in which people are not so afraid, or ignorant, of differences that they will countenance cruelty to families and children.

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