United States v. Skrmetti (23-477)
argument 23-477United States v. Skrmetti
Supreme Court of the United States
2h 21m
7 speakers
7 chapters
transcribed 1 month ago
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Transcript
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What is the case and the Tennessee law (SB 1) being argued about?
We'll hear argument this morning in case twenty three four seven seven, United States versus Scrometti. General Pilager.
Mr Chief Justice, and may it please the court. This case is about access to medications that have been safely prescribed for decades to treat many conditions, including gender dysphoria. But SB One singles out and bans one particular use. In Tennessee, these medications can't be prescribed to allow a minor to identify with or live as a gender inconsistent with the minor's sex. It doesn't matter what parents decide is best for their children, it doesn't matter what patients would choose for themselves, and it doesn't matter if doctors believe this treatment is essential for individual patients. SB one categorically bans treatment when and only when it's inconsistent with the patient's birth sex. Tennessee says that sweeping ban is justified to protect adolescent health.
But the state mainly argues that it had no obligation to justify the law and that SB one should be upheld so long as it's not wholly irrational. That's wrong. SB One regulates by drawing sex-based lines and declares that those lines are designed to encourage minors to appreciate their sex. The law restricts medical care only when provided to induce physical effects inconsistent with birth sex. Someone assigned female at birth can't receive medication to live as a male, but someone assigned male can. If you change the individual sex, it changes the result. That's a facial sex classification full stop, and a law like that can't stand on bare rationality. To be clear, states have leeway to regulate gender-affirming care.
But here, Tennessee made no attempt to tailor its law to its stated health concerns. Rather than impose measured guardrails, SB1 bans the care outright, no matter how critical it is for an individual patient. And that approach is a stark departure from the state's regulation of pediatric care in all other contexts. SB1 leaves the same medications and many others entirely unrestricted when used for any other purpose, even when those uses present similar risks. The Sixth Circuit never considered whether Tennessee could justify that sex based line, because the Equal Protection Clause requires more, this court should remand so that SB one can be reviewed under the correct standard. I welcome the Court's questions.
Uh much of your uh the latter part of your opening statement suggests that the um well it seemed to suggest that there's an outright ban on mistreatment. But that's not the case. It's uh really for minors. Uh so why isn't this simply a case of age uh classification when it comes to these treatments as opposed to a ban, as you suggested in your opening statement?
It's certainly true, Justice Thomas, that the statute classifies based on age, but it packages that age classification with a sex restriction and says that for all adolescents, you cannot take these medications if they're inconsistent with your sex. So I acknowledge that the state so far has not banned this care for adults, although I think that the arguments it's making that this isn't a sex-based line in the first place would equally apply in that context. But the The Court has likewise made clear that when you classify on the basis of multiple characteristics, you can't avoid hide-and-scriny just because you have a non-protected characteristic that accompanies the protected one. And if you look at it from the standpoint of the plaintiffs who are actually affected by this law, the reason I'm calling it a categorical ban is because the state has left no out for those patients to obtain these medications when there's a showing of individual
medical need. And that is, I think, a a stark departure from how the state ordinarily handles issues related to measuring risks and benefits, even in the pediatric context.
Well is there no difference uh in uh The d if a girl takes uh testosterone uh or if a boy takes uh testosterone.
So the district court specifically considered this question in detail and found that with respect to the risks that the state had identified, it was not substantiated that there would be unique risks associated with a cross sex use of the state.
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Chapters
7 chapters
1
What is the case and the Tennessee law (SB 1) being argued about?
0:00–8:10
2
How do the parties frame SB 1 as a facial sex classification and why does it trigger heightened scrutiny?
8:10–56:37
3
What medical and international evidence do the parties cite about the benefits and risks of gender‑affirming care?
56:37–1:16:16
4
How do the parties argue about the risk of suicide and the scientific evidence for gender‑affirming medication?
1:16:16–1:30:20
5
Is transgender status an immutable characteristic that qualifies as a quasi‑suspect classification?
1:30:20–1:42:10
6
What specific relief are the parties seeking and how does it relate to the injunction on SB 1?
1:42:10–2:04:07
7
Why do the advocates disagree on whether the case should be reviewed under rational‑basis or intermediate scrutiny?
2:04:07–2:21:09