Attorney General Bonta Leads 20 States in Opposing Tennessee’s Law Barring Access to Gender-Affirming Care for Transgender Youth

OAKLAND — California Attorney General Rob Bonta led a multistate coalition of 20 attorneys general in filing an amicus brief in the U.S. Supreme Court in U.S. v. Skrmetti, urging the Court to reverse a decision from the Sixth Circuit Court of Appeals upholding a state law in Tennessee that bans critical, lifesaving gender-affirming care for transgender adolescents suffering from gender dysphoria. In April 2023, plaintiffs in L.W. v. Skrmetti sued to enjoin Tennessee’s Senate Bill (SB) 1, which prohibits medical professionals from treating transgender adolescents with gender dysphoria using gender-affirming puberty blockers and hormone therapy—regardless of what the transgender minor, their parents, and their medical providers deem to be medically necessary, and even though the medical and scientific evidence is clear that the benefits of gender-affirming care far outweigh any limited risks, and every major medical organization agrees that such care is safe and effective. In the amicus brief, the coalition stresses that a ban on gender-affirming care constitutes discrimination on the basis of sex and transgender status, and violates the Equal Protection Clause of the U.S. Constitution.

“Amidst a growing assault on LGBTQ+ rights nationwide, it is crucial to safeguard and uphold health care rights and freedoms for all, particularly our most vulnerable communities,” said Attorney General Bonta. “In our ongoing efforts to ensure equal and uninterrupted medical care for everyone, I urge the Supreme Court to reverse the lower court’s ruling. Tennessee's discriminatory law only serves to further marginalize transgender individuals and put their lives at risk.”

In August 2023, Attorney General Bonta led a coalition in support of the plaintiffs, stressing the importance of gender-affirming care for the health and well-being of transgender youth. After a district court ruled that SB 1 likely violated the Equal Protection Clause and granted a preliminary injunction against the law, the Sixth Circuit Court of Appeals reversed the decision. Unlike the district court, the Sixth Circuit failed to recognize that SB 1 discriminates on the basis of sex and transgender status.

Many transgender teens suffer from gender dysphoria, which results from the incongruence between their gender identity and sex assigned at birth. When left untreated, gender dysphoria has been found to cause severe distress and anxiety, depression, fatigue, decreased social functioning, substance misuse, and a poorer quality of life. Among transgender people, suicide attempts are nine times more common than in the overall U.S. population. Those risks are even higher among transgender youth.

In their amicus brief, the coalition asserts that SB 1:

• Significantly harms the health and lives of transgender adolescents by denying them medically necessary care that protects their physical, emotional, and psychological health.
• Is discriminatory because it bans medical treatment for transgender youth while permitting it for cisgender youth. 
• Violates the Equal Protection Clause because Tennessee cannot justify categorically banning a vulnerable group of people from accessing a beneficial form of care.

In filing the amicus brief, Attorney General Bonta was joined by the attorneys general of Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, and the District of Columbia.

A copy of the amicus brief is available here.