Trans rights supporters, opponents rally outside Supreme Court as justices consider Tenn. law

At least 1,000 people rallied outside the U.S. Supreme Court on Wednesday as the justices considered whether a Tennessee law banning gender-affirming medical care for transgender youth is unconstitutional.

Dueling rallies began early in the morning, with protesters supporting trans rights and protesters supporting Tennessee’s ban on gender-affirming care each stationed with podiums on opposite sides.

Trans rights protesters, who significantly outnumbered the other group, held signs reading “Keep hate out of healthcare,” and “Respect family medical decisions.” On the other side, protesters carried signs with messages like “Sex change is fantasy,” and “Stop transing gay kids.”

Ari, a trans person who grew up in Nashville and now lives in D.C., spoke to the Washington Blade about the negative effects of the Tennessee law on the well-being of trans youth. 

“I grew up with kids who died because of a lack of trans healthcare, and I am scared of that getting worse,” they said. “All that this bill brings is more dead kids.”

The Tennessee law that is being challenged in U.S. v Skrmetti took effect in 2023 and bans medical providers from prescribing medical treatments such as puberty blockers and hormone therapies to trans youth. 

A number of Democratic lawmakers, including U.S. Rep. Mark Takano (D-Calif.), co-chair of the Congressional Equality Caucus, and U.S. Sens. Ed Markey (D-Mass.) and Jeff Merkley (D-Ore.) addressed the crowd in support of trans rights. 

In his speech, Merkley said Americans deserved freedom in accessing gender affirming care and criticized the law as political intervention in private medical decisions. 

“Americans should have the freedom to make medical decisions in the privacy of their doctor’s office without politicians trying to dictate to them,” he said. 

Robert Garofalo, a chief doctor in the division of Adolescent and Young Adult Medicine at a Chicago children’s hospital, emphasized the importance of trans youth having access to gender affirming care. 

“We [providers] are seeing patients and families every day, present with crippling fears, added stress and anxiety as they desperately try to locate care where it remains legal to do so,” Garofalo, who is also a professor of pediatrics at Northwestern University, told the crowd. “Transgender children and adolescents deserve health care that is grounded in compassion, science and principles of public health and human rights. They must not be denied life saving medical care — their lives depend on it.”

Major U.S. medical associations, including the American Medical Association and the American Academy of Pediatrics, support gender affirming care. 

Research has found gender affirming care improves the mental health and overall well-being of gender diverse children and adolescents. Those who are denied access to gender affirming care are at increased risk for significant mental health challenges.  

An unlikely coalition came out to support Tennessee’s ban on gender affirming care. Far-right figures, such as U.S. Rep. Marjorie Taylor Greene (R-Ga.) and Matt Walsh — both of whom have a history of making homophobic statements — were joined by groups such as the LGBT Courage Coalition and Gays Against Groomers. 

The groups questioned the quality of the research finding gender-affirming care to have a positive effect on the well-being of trans and gender nonconforming youth and argued that minors cannot consent to medical treatment. Ben Appel, a co-founder of the LGBT Courage Coalition, which he notes was “co-founded by gay, lesbian, bisexual, and trans adults who oppose pediatric gender medicine, which we know to be non-evidence-based and harmful to young gay people,” said gender nonconformity is often part of the lesbian, gay, and bisexual experience and should not be “medicalized.” 

“I care about the adult gay detransitioners who have been harmed … by these homophobic practice,” he said “They should have just been told they’re gay.” 

Claire, a Maryland resident who attended the rally in favor of the Tennessee law and claims to have detransitioned, described being prescribed testosterone and having a mastectomy at 14, medical treatments she says she was unable to consent to at that age. She doesn’t oppose gender affirming care for adults but is opposed to “medical experimentation on children.”

“I think that adults should be allowed to do whatever they want with their bodies. I think that it is if someone is happy with the decision that they made that’s great,” she said. “I was not able to make that decision. I was a child.” 

But trans activists fear that a ruling in favor of Tennessee could pave the way for states to restrict access to gender-affirming care for adults.

“There’s also broader implications for civil rights and trans rights, more broadly, for adults in the future. There are some states that have tried to ban some healthcare for adults — they haven’t yet — but I think that’s something we might also see if the Supreme Court rules that way,” Ethan Rice, a senior attorney at Lambda Legal, one of the legal organizations representing the plaintiffs in U.S. v Skrmetti, said.

In the case, three Tennessee families and a physician are challenging the Tennessee law on the grounds that it violates the Equal Protection Clause in the 14th Amendment by drawing lines based on sex and discriminating against trans people. The statute bans medications for trans children while allowing the same medications to be used when treating minors suffering from other conditions, such as early-onset puberty. 

A 2020 Supreme Court decision determined sex-based discrimination includes discrimination based on gender identity or sexual orientation. The key question in U.S. v. Skrmetti is whether this interpretation applies under the Equal Protection Clause.

“We really hope that the Supreme Court recognizes their own precedent on sex discrimination cases and comes out the right way, saying this is sex discrimination by the state of Tennessee and thus is unconstitutional,” Rice said. 

Twenty-six states currently have laws or policies restricting minors’ access to gender-affirming care. If the court rules against Tennessee, similar bans in other states would also be unconstitutional, granting trans youth greater access to gender affirming care nationwide. 

Edith Guffey, the board chair at PFLAG, expressed doubt the court will strike down the law, citing its sharp ideological turn to the right in recent years. But she said she remains hopeful. 

“I hope that the court will … step outside agendas and look at the needs of people and who has the right to say what’s good for their children,” she said.

Chase Strangio, an ACLU attorney representing the families, on Wednesday became the first openly trans lawyer to argue before the Supreme Court. He addressed the trans rights protesters after the hearing. 

“Whatever happens, we are the defiance,” Strangio said. “We are collectively a refutation of everything they say about us. And our fight for justice did not begin today, it will not end in June — whatever the court decides.”