Supreme Court Confronts Transgender Healthcare Ban: What’s at Stake in U.S. v. Skrmetti

The Supreme Court is poised to issue a decision in United States v. Skrmetti, a case that could profoundly shape the future of LGBTQ+ rights, parental rights, and healthcare access in this country. At the center of the case is Tennessee’s ban on gender-affirming medical care for transgender minors—a law now being challenged as unconstitutional under the Equal Protection Clause of the Fourteenth Amendment.

The plaintiffs include three transgender teenagers, their families, and a Tennessee physician who provides gender-affirming care. The Biden administration has also joined the case in support of their claim. They argue that Tennessee’s law unlawfully discriminates against transgender youth by denying them access to medically necessary care. For context, gender-affirming care for minors typically includes treatments like puberty blockers and hormone therapy—interventions that are recommended by leading medical organizations and, for many transgender youth, are critical to their mental and physical well-being.

One of the most significant legal questions here is whether this law amounts to discrimination on the basis of sex or transgender status. The Tennessee law bans these treatments when provided to transgender youth, but still permits them for other medical conditions, such as precocious puberty or congenital issues. This unequal treatment is central to the plaintiffs’ argument that the law violates the Equal Protection Clause.

The Court will also decide what level of scrutiny should apply to laws like this. If the Court recognizes this as sex-based discrimination, the state would face a higher bar in defending the law. The plaintiffs further argue that the Court’s reasoning in Bostock v. Clayton County—which found that discrimination against transgender people is a form of sex discrimination in employment—should extend to healthcare and other equal protection contexts.

Lower courts have been divided. The District Court initially blocked the law, finding it likely unconstitutional, but the Sixth Circuit Court of Appeals reversed that decision, applying a more deferential review and allowing the ban to go into effect.

When the Supreme Court heard oral arguments in December 2024, the justices appeared sharply divided. Some focused on the discrimination issue, while others questioned the extent of parental rights and the state’s role in regulating medical care for minors.

Now, why does this matter here in Nebraska—and to our firm?

Several states, including Nebraska, have enacted or are considering laws that restrict access to gender-affirming care for minors. The Nebraska Legislature passed LB 574 (known as the “Let Them Grow Act”) in 2023, which placed significant restrictions on gender-affirming care in our state. The ruling in U.S. v. Skrmetti could either bolster or undermine the legal arguments being made against Nebraska’s law and similar legislation across the country. In short, this case will help define what protections transgender Nebraskans can expect under both state and federal constitutional law.

At Zachary W. Anderson Law, we care deeply about protecting the rights of LGBTQ+ individuals and families in Nebraska. We actively represent clients in family law and guardianship matters where gender identity and LGBTQ+ issues are central concerns. This case speaks directly to the values we hold as a firm—advocating for equal treatment under the law, for bodily autonomy, and for the rights of parents to make informed healthcare decisions for their children.

A decision is expected by June 2025. Whatever the outcome, United States v. Skrmetti will shape the legal landscape in Nebraska and nationwide for years to come.

If you or your family have questions about how this case—or Nebraska’s own laws—might impact you, please reach out. We are always here to help. You can contact us at (402) 259-0059 or zach@zandersonlaw.com.