Tennessee is protecting minors from trans activism — why why won't Biden-Harris? 

Last week, my office filed a brief at the U.S. Supreme Court in U.S. v. Skrmetti, the federal government’s challenge to a Tennessee law protecting minors from risky gender-transition procedures. Tennessee’s evidence-based law is not only constitutional but reasonable. Medical research and practices in Europe support a cautious approach.

In recent years, the provision of drugs and surgeries to transgender-identifying kids spiked abruptly. Traditionally, most U.S. doctors declined to provide these irreversible interventions to minors. And over time, many of the European countries that originally pioneered these interventions have pulled back, citing unproven benefits and serious safety concerns for minors. 

Tennessee’s law arose following revelations of doctors subjecting children to pharmaceutical and surgical gender-transition procedures in Nashville. Reporting revealed that doctors had broadly prescribed these irreversible interventions despite acknowledging that they hadn’t “been doing this...long enough to know the long-term effects” on kids.  

In response, a bipartisan coalition of Tennessee legislators passed a law to protect minors from irreversible gender-transition procedures — surgery, hormones and puberty blockers. Before passing this law, the legislature heard testimony, reviewed medical evidence and considered the heightened protections in Europe against the use of these procedures on children.  

The evidence drove Tennessee’s law. The science shows that gender dysphoria goes away for most kids unless they are steered into a drug-based regimen. And a growing number of people have come forward to tell how they succumbed to pressure to undergo these procedures as minors, inflicting irreversible damage to their bodies.

Given the serious risks and the unexplained rise in gender dysphoria among youth in recent years, Tennessee’s elected officials determined that protecting minors was necessary. 

The Biden-Harris administration has built its opposition to Tennessee’s law on the foundation of a medical consensus that simply does not exist. Countries such as the United Kingdom, Sweden and Finland, which previously embraced pediatric gender-transition procedures have since restricted them after assessing the evidence.

Doctors have aired concerns over the significant risks associated with these procedures in national publications. And now nearly half of the states in this country have enacted protections similar to Tennessee’s. Yet the Biden-Harris administration proceeds as if these countervailing medical views did not exist.  

Not only that, but the federal government continues to point to discredited guidelines propounded by the World Professional Association of Transgender Health — guidelines that the government itself influenced.

WPATH initially commissioned a Johns Hopkins-led review to provide evidentiary support for its guidelines, but it abandoned that approach after the medical review found “little to no evidence” that children benefitted from gender-transition interventions.

One drafter put it bluntly: “Our concerns, echoed by the social justice lawyers we spoke with, is that evidence-based review reveals little or no evidence and puts us in an untenable position in terms of affecting policy or winning lawsuits.”  

Politics, not science, drove the guidelines. In fact, the very administration that asks the court to rely on these guidelines intervened in their drafting to remove age minimums on the procedures at issue. 

Further, the question here is not who has the best policy; it is whether unconstitutional discrimination occurred. It hasn’t.  

It is perfectly legal to say that drugs can be prescribed for one reason but not another. That happens all the time. Doctors can use morphine to treat a patient’s pain but not to assist a patient’s suicide. Doctors can prescribe steroids to address medical conditions but not to provide athletic advantage. The challenged law fits with states’ routine use-based limits on drugs.  

The Biden-Harris administration invokes the Constitution’s heightened protections against sex discrimination — protections that stem from a history of pervasive discrimination against women. But nothing in Tennessee’s law depends on sex. The government’s theory would perversely erode women’s rights by enabling men to claim constitutionally mandated access to women’s bathrooms, women’s locker rooms and women’s sports.  

Many doctors, states, and countries share Tennessee’s view on gender-transition interventions for minors; the federal government and others do not. People who disagree with Tennessee’s law can advocate for a different law through the democratic process. While the federal government is free to favor its transition-first, ask-questions-later approach, the Constitution does not bind Tennessee to that same choice. 

Jonathan Skrmetti serves as Tennessee’s attorney general and reporter.