June 18, 2025
See the statements below from the O’Neill Institute’s health law experts on the Supreme Court’s decision in United States v. Skrmetti.
Michele Bratcher Goodwin, Linda D. & Timothy J. O’Neill Professor of Constitutional Law and Global Health Policy; Co-Faculty Director, O’Neill Institute
Today, the Supreme Court ruled 6-3 to uphold laws that ban gender affirming care for trans youth. Missing from much of the analysis regarding the legislation is that gender affirming care for youth predates these laws by decades. That is, these states have tolerated and embraced gender-affirming care for cis-gender youth.
The Tennessee law explicitly and unconstitutionally discriminates based on sex. It explicitly permits hormone treatments and gender-affirming care for youth who identify as cisgender while denying the exact same care for youth who identify as trans. The state could altogether ban gender-affirming care for all youth. It could also ban all hormone care and therapy for all youth. But that is not what the state law is intended to do. It engages in invidious discrimination, because it explicitly discriminates against one class of youth — denying them equal access to the medicines it provides to others.
This case must be understood as not only preserving invidious discrimination against trans youth, but also abandoning core principles embedded in constitutional law.
Lawrence O. Gostin, Founding O’Neill Chair in Global Health Law; Co-Faculty Director, O’Neill Institute
Today, the Supreme Court decided in United States v. Skrmetti that discriminating against transgender minors by restricting their access to health care does not run afoul of the 14th Amendment’s equal protection clause. It’s jaw-dropping to see a majority of Supreme Court justices turn a blind eye while transgender minors are flatly denied access to health services in consultation with their doctors. The Court is greenlighting red state laws that will deeply affect the lives of marginalized and victimized people seeking healthcare, social acceptance, and dignity. This decision paves the way for additional restrictions on other essential but politically fraught services, notably within sexual and reproductive health.
Discrimination has no place in America, and it is sad to see the nation’s highest court side with states that discriminate against our most vulnerable and marginalized citizens.
For media inquiries, please contact oneillcomms@georgetown.edu.