Democratic leaders and professional medical organizations on Wednesday denounced the Supreme Court’s ruling upholding a 2023 Tennessee law banning gender-affirming care for transgender minors, a decision the high court delivered along ideological lines that stands to impact similar laws passed in roughly half the country.
The high court’s three Democratic-appointed justices dissented with the conservative majority. Justice Sonia Sotomayor, joined by joined by Justices Elena Kagan and Ketanji Brown Jackson, said Wednesday’s decision “abandons transgender children and their families to political whims.”
“Once again, politicians and judges are inserting themselves in exam rooms,” Rep. Sarah McBride (D-Del.), the nation’s first openly transgender member of Congress, said Wednesday on the social platform X. “This ruling undermines doctors in delivering care to some of the most vulnerable patients in our country.”
Rep. Jan Schakowsky (D-Ill.), whose grandson is transgender, said the court’s decision may force families living in Tennessee and other states with restrictions on gender-affirming care for youth to leave their homes to “ensure their kids can access medically necessary care.”
Including Tennessee, 25 Republican-led states since 2021 have passed laws prohibiting health care professionals from providing puberty blockers, hormone therapy and rare surgeries to transgender youth. Court challenges to those laws have been met with mixed results.
Responses from other Democratic lawmakers were more succinct.
“This is just wrong,” said Sen. Jeff Merkley (D-Ore.).
Merkley, a Senate sponsor of the Equality Act, filed an amicus brief late last year asking the Supreme Court to strike Tennessee’s law alongside Sen. Ed Markey (D-Mass.) and Democratic Reps. Mark Pocan (Wis.), Jerry Nadler (N.Y.) and Frank Pallone (N.J.), who also denounced the court’s ruling on Wednesday.
“Today, hate won,” Markey said in a statement.
In 2023, Markey and Rep. Pramila Jayapal (D-Wash.), whose adult child is transgender, introduced the Transgender Bill of Rights, a landmark resolution to recognize the federal government’s responsibility to protect and codify the rights of trans and nonbinary people nationwide.
From her office in Seattle, Jayapal told reporters Wednesday afternoon that the Supreme Court’s ruling puts “a cruel and politically motivated policy over the lives of people.”
Some of Congress’s most vocal critics of gender-affirming care were noticeably quiet on Wednesday’s ruling. In a post on X, Rep. Marjorie Taylor Green (R-Ga.) encouraged the federal legislature to pass her Protect Children’s Innocence Act, which would make it illegal to provide transition-related care to youth, without mentioning the case directly.
Tennessee’s Republican attorney general, Jonathan Skrmetti, celebrated the court’s ruling, saying voters’ “common sense” prevailed over “judicial activism.”
“A bipartisan supermajority of Tennessee’s elected representatives carefully considered the evidence and voted to protect kids from irreversible decisions they cannot yet fully understand,” Skrmetti wrote in a statement following the decision.
“This victory transcends politics,” he added. “It’s about real Tennessee kids facing real struggles. Families across our state and our nation deserve solutions based on science, not ideology.”
The World Professional Association for Transgender Health (WPATH), an international nonprofit that develops standards of trans health care, called Wednesday’s ruling “a dangerous setback for transgender health and human rights in the United States.”
“This decision will effectively allow states to ban evidence-based gender-affirming healthcare for thousands of transgender and gender diverse youth and their families. Furthermore, it will make it much more difficult to create an evidence base to support access to healthcare of this kind,” the organization said Wednesday in an emailed statement.
“A ruling like this does not change the fundamental fact that transgender youth exist, their lives are improved when they can access care and are harmed whenever the government comes in between them and the professional experts trained to provide them this care,” WPATH said. “Let us be clear — healthcare bans of any kind are rooted in stigma, misinformation, and fear and this one comes at the expense of the youth in need of this care.”
