The Supreme Court on December 4 will hear oral arguments in a case dealing with Tennessee’s law banning irreversible gender transition procedures for children — and it promises to be one of the most significant cases the court has looked at this term.

Tennessee Gov. Bill Lee (R.) signed the much-discussed Senate Bill 1 into law on March 22, 2023, which went into effect on July 1, 2023. The bill bans doctors or health care providers from performing so-called “gender-affirming” surgeries or hormonal procedures on minors, including surgery, puberty blockers, and hormones.

The bill followed a September 2022 investigation into Vanderbilt University Medical Center (VUMC) by the The Daily Wire’s Matt Walsh, who exposed VUMC’s gender transition procedures for children and shocking attitudes towards gender transitions in general. Walsh and The Daily Wire found that the hospital regarded transgender procedures as a “big money maker” and pressured employees to ignore their “religious beliefs” on transgender issues or face “consequences.”

The Biden administration joined the ACLU and several teenage plaintiffs suing to stop the law, and a Tennessee district court initially blocked it in April 2023. But in September 2023, a sixth circuit court upheld Tennessee’s protections for children. The Supreme Court took up the case in June 2024, combining the Justice Department and ACLU cases into United States v. Skrmetti, marking the first time that the High Court took up a case of this kind.

“The people of Tennessee, through their elected representatives, took measured action with Senate Bill 1 to protect kids from irreversible, unproven medical procedures,” Tennessee Attorney General Jonathan Skrmetti said in an October statement. “Lawmakers recognized that there is little to no credible evidence to justify the serious risks these procedures present to youth and joined a growing number of European countries in restricting their use on minors with gender-identity issues.”

The ACLU led a variety of left-wing legal groups in suing Tennessee in April 2023 to block the law from going into effect, calling these transgender procedures “medically necessary gender-affirming care for Tennessee’s transgender youth.” That claim is based on activist assertions that young people suffering from gender dysphoria may commit suicide if they do not have access to transgender hormones or surgeries.

Recent research has shown that, contrary to such claims, these procedures actually increase the likelihood that minors will attempt suicide. According to an April study, “gender-affirming surgery is significantly associated with elevated suicide-attempt risks, underlining the necessity for comprehensive post-procedure psychiatric support.”

Yet the ACLU and their allies are suing Tennessee on behalf of a Nashville, Tennessee couple and their 15-year-old son, who identifies as a girl, as well as a doctor from Memphis, Tennessee, Dr. Susan Lacy.

“It was incredibly painful watching my child struggle before we were able to get her the life-saving healthcare she needed. We have a confident, happy daughter now, who is free to be herself and she is thriving,” the ACLU’s client, Samantha Williams, said earlier this year of her trans-identifying son.

“I am so afraid of what this law will mean for her,” she said. “We don’t want to leave Tennessee, but this legislation would force us to either routinely leave our state to get our daughter the medical care she desperately needs or to uproot our entire lives and leave Tennessee altogether. No family should have to make this kind of choice.”

Skrmetti’s office argues that states have governed the practice of medicine within their borders since the United States was founded, pointing out that it is states who license doctors and regulate medical practices, which includes restricting the administration of drugs. The Tennessee lawmakers who passed Senate Bill 1 used that power to stop the use of hormonal and surgical procedures for minor gender transition procedures, Skrmetti’s office said.

More than 20 other states have passed similar laws protecting children, they pointed out.

“The federal government, in its arguments to the Supreme Court, puts its faith in a false and manufactured consensus that ignores the many doctors, States, and countries who have looked at the evidence and determined these treatments are too risky for kids,” Skrmetti added. “The Constitution does not prevent the States from regulating the practice of medicine where hot-button social issues are concerned. People who disagree with restrictions on irreversible pediatric procedures for gender transition are free to advocate for change through state elections.”

The ACLU’s case will be argued by Chase Strangio, a woman who identifies as a transgender man. The ACLU has advertised that Strangio will be the first openly trans-identifying individual to argue a case before the Supreme Court, describing Strangio as “our nation’s leading legal expert on the rights of transgender people, bar none.”