Justice Clarence Thomas’s shunning of “experts” defending gender-affirming care is delighting conservatives in their assault on liberal influence in academics and medicine, a mission now reaching the courts.
The conservative justice argued in a solo opinion concurring with the court’s 6-3 decision to uphold Tennessee’s transgender youth care ban that so-called experts have jumped on the bandwagon to embrace such treatment while evidence to the contrary mounts.
“This case carries a simple lesson: In politically contentious debates over matters shrouded in scientific uncertainty, courts should not assume that self-described experts are correct,” Thomas wrote.
Thomas’s opinion quickly garnered the attention of prominent Republicans, including Vice President Vance, who made his debut on liberal social media platform Bluesky by complimenting the opinion as “quite illuminating.”
“I might add that many of those scientists are receiving substantial resources from big pharma to push these medicines on kids. What do you think?” Vance wrote Thursday, quickly sparking thousands of replies dripping with snark.
Since Trump has taken office, his administration has abandoned President Biden’s defense of gender-affirming care. Trump’s Justice Department dropped the legal challenge to Tennessee’s ban, and in May, his Department of Health and Human Services (HHS) declared there is a “lack of robust evidence” for the treatments.
In a New York Times opinion piece following the Supreme Court ruling, the mother of the transgender teen who challenged Tennessee’s law mourned the decision to block care for her daughter.
“I am deeply afraid for what this decision will unleash — politically and socially,” Samantha Williams wrote. “Now that the Supreme Court has denied the rights of young people like my daughter and families like ours, what’s next?”
Major American medical groups have said gender-affirming care for transgender youth and adults is medically necessary.
But Thomas in his opinion wrote that it’s legally irrelevant, saying trusting those groups would otherwise allow “elite sentiment” to “distort and stifle democratic debate.”
“There are particularly good reasons to question the expert class here, as recent revelations suggest that leading voices in this area have relied on questionable evidence, and have allowed ideology to influence their medical guidance,” Thomas wrote.
The Supreme Court’s decision instead looks to Europe, citing health authorities in Finland, Norway, Sweden and the United Kingdom. The justices particularly emphasized the Cass Review, an influential 2024 report from England questioning the treatments.
“Health authorities in a number of European countries have raised significant concerns regarding the potential harms associated with using puberty blockers and hormones to treat transgender minors,” Chief Justice John Roberts wrote for the majority.
The increased prominence of conservatives’ attacks come as public trust in health officials and agencies continues to plummet more broadly, a decline that began during the COVID-19 pandemic.
Trust in state and local public health officials dropped by 10 percentage points to 54 percent, while the share of those who say they trust the U.S. Centers for Disease Control (CDC) has also slipped five percentage points, according to January polling from KFF, formerly known as the Kaiser Family Foundation.
“Justice Thomas soundly put to rest the persistent sham that we should quiet down and ‘trust the science’ when it comes to life-altering experimentation on minors,” Katherine Green Robertson, chief counsel of Alabama’s attorney general’s office, said in a statement following the decision.
The state filed a friend-of-the-court brief in the case that urged the justices not to decide it on “euphemisms about ‘affirming care’ and unsupported appeals to ‘expert’ organizations.”
“Alabama is proud to have armed the Court with a full rundown of the medical community’s shameless political collusion on this matter, which should permanently discredit every organization involved,” she said.
The justices’ reliance on outside research has come into question before.
Justice Ketanji Brown Jackson caught heat after a study she cited in her 2023 dissent in Students for Fair Admissions v. Harvard, which sharply limited the use of race as a factor in college admissions, was disputed.
In an impassioned dissent expounding on the benefits of diversity in education, Jackson pointed to a friend-of-the-court brief by the Association of American Medical Colleges, which referenced the 2020 study.
“It saves lives,” she wrote, pointing to the research which showed that having a Black physician more than doubles the likelihood that a high-risk Black baby will live.
In the following months, critics began to debunk the claim, suggesting at first that the justice misrepresented the statistic, and later, that the research itself was inaccurate.
“Even Supreme Court justices are known to be gullible,” lawyer Ted Frank wrote in a Wall Street Journal op-ed at the time.
It’s not just studies that support left-leaning views that have come under scrutiny, either.
A month before the Supreme Court weighed a challenge to mifepristone access, one of the two common drugs used in medication abortion, a medical journal retracted two studies claiming to show the harms of the pill.
The studies, published in the Sage journal Health Services Research and Managerial Epidemiology and backed by an anti-abortion group, were retracted after a reader raised concerns about the study’s accuracy and a review found the conclusions “invalidated in whole or in part.”
U.S. District Judge Matthew Kacsmaryk had pointed to the studies in his decision siding with the conservative medical group Alliance for Hippocratic Medicine, which invalidated the Federal Drug Administration’s (FDA) approval of mifepristone because it overlooked safety concerns.
The justices ultimately ruled unanimously last year that the anti-abortion doctors did not have standing to challenge access to mifepristone, declining to address the underlying regulatory or safety issues.
In the gender-affirming care case, the Supreme Court’s decision aligned with the conservative voices that have called on the court to give credence to political forces over educational ones — and the shift did not go unnoticed.
“The vibe shift is real,” Roger Severino, a vice president at the Heritage Foundation who ran HHS’s civil rights office during Trump’s first term, told supporters after the decision.
“Not only was it political in the last election, President Trump’s closing argument is that ‘she is for they/them, and he is for you,’” he continued. “And here, the court — not that they’re political animals — at least they’re consistent with where the American people are.”