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

The Supreme Court is preparing to rule in United States v. Skrmetti, a landmark case that could reshape the legal landscape for LGBTQ+ rights, parental rights, and healthcare access—not only in Tennessee, but in Nebraska and across the country.

At the heart of the case is Tennessee’s ban on gender-affirming medical care for transgender minors, now under challenge as unconstitutional under the Equal Protection Clause of the Fourteenth Amendment.

What Is United States v. Skrmetti About?

The plaintiffs include three transgender teenagers, their parents, and a Tennessee physician who provides gender-affirming care. They argue that Tennessee’s law discriminates against transgender youth by denying access to widely accepted medical treatments—like puberty blockers and hormone therapy—recommended by major medical organizations such as the American Academy of Pediatrics and the Endocrine Society.

These treatments are often crucial to the mental health and physical wellbeing of transgender youth. The ban, they argue, is not based on medical science but rather on political and ideological motivations—and violates constitutional guarantees of equal protection.

The Constitutional Questions Before the Court

One of the most pressing legal questions is whether Tennessee’s law constitutes discrimination based on sex or transgender status. The law bans puberty blockers and hormone therapy when used for gender-affirming purposes, but still allows those same treatments for other conditions like precocious puberty. This inconsistency is central to the plaintiffs’ claim of unequal treatment under the law.

The Court will also consider what level of constitutional scrutiny should apply to laws regulating transgender care. If it recognizes this as sex-based discrimination, the state would have to meet a much higher standard to justify the law. The plaintiffs argue that the Court’s reasoning in Bostock v. Clayton County—which found that discrimination against transgender employees is a form of sex discrimination—should logically extend beyond the workplace and into the realm of healthcare and civil rights protections.

What Have the Lower Courts Said?

The District Court initially blocked Tennessee’s law, ruling it likely unconstitutional. But the Sixth Circuit Court of Appeals reversed that decision and allowed the ban to take effect. The appellate court applied a more deferential legal standard, focusing on the state’s right to regulate medical treatments.

During oral arguments in December 2024, the Supreme Court justices appeared divided. Some focused on the potential discriminatory impact of the law, while others examined parental rights, state authority, and whether medical decisions for minors are constitutionally protected.

Why This Case Matters in Nebraska

You might be wondering: what does a Tennessee case have to do with LGBTQ+ rights in Nebraska?

Here’s the connection. In 2023, the Nebraska Legislature passed LB 574 (the “Let Them Grow Act”), which restricts gender-affirming medical care for transgender minors here in our state. That law echoes Tennessee’s in both structure and intent.

The ruling in United States v. Skrmetti will set a national precedent. It could either bolster or weaken the legal arguments against Nebraska’s own law, depending on the outcome. It may also influence how courts interpret parental rights, bodily autonomy, and state control over medical decisions in future legal challenges.

What This Means for LGBTQ+ Families in Nebraska

At Zachary W. Anderson Law, we represent LGBTQ+ clients and families across Nebraska, especially in matters where gender identity intersects with family law, guardianship, and healthcare rights.

This case strikes at the core of our values as a firm:

• Protecting equal rights under the law

• Defending parental authority in medical decisions

• Supporting the bodily autonomy of transgender youth

Whether the Supreme Court limits or expands constitutional protections, the outcome will shape how we fight for our clients’ rights — and how Nebraska’s courts interpret similar legal challenges.

When Will the Court Decide?

The Supreme Court is expected to issue its opinion by June 2025. That decision will have major implications not just for Tennessee and Nebraska, but for LGBTQ+ legal protections nationwide.

If you’re concerned about how this ruling—or Nebraska’s own legislation—could affect you or your family, please reach out. You don’t have to navigate these legal and emotional issues alone.

Call or text: (402) 259-0059 or Email: zach@zandersonlaw.com.

Frequently Asked Questions

What is United States v. Skrmetti?

It’s a pending Supreme Court case challenging Tennessee’s ban on gender-affirming medical care for transgender minors. The case could set a national precedent regarding transgender rights, parental rights, and access to healthcare under the U.S. Constitution.

How does this case affect Nebraska?

Nebraska passed a similar law (LB 574) in 2023. The ruling in U.S. v. Skrmetti could determine whether Nebraska’s law—and others like it—are constitutional, and may shape future litigation here in the state.

What is gender-affirming care?

Gender-affirming care includes medical treatments that help a person’s physical body align with their gender identity. For minors, this often includes puberty blockers, hormone therapy, and mental health support, all backed by major medical organizations.

Does the Constitution protect parental rights to seek medical care for their children?

Yes—but how far those protections extend is part of what the Supreme Court is deciding in this case. The plaintiffs argue that parents have a constitutional right to seek medically necessary care for their transgender children without government interference.

What was the Bostock v. Clayton County decision?

In 2020, the Supreme Court ruled in Bostock that discrimination against transgender people in the workplace is a form of sex discrimination under federal law. Plaintiffs in the Skrmetti case are asking the Court to apply similar reasoning to healthcare and equal protection rights.