Chase Strangio: The fight will not end at the Supreme Court

Cheers erupted outside the Supreme Court as the crowd welcomed Chase Strangio to the microphone following his historic arguments before the justices.

Strangio, the first openly transgender lawyer to argue before the Supreme Court, told the justices that Tennessee’s law took away “the only treatment that relieved years of suffering for each of the adolescent plaintiffs.”

Strangio, an attorney with the American Civil Liberties Union, represents three transgender youth and their parents who initially challenged the law.

Strangio thanked those who braved the frigid Washington, DC, weather to stand up for their rights and the rights of transgender people across the country. He said he felt emboldened by their support inside the courtroom.

“Whatever happens we are the defiance,” Strangio said. “We are collectively a refutation of everything they say about us. And our fight for justice did not begin today, it will not end in June – whatever the courts decide.”

During arguments, SCOTUS conservative majority appears ready to endorse Tennessee law

The Supreme Court’s conservative majority expressed deep skepticism Wednesday about a challenge to a Tennessee law banning gender-affirming care for minors, with several key justices repeatedly questioning whether the thorny issues should be left to elected lawmakers to decide.

Justice Brett Kavanaugh, another conservative who tends to be close to Roberts on high court, picked up on the concern that transgender care may not be a matter for courts to decide – a notion that would lean toward the Tennessee law being upheld.

“Why isn’t it best to leave it to the democratic process?” Kavanaugh asked.

The court’s three liberals indicated they strong support the Biden administration and trans youth that challenged Tennessee’s law banning puberty blockers and hormone therapy. Nearly half of the nation’s states have enacted similar bans on transgender care.

Justice Elena Kagan pushed back on the central argument made by Tennessee – and several of her conservative colleagues on the court – that Tennessee’s law is not based on sex. And Justice Ketanji Brown Jackson repeatedly said she was “nervous” that some of her colleagues seemed eager to hand the issue off to lawmakers.

One major question mark: Justice Neil Gorsuch. The conservative was closely watched as a key vote in the case. Gorsuch never asked a question, which is highly unusual and leaves his vote uncertain.

Gorsuch wrote the majority opinion in an unexpected decision four years ago in Bostock v. Clayton County that protected transgender employees from discrimination in the workplace.

A decision in the case is expected by July.

"The case is submitted": Oral arguments on transgender care case wrap

At 12:29 p.m. ET, after roughly two and a half hours of oral arguments on the transgender care case, Chief Justice John Roberts gaveled the session closed.

A decision in US v. Skrmetti is expected by July 2025.

ACLU attorney points to historical anti-trans laws, rebutting Amy Coney Barrett

Chase Strangio countered claims by Justice Amy Coney Barrett that there was a historical absence of anti-transgender laws, with the ACLU attorney raising early in his arguments that that there were examples of government discrimination against transgender people in the form of bans on transgender service in the military and prohibitions on crossdressing.

Barrett later said that she had thought of the military example but had not thought of the cross-dressing ban, while asking Strangio for any other examples. Strangio said that there were other types of laws that lumped transgender and homosexuality together in their frameworks, but said the military and crossdressing policies were the most salient examples.

Barrett is interested in such laws because she had stressed that courts had previously deemed certain categories of people to be “suspect classes,” and it’s been after a pattern of state discrimination towards those classes.

Justice Jackson: "Suddenly quite worried" and "nervous" about conservatives' arguments

Justice Ketanji Brown Jackson said she was “suddenly quite nervous” that some of the conservatives seemed to be eager to bow out of the complicated issues involving transgender care just because the court doesn’t have medical expertise.

Jackson, after hearing several of her conservative colleagues make that point, noted that the court has historically weighed into those issues and she repeatedly called attention to a landmark 1967 decision that invalidated laws banning interracial marriage under the Constitution.

“I’m getting kind of nervous,” Jackson said at one point.

Strangio makes history as first trans lawyer at Supreme Court

Chase Strangio, the first openly transgender lawyer to argue before the Supreme Court, told the justices that Tennessee’s law took away “the only treatment that relieved years of suffering for each of the adolescent plaintiffs.”

Strangio, an attorney with the American Civil Liberties Union, represents three transgender youth and their parents who initially challenged the law.

Tennessee’s law, he said, “bans medical care only when it is inconsistent with a person’s birth sex. An adolescent can receive medical treatment to live and identify as a boy if his birth sex is male but not female.”

Hear more about him on today’s One Thing podcast.

Conservatives divided on issue of parental rights

Justice Amy Coney Barrett asked about the issue of parental rights, a question that isn’t directly at issue in the Skrmetti case but that has been playing out in briefs and causing an interesting debate among conservatives.

Some Republicans are siding with the Biden administration and opposing Tennessee’s transgender law because, they say, it conflicts with a long-held conservative notion of parental rights. When transgender minors in Tennessee seek treatment, they are making those medical decisions alongside their parents.

“Since when does a conservative say, ‘The state knows what is best for my child,’” said former Virginia Rep. Barbara Comstock, an anti-Trump Republican who opposes Tennessee’s law. “If you decide a state can do this, then it puts all parental decisions at risk of being overruled by the government.”

Tennessee, and many conservatives who support the state’s position, argues parental rights aren’t a factor in the case. That’s in part because states have a long history of regulating medicine for people of all ages. “Even adults lack a substantive-due-process right to demand access to a particular medication,” the state told the Supreme Court.

What is the controversial Cass Review that Justice Alito cited?

Justice Samuel Alito questioned whether there is “overwhelming evidence” of benefits for puberty blockers and hormone treatments for transgender youth, noting the UK and Sweden have both shifted policies to limit access to the treatments.

He homed in on what’s known as the Cass Review, a research review in the United Kingdom, which found the rationale for early puberty suppression was “unclear” and that any benefit for mental health was supported by “weak evidence.”

The review – known named for Dr. Hilary Cass, the pediatrician who conducted it – and its methodology has come under sharp criticism from LGBTQ advocates, scholars and practitioners, but has also prompted providers in the UK to scale back their use of the treatment.

Earlier this year, England’s National Health Service stopped prescribing puberty blockers for children and young people with gender dysphoria or gender incongruence, saying there is “not enough evidence to support the safety or clinical effectiveness” of puberty-suppressing hormones. The decision meant puberty blockers would be available through clinical researcher trials and in private clinics. People who were already using the treatment via NHS would be able to continue treatment.

Still, Solicitor General Elizabeth Prelogar said, the UK and other countries “have not outright banned this care.” The Cass Review, she said, notes at multiple points that such care “can be medically indicated for some transgender adolescents” even as it calls for a more individualized approach.

In the United States, major mainstream medical associations – including the American Medical Association, the American Psychiatric Association, the Endocrine Society, the American Psychological Association, the American Academy of Pediatrics and the American Academy of Child & Adolescent Psychiatry – have affirmed the practice of gender-affirming care and agree that it’s the gold standard of clinically appropriate care that can provide lifesaving treatment for children and adults.

Kavanaugh echoes Roberts’ concerns about courts weighing treatment bans' constitutionality

Justice Brett Kavanaugh picked up on Chief Justice John Roberts’ concern that this is not a natter courts should be wading into, asking US Solicitor General Elizabeth Prelogar, “Why isn’t it best to leave it to the democratic process?”

Prelogar acknowledged that legislatures should have leeway, but said that leeway was still constrained by the provisions in the constitution that say that individuals get equal protection under the law.

She also stressed that the Supreme Court could write a “very narrow” opinion case that merely instructs lower courts to demand more evidence from the state justifying the ban on transgender care for minors.

Kavanaugh, while nodding to the evidence of the treatments’ benefits highlighted by Sotomayor, said that there were risks on the other side, and returned to his skepticism that courts should be the decider of whether these state laws are constitutional.

“How do we as a court choose which set of risks is more serious in deciding whether to constitutionalize this whole area?” Kavanaugh said.

Trans lawmaker: "This is the most important case in the history of my community"

Minnesota state Rep. Leigh Finke, a Democrat and the first out transgender lawmaker in the state’s legislature, told CNN that gender-affirming care bans target trans people “simply because of who we are.”

She added: “What (lawmakers) are saying is that a certain class, a certain demographic of Americans, shouldn’t have access to the health care that they need because of who they are.”

By enacting trans care bans, Finke argued, conservative lawmakers are injecting themselves into private health decisions.

“Gender-affirming care is health care. Health care decisions belong in the home, in the doctor’s office — not in the courts, not with politicians,” she said.

These gay Americans say they oppose gender-affirming care — and explain why they came to SCOTUS today

Glenna Goldis and her friend, Jose, said they came to the Supreme Court from Brooklyn, New York, today to offer a more nuanced opinion about the case.

Glenna and Jose, who did not want to share a last name, said they want to protect the rights of same-sex children to explore their identity, without taking medications that could potentially harm them.

Key things to know about gender-affirming care as justices hear challenge to Tennessee ban

Gender-affirming care for transgender people — especially trans children and teens — has become the latest fault line in a growing American cultural rift and lies at the center of US v. Skrmetti. But what is it?

The multidisciplinary approach includes medically necessary and scientific evidence-based practices to help a person safely transition from their assigned gender – the one a clinician assigned them at birth, based mostly on anatomic characteristics – to their affirmed gender – the gender by which the person wants to be known.

Major mainstream medical associations agree that these treatments are the gold standard of clinically appropriate care that can provide lifesaving treatment for children and adults.

A transition plan can be as simple as offering support to someone when they start using different pronouns, change their hairstyle or clothing, or use a different name. It will often include mental health counseling.

Care could also include age-appropriate medication and surgery, including hormone treatments, puberty blockers, voice and communication therapy, gynecologic and urologic care and reproductive treatments. Typically, surgeries are offered only to adults.

Read more about this care, puberty blockers and hormones for trans youth.

Thomas poses first question: Isn't the Tennessee law age based?

As he has in recent years, conservative Justice Clarence Thomas – the most senior associate justice – asked the first question during the arguments: Why the court shouldn’t look at this as an age-based ban rather than a sex-based prohibition.

Thomas said it’s “not the case” that it’s a ban.

After years of not speaking during arguments, Thomas has become a regular participant since the pandemic forced format changes to the court’s debates. His first question often steers the arguments for several minutes with other justices building off his queries with follow up questions.

Will this be Elizabeth Prelogar’s last argument as solicitor general?

US Solicitor General Elizabeth Prelogar, who has won bipartisan praise for her advocacy, is representing the Biden administration. Prelogar has held the post throughout Biden’s administration, arguing more than 20 times since she was confirmed by the Senate in late 2021.

It’s not clear if this will be Prelogar’s last appearance at the high court as solicitor general. The federal government is a party in only a handful of major cases between now and when President-elect Donald Trump’s administration takes over on January 21. DOJ has asked to take part in oral arguments in an important First Amendment case set for mid-January.

A Department of Justice spokesperson declined to comment.

An Idaho native and a former Fulbright fellow, Prelogar clerked for Attorney General Merrick Garland, then a judge on the US Court of Appeals for the District of Columbia Circuit. She also clerked for two Supreme Court justices: Ruth Bader Ginsburg and Elena Kagan.

Prelogar’s exchanges with conservative Justice Samuel Alito have offered some of the most riveting moments at the hight court in recent years.

Abortion decision plays key role in transgender case

In defending its ban on transgender care for minors, Tennessee is relying heavily on the Supreme Court’s divisive decision from 2022 overturning Roe v. Wade. In its most recent brief, the state cites the decision in Dobbs v. Jackson Women’s Health Organization nearly a dozen times.

That’s because, in Dobbs, a majority of the court ruled that the “regulation of a medical procedure” that applies to only one sex – for instance, abortion – doesn’t necessarily violate the Constitution. Tennessee argues that its ban is also simply a regulation of a medical procedure.

