Sex & Gender /

Department of Justice Sues Tennessee Over Law Banning 'Critical, Medically Necessary Care for Transgender Youth'

The DOJ said Senate Bill 1 violates the Equal Protection Clause and discriminates against minors who identify as transgender


The U.S. Department of Justice is suing Tennessee after the state restricted what medical intervention could be offered to minors who identify as transgender.

Governor Bill Lee signed Senate Bill 1 into law in March. The law prohibits minors from being given puberty blockers or hormones used to alter biological manifestations of gender. Transgender-identifying minors who are already taking the now outlawed prescriptions — or begin them before July 1 — will be able to continue their treatments until March 31, 2024.

If healthcare providers violate this law, they can be fined up to $25,000 by the attorney general.

The DOJ said the law “discriminates against transgender youth” and violated the “Equal Protection Clause by discriminating on the basis of both sex and transgender status.”

“No person should be denied access to necessary medical care just because of their transgender status,” Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division said in an April 27 statement. “The right to consider your health and medically-approved treatment options with your family and doctors is a right that everyone should have, including transgender children, who are especially vulnerable to serious risks of depression, anxiety and suicide.” 

Clarke said that the DOJ’s Civil Rights “will continue to aggressively challenge all forms of discrimination and unlawful barriers faced by the LGBTQI+ community.”

The office of Tennessee Attorney General Jonathan Skrmetti pushed back against the accusation of discrimination, suggesting the department’s use of the phrase “medically necessary” is misleading. A spokeswoman for Skrmetti said that “mounting evidence has persuaded a growing number of countries that irreversible medical interventions are not appropriate for kids showing symptoms of gender dysphoria,” reports The Washington Examiner

Tennesse lawmakers who voted in favor of SB 1 have pointed to changes in policy regarding the treatment of gender dysphoria in minors in Western European countries. They also argued that the treatments have permanent, irreversible consequences and therefore must be regarded with extreme caution.

“No child should ever be put in the position of making a permanent, life-altering decision to disfigure their body in this way,” wrote Tennessee House Majority Leader William Lamberth, the lead sponsor of the bill, in an opinion piece for The Tennessean in October. “They can’t possibly understand the future reality of what that means. Least of all, a child under distress because they’re experiencing gender confusion.”

The federal government has taken a number of steps to intervene and block state laws that restrict doctors from offering minors medical intervention to address gender-related issues.

The DOJ sued Alabama over its Senate Bill 184 on April 29, 2022 – just over 20 days after the measure was passed by the state Senate. The law recognizes sex as the “biological state of being female or male, based on sex organs, chromosomes, and endogenous hormone profiles, and is genetically encoded into a person at the moment of conception, and it cannot be changed.” The law also made it a Class C felony for health care workers to provide minors any “gender-changing practice,” which includes puberty blockers, hormonal treatments and cosmetic procedure. The legislature said the prohibited medical intervention did not address the psychological issues minors with gender dysphoria are experiencing and “can result in a higher rate of substance abuse and depression,” per The Samford Crimson

S.B. 184 thus discriminates against transgender youth by denying them access to certain forms of medically necessary care,” said the DOJ in a press release. “It further discriminates against transgender youth by barring them from accessing particular procedures while allowing non-transgender minors to access the same or similar procedures.”

The federal agency said the lawsuit is part of its work to “combat discrimination based on gender identity.”

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