RALEIGH — The Supreme Court upheld the 6th Circuit Court of Appeals ruling involving a Tennessee law banning puberty blockers and hormone therapy for transgender minors, a decision that could affect a lawsuit in North Carolina.
In its 6-3 ruling in USA v. Skrmetti, the Supreme Court rejected the plaintiff’s central argument that the law violated the Constitution’s equal protection clause.
“This case carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field. The voices in these debates raise sincere concerns; the implications for all are profound,” wrote Chief Justice John Roberts for the majority. “The Equal Protection Clause does not resolve these disagreements. Nor does it afford us license to decide them as we see best.”
The ruling also rejected the application of the case Bostock v. Clayton County, stating that the reasoning does not apply, as changing a minor’s sex or transgender status does not alter the Tennessee law’s application.
Democratic Justice Sonya Sotomayor, Ketanji Brown Jackson and Elena Kagan all dissented.
“In today’s historic Supreme Court win, the common sense of Tennessee voters prevailed over judicial activism,” Tennessee Attorney General Jonathan Skrmetti said in a press statement. “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.”
The high court’s ruling in Skrmetti has implications for a 2019 lawsuit filed against the North Carolina State Health Plan (SHP).
“The Court’s ruling in Tennessee’s equal protection case upholds our arguments in the long-running Kadel v. Folwell case here in North Carolina,” said North Carolina Treasurer Brad Briner in a press release. “In its simplest form, this case has always been about ensuring that the State Health Plan can conduct its business in a manner that best serves the members of the Plan. We are thankful that the Supreme Court has affirmed the ability of the Plan to do just that.”
The Kadel v. Folwell case was filed over the SHP’s exclusion of coverage for medications and treatments related to gender transition surgeries. The exclusion dates back to the 1990s, with a one-year window in 2016 during which the exclusion of those treatments was not enforced.
Like Skrmetti, the plaintiffs in Kadel had also invoked the 14th Amendment’s equal protection clause.
“Based on the decision in Skrmetti today, it is expected the Supreme Court will issue an order in the Plan’s appeal in Kadel reversing the decision of the 4th Circuit and remanding the case,” Briner’s press release stated. “It is anticipated this order will also remove the injunction against the Plan.”
The treasurer’s release also says that after the Supreme Court issues an order in the Kadel case, the SHP will “evaluate the order and work with Aetna, Caremark and the Plan’s other vendors to guarantee the Plan is following the law.”
In June 2023, 21 states joined an amicus brief in support of the SHP’s position, a number that grew to 23 the following year in an additional amicus support brief.
The Supreme Court’s ruling will also likely impact a complaint challenging a 2023 law enacted that bans gender surgeries for minors. The Biden administration had intervened in the case in October 2023, but the Trump administration withdrew the government’s participation this February.
Including North Carolina, 27 states have some form of law banning gender-affirming care, such as hormone treatments, puberty blockers and transition surgeries for minors. According to The New York Times, 19 of the bans have been legally challenged with “mixed results.”