But the transgender minors affected by the ban say the law is not like abortion – an across-the-board ban on a procedure. Instead, they argue, the state creates different restrictions based on an individual’s sex assigned at birth. An adolescent whose sex is assigned as male at birth may take testosterone, for instance, but an adolescent whose sex is assigned as female is barred from doing so.

Trump looms large over transgender legal fight

President-elect Donald Trump ran for a second term in part on a message of ending “transgender craziness” and he specifically attacked Vice President Kamala Harris for supporting “they/them,” a reference to pronouns sometimes used by transgender and non-binary individuals.

The Skrmetti appeal is likely to still be pending at the Supreme Court when Trump moves into the White House on January 21.

If the incoming Justice Department announces it is changing positions in the case, that could give the Supreme Court an out – an opportunity to dismiss the appeal. On the other hand, with the case fully briefed and argued there’s a good chance the court would simply proceed as planned.

“It’s not all that unusual,” said Pratik Shah, a veteran Supreme Court attorney who is working with the ACLU on behalf of the trans clients. “It shouldn’t change anything in terms of the court’s ability and process for deciding the case.”

What the scene is like outside the Supreme Court ahead of the high-stakes arguments on transgender rights

The Supreme Court’s highest-profile case of the term has drawn large crowds and dueling rallies outside the courthouse long before arguments are set to begin.

Hundreds of people gathered outside the building more than hour before the justices are set to hear the transgender care case – with music blaring and many carrying signs in support of transgender rights.

Although the dueling rallies are separated by barricades, both sides are using their platforms — and their music — to try to drown out the opposition. The atmosphere feels like a blend of a dance party and a political rally.

It is, by far, the largest group to appear outside the court since the term began in October, reflecting the significance of the case.

Arguments will begin at 10 a.m. ET in the case over Tennessee’s ban on gender-affirming care for minors.

Chase Strangio: The ACLU attorney with a personal stake in the SCOTUS decision

Chase Strangio will make history Wednesday as the first known transgender attorney to argue before the Supreme Court. The attorney for the ACLU will have a scheduled 15 minutes to present the argument against Tennessee’s ban to the justices.

When he spoke to CNN recently, Strangio said he has a visceral understanding of just how much is at stake.

“It is not lost on me that I will be standing there at the lectern at the Supreme Court in part because I was able to have access to the medical care that is the very subject of the case that we’re litigating,” he said. “I’m keenly aware that I want to preserve the ability for other people to access that care.”

Since joining the ACLU, Strangio has been a central part of legal teams that have secured major victories for LGBTQ Americans before the Supreme Court, including the right to marriage equality and a 2020 ruling that held LGBTQ discrimination in the workplace violates the Civil Rights Act of 1964.

Strangio told CNN he views his appearance before the court as a small part of the ongoing fight for civil rights in the United States.

“I think about all of the arguments that have that have been held in the Supreme Court over just the basic dignity of people … this is part of that history,” he said.

Read more from CNN’s profile of Chase Strangio.

Here's what to know about the Tennessee transgender care ban

The state law, enacted last year, bans hormone therapy and puberty blockers for minors and imposes civil penalties for doctors who violate the prohibitions. It is among a growing number of state laws enacted in recent years targeting transgender care.

Laws in Kentucky and Tennessee were challenged by the Biden administration and families of transgender minors. The Supreme Court only agreed to hear the challenge filed by the Biden administration in Tennessee.

In September 2023, the 6th US Circuit Court of Appeals in Cincinnati reversed a district court ruling that blocked the gender-affirming care ban from being enforced. In other words, the appeals court allowed the ban to take effect.

Republican lawmakers who support the ban say decisions about care should be made after an individual becomes an adult. Opponents argue that in addition to violating the civil rights of trans youth, the laws also run afoul of parents’ rights to make decisions about their child’s medical care.

Tennessee’s law says that medical providers cannot perform procedures that “enable a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex” or “treat purported discomfort or distress from a discordance between the minor’s sex and asserted identity.”

Read more about transgender care bans.