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The case U.S. v. Skrmetti is about the Equal Protection clause of the U.S. Constitution. The decision will shape gender-affirming care in America.
This week, the U.S. Supreme Court will hear U.S. v. Skrmetti, a case that could redefine access to health care for transgender youth and shape constitutional protections against sex-based discrimination. The challenge centers on a Tennessee law that bans gender-affirming medical care for minors, including puberty blockers and hormone therapy.
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At the heart of the lawsuit is L.W., a 16-year-old transgender girl, whose family contends that the law violates the Equal Protection Clause and interferes with parental rights. Represented by the American Civil Liberties Union, they argue that the ban is an unconstitutional intrusion into private medical decisions.
Related: What is U.S. v. Skrmetti, the Supreme Court case that could change gender-affirming care forever?
During a press call Monday morning, L.W.’s father, Brian Williams, shared how his family has been impacted. He described the long journey of supporting L.W. after she came out as transgender and the life-changing role of gender-affirming care.
“Every decision we make as a family is to help give our children the future they deserve,” Williams said. “When L.W. first came out as transgender, it was the start of a long but loving process of learning, growth, and patience.”
Williams recounted how, after extensive consultations with medical experts and therapists, L.W. began puberty blockers at 13 and hormone therapy a year later. Now, she is a thriving teenager who enjoys making music, designing video games, and planning for college.
“Her joy, her smile, and her confidence would not be what they are if it were not for the healthcare we and her doctors know is right for her,” he said.
Related: Trans teen pleads with SCOTUS to strike down Tennessee’s gender-affirming care ban ahead of landmark hearing
The Tennessee law, SB 1, has forced the family to travel to another state for care — a burden they know many others cannot afford.
“Tennessee’s ban on gender-affirming medical care is an active threat to the future my daughter deserves,” Williams said. “It infringes not only on her freedom to be herself but on our family’s love for her.”
He urged others to approach transgender youth and their families with empathy. “At the very least, we’d ask others to do what we did all those years ago when L.W. first came out to us: open your hearts and listen.”
Also speaking on the call was Rick Colby, a Republican lobbyist and the self-described “conservative” father of a transgender son, Ashton, who transitioned in 2012. Colby described how supporting Ashton through his transