United States v. Skrmetti -- The Future of Children's Gender Dysphoria Treatment

Background

For generations, treatment regarding “gender dysphoria” -- when individuals feel as if they are discomforted or not fit to their birth sex -- has been developed and refined from worldwide organizations, usually centered in the developed world. One of the biggest controversies to this care revolves around the application of it on children. Over the past few years, about half of these United States have initiated some sort of ban/restriction on children use of ‘hormone blockers’, which are used to delay or restrict hormone development in puberty, to allow one to live as their gender of choice without developing the features of their non-preferred gender.

Numerous skeptics worldwide have debated the efficacy of these hormone blockers, which brings a debate into how much the government may regulate it, in line with historical regulations of health and cosmetics, versus the equal rights that an individual has under the law. This critical question will come up in less than a week before the Supreme Court, in the appeal of United States v. Skrmetti. The Appeal asks for recourse on the 2023 6th District Court of Appeals decision on the case, which ruled in favor of the defendants (the states with the bans on hormone blockers for kids) in

a 2-1 vote. It is heading for an oral argument infront of the Supreme Court on December 4th.

In Favor

Most of the arguments on the ‘in favor’ side revolve around the changing dynamics around the health effects of puberty blockers. In the majority opinion of the appealed case, the judges found that states are engaged in intense debate around this topic, with most of the legislative action being conducted in the past 2 years. The appeal bases itself on the precedent that state governments are allowed to regulate healthcare, and in this argument, they should be able to, especially when the danger to the public for this health could outweigh the benefits, due to the scientific community’s divide on the issue. It seems that the argument presented by the majority revolves around the idea of the laboratory of democracy, with a heavy emphasis on voters and legislatures having the ability to regulate this care before a judge steps in to “extend a protected

class” for transgender children.

In Opposition

The argument presented by the plaintiffs surrounds the idea that transgender children fall under the equal protection clause of the 14th Amendment, thus the regulations from the states on puberty blockers are a discriminatory violation of the transgender individual’s rights. The key part of the plaintiff’s appeal is about the level of scrutiny the 6th Circuit placed upon the case, which was not a heightened levels. The plaintiffs buttress the argument by showcasing that these laws specifically mention ‘sex’ as a defining characteristic to the restriction of the care, claiming that a specific focus on ‘sex’ is a violation of the transgender kid’s rights.

What to Expect

Considering the majority's arguments, mainly those surrounding states rights, laboratory of democracy, and divided science, it seems very difficult for a conservative-dominated Supreme Court to be favorable to the plaintiffs. What will need to be reviewed is the level of scrutiny applied to these laws -- if the Supreme Court heightens the scrutiny, then victory for the plaintiffs seems more likely. However, in light of the Dobbs decision merely 2 years ago, which famously referred a major culture war issue back to the states, it is forseeable that the Court could rule similarly to Dobbs, keeping this controversial issue in the hands of each state. All eyes regarding

whether or not these blockers will remain in place will be on the 9 person bench in less than a week.