Tennessee Ban on Puberty Blockers, Hormones for Children Likely Violates Constitution

A new Tennessee law that bans transgender procedures for minors was partially blocked by a federal judge, who said the prohibition likely runs afoul of the U.S. Constitution.

“If Tennessee wishes to regulate access to certain medical procedures, it must do so in a manner that does not infringe on the rights conferred by the United States Constitution, which is of course supreme to all other laws of the land. With regard to SB1, Tennessee has likely failed to do just this,” U.S. District Judge Eli Richardson wrote in a 69-page ruling.

Richardson, a Trump appointee, ruled in favor of plaintiffs, which include the couple Samantha Williams and Brian Williams and their 15-year-old child, who is said to be transgender.

The ruling imposes a preliminary injunction on parts of state law 68-33-101, which was passed by state legislators and signed by Tennessee Gov. Bill Lee in March.

The law, which is set to go into effect on July 1, bars health care providers from performing on a minor or administering to a minor a medical procedure “if the performance or administration of the procedure is for the purpose of enabling a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex or treating purported discomfort or distress from a discordance between the minor’s sex and asserted identity.”

Richardson’s ruling enables minors to continue receiving puberty blockers and cross-sex hormones.

The part of the law that bans surgical procedures such as the removal of breasts was not blocked because none of the plaintiffs were seeking such procedures.

The judge said that gender dysphoria, or a person feeling they are a different gender, is “a common condition for transgender people” and that procedures and prescriptions such as puberty blockers can help treat a person “to live in alignment with their gender identity.” The law “in effect bans minors from receiving all treatment for gender dysphoria,” he said.

Plaintiffs alleged the law infringed on rights granted by the Fourteenth Amendment’s Due Process clause because the government was burdening their fundamental right to seek “appropriate medical care” for their children.

“There is no situation where a minor will access the care subject to the Ban without the consent of their legal guardian, and there certainly is no world where a parent may decide for their child that gender-affirming care is needed over the minor’s objection,” they said. “Thus, every application of the Ban necessarily substitutes the judgment of the State for the aligned wishes of the parent and child.”

Tennessee Attorney General Jonathan Skrmetti and other defendants said parents do not have a fundamental right to have the transgender procedures and treatments performed on their children.

“Plaintiffs make no effort to prove that a fundamental right to these treatments existed in 1868 when the Fourteenth Amendment was ratified,” the defendants said, adding later that “parental direction does not create a backdoor constitutional right to a treatment that the State can lawfully ban.”

The judge sided with the plaintiffs, pointing to a ruling in a different case that found parents “possess a fundamental right to make decisions concerning the medical care of their children.”

“Under binding Sixth Circuit precedent, parents have a fundamental right to direct the medical care of their children, which naturally includes the right of parents to request certain medical treatments on behalf of their children,” he said.

That means the law must survive a test known as strict scrutiny, or be narrowly tailored to advance a compelling state interest. Defendants have not met that bar, in part because they have not shown that the law treats “transgender minors” differently from other minors, according to the judge.

The ruling will hold until the judge revokes it or enters a permanent ruling after the case develops further.

The American Civil Liberties Union, which is representing the plaintiffs, hailed the ruling.

“This law is an intrusion upon the rights and lives of Tennessee families and threatens the futures of trans youth across the state. We are determined to continue fighting this unconstitutional law until it is struck down for good,” Lucas Cameron-Vaughn, an attorney for the group, said in a statement. “And to trans youth and their families: we see you, and we will not stop until all trans Tennesseans have the care and support they need to thrive.”

Tennessee House Majority Leader William Lamberth, a Republican who wrote the law, said in a statement that he was disappointed in the ruling.

“It is a sad day in Tennessee when, in place of protecting innocent children, our courts normalize a dangerous ideology that promotes the abuse and chemical castration of healthy young people,” Lamberth said. “I am grateful for the wisdom of the General Assembly in recognizing and passing legislation that, despite today’s disappointing ruling, will protect children from gender-mutilating surgeries beginning July 1st. Tennessee Republicans will vigorously fight this decision to the highest court in the nation.”