Biden administration sues Tennessee over trans gender-affirming care ban

The Department of Justice filed a lawsuit yesterday against the state of Tennessee over its S.B. 1, a bill that bans gender-affirming care for transgender minors and gives trans youth already receiving gender-affirming care until March 2024 to detransition.

“No person should be denied access to necessary medical care just because of their transgender status,” Assistant U.S. Attorney General Kristen Clarke said in a statement. “The right to consider your health and medically-approved treatment options with your family and doctors is a right that everyone should have, including transgender children, who are especially vulnerable to serious risks of depression, anxiety and suicide.”

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The law, passed in early March 2023, is set to go into effect in July and bans all forms of gender-affirming care, including reversible puberty blockers. Puberty blockers are life-saving treatments used to delay the permanent effects of puberty so that trans youth, their families, and their doctors can understand their identities better.

The legislation allows for the same medications to be used by cisgender youth for other conditions. The bill doesn’t ban any treatment for being too dangerous; it bans a class of people from using them for a specific purpose.

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The DOJ lawsuit alleges that S.B. 1 violates the Equal Protection Clause of the Fourteenth Amendment because, instead of banning certain procedures and medications, it only bans those procedures and medications when transgender youth want to access them for gender-affirming care.

Citing the World Professional Association for Transgender Health (WPATH), the Endocrine Society, and the American Academy of Pediatrics, the DOJ argues that gender-affirming care is the “widely accepted and endorsed” form of treatment for gender dysphoria in children and teenagers.

The DOJ also argues that Tennessee lawmakers “made comments reflecting moral disapproval or disbelief of youth who identify as transgender” while debating the bill, showing that it wasn’t based on science but instead on the lawmakers’ antipathy towards transgender people.

“If you don’t know what you are – a boy or girl, male or female – just go in the bathroom and take your clothes off and look in the mirror, and you’ll find out,” the DOJ quotes state Rep. Paul Sherrell (R) as saying. The DOJ also quotes the bill’s sponsor in the Tennessee House of Representatives, state Rep. William Lamberth (R), arguing that there is “a growing social contagion of gender dysphoria” caused by “social media glorifying the process of transitioning.”

The DOJ also quotes Lamberth, and several other Republicans who supported the bill, saying that procedures banned by the bill would still be allowed for cis and intersex kids. For example, one Republican state senator said that a cisgender boy who develops breasts in a condition known as gynecomastia would be allowed to get a double mastectomy, but a transgender boy who develops breasts would not.

The lawsuit concludes that S.B. 1 discriminates, was motivated by an intent to discriminate, and is administered in a discriminatory manner against a group of people defined by sex and transgender status while not achieving any legitimate state goal.

“Left unchallenged, it would prohibit transgender children from receiving health care that their medical providers and their parents have determined to be medically necessary,” Henry Leventis, the U.S. attorney for the Middle District of Tennessee, said. “In doing so, the law seeks to substitute the judgment of trained medical professionals and parents with that of elected officials and codifies discrimination against children who already face far too many obstacles.”

Tennessee Gov. Bill Lee (R) told CNN that the state is “committed to protecting children from permanent, life-altering decisions.”

“This is federal overreach at its worst, and we will work with [Tennessee] Attorney General [Jonathan] Skrmetti to push back in court and stand up for children,” he said.