WPATH, formerly the Harry Benjamin International Gender Dysphoria Association, has researched transgender health since 1979 but has only recently become a target of the White House and Republicans in Congress, who claim the organization is manipulating its findings to further a political agenda. In a January executive order aimed at eliminating federal support for gender-affirming care for minors, Trump said the organization’s guidance regarding treatment “lacks scientific integrity.”
In a concurring opinion Wednesday morning, Justice Clarence Thomas, one of the high court’s leading conservatives, said courts should not defer to “self-described experts” on gender-affirming care, claiming “prominent medical professionals,” including those affiliated with WPATH, have dismissed “grave problems” undercutting their assertion that there is a consensus around the efficacy of gender dysphoria treatments for youth.
“They have built their medical recommendations to achieve political ends,” Thomas wrote.
In a joint statement on Wednesday, six other medical groups, led by the Endocrine Society, said they are “disappointed” by the Supreme Court’s ruling, which they claimed would increase “the likelihood that other states will limit or eliminate families’ and patients’ ability to access medical care.”
“Decisions about medical care must be based on individualized assessments by qualified professionals in consultation with the patient and their parents or legal guardians and guided by well-designed medical evidence,” wrote the American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American College of Physicians, American Psychiatric Association, the Endocrine Society and the National Association of Pediatric Nurse Practitioners.
The six organizations, part of an earlier amicus brief in the case against Tennessee’s law, said health professionals “must be able to rely on their training, education, and expertise to provide appropriate care based on the needs and values of each patient and their family, without bans or interference.”
In a separate statement, Susan J. Kressly, president of the American Academy of Pediatrics, said the court’s ruling Wednesday “will have profound and far-reaching consequences” for the health and well-being of transgender youth nationwide and the doctors who care for them.
“To be clear — regardless of today’s legal ruling — the science still supports gender-affirming care, children will still need it,” Kressly said.
Adrian Shanker, who led LGBTQI+ health policy at the Department of Health and Human Services (HHS) under President Biden’s administration, told The Hill in an interview Wednesday that the Supreme Court’s ruling on gender-affirming care is part of an “avalanche of attacks” on trans people and bodily autonomy.
“It really isn’t just one isolated incident — it’s a shift politically that has made it very difficult for trans people to access the care that their bodies need, and ultimately, that’s just going to lead to significant harm for one of the marginalized populations in our society,” Shanker said.
In May, Trump’s HHS broke with major medical groups, which have said gender-affirming care for trans youths and adults is medically necessary, in an unsigned report that declared there is a “lack of robust evidence” to support providing such interventions for minors.
Trump, who campaigned heavily on a promise to ban gender-affirming care for youth, has, in addition to his executive order, called for Congress to pass legislation “permanently banning and criminalizing sex changes on children and forever ending the lie that any child is trapped in the wrong body.” He has endorsed Greene’s bill.
The Centers for Medicare and Medicaid Services (CMS) has also instructed states not to use Medicaid funding for transition-related care for minors and recently demanded hospitals providing gender-affirming care to young people to hand over data on their standards of care and finances.
The White House did not immediately return a request for comment on Wednesday’s Supreme Court ruling.
Do No Harm, a medical group that advocates against gender-affirming care for youth, applauded the court’s decision, which the organization’s chair, Stanley Goldfarb, said “should end the debate over laws like Tennessee’s.”
Kristina Rasmussen, the group’s executive director, said it plans to advocate for similar bans on transition-related care in other states.
Jamie Reed, a former caseworker at the Washington University Transgender Center who helped jumpstart the Missouri legislature’s efforts to ban gender-affirming care for minors, said Wednesday’s ruling “confirms what whistleblowers, parents, and detransitioners have been saying for years.”
“These are not settled, safe, or evidence-based practices,” Reed, now the co-executive director of the LGB Courage Coalition, an organization that opposes transition-related care for youth, said in a statement. “They are high-risk interventions being pushed on vulnerable children in the name of ideology.”