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The U.S. Supreme Court on Monday jumped into the fight over transgender rights, agreeing to hear an appeal from the Biden administration seeking to block bans on gender-affirming care like the one in Kentucky.
The justices’ action comes as Republican-led states have enacted a variety of restrictions on health care for transgender people, school sports participation, bathroom usage and drag shows. The administration and Democratic-led states have extended protections for transgender people, including a new federal regulation that seeks to protect transgender students.
The case involves a Tennessee law that restricts puberty blockers and hormone therapy for transgender minors. The Sixth Circuit U.S. Court of Appeals in Cincinnati allowed the law and a similar one in Kentucky to take effect after lower courts had blocked them. The Supreme Court did not act on a separate appeal from Kentucky and did not explain why.
In their appeal, lawyers for the transgender teens in Tennessee told the justices, “Without this Court’s prompt intervention, transgender youth and their families will remain in limbo, uncertain of whether and where they can access needed medical care.” Arguments will take place in the fall.
Last month, South Carolina became the 25th state to adopt a law restricting or banning gender-affirming medical care for transgender minors, even though such treatments have been available in the United States for more than a decade and are endorsed by major medical associations.
Most of the state bans face lawsuits. The justices had previously allowed Idaho to generally enforce its restrictions, after they had been blocked by lower courts.
Kentucky and at least 23 other states ban transgender women and girls from competing in certain female sports competitions. At least 11 states have adopted laws barring transgender girls and women from girls’ and women’s bathrooms at public schools, and in some cases other government facilities.
The nation’s highest court has only rarely taken up transgender issues. In 2020, the justices ruled that a landmark civil-rights law protects gay, lesbian and transgender people from discrimination in employment.
Gender-affirming care includes a range of medical and mental health services to support a person’s gender identity, including when it’s different from the sex they were assigned at birth.
The services are offered to treat gender dysphoria, the unease a person may have because their assigned gender and gender identity don’t match. The condition has been linked to depression and suicidal thoughts.
Gender-affirming care encompasses counseling and treatment with medications that block puberty, and hormone therapy to produce physical changes. Those for transgender men cause periods to stop, increase facial and body hair, and deepen voices, among others. The hormones used by transgender women can have effects such as slowing growth of body and facial hair and increasing breast growth.
Gender-affirming care can also include surgery, including operations to transform genitals and chests. These surgeries are rarely offered to minors.
Every major U.S. medical group, including the American Academy of Pediatrics and the American Medical Association, has opposed the bans and said that gender-affirming treatments can be medically necessary and are supported by evidence.
But around the world, medical experts and government health officials are not in lockstep. Some European countries in recent years have warned about overdiagnosis of gender dysphoria. England’s health service stopped prescribing puberty blockers to children with gender dysphoria outside of a research setting.
Contributing: Geoff Mulvihill and Carla K. Johnson, AP.
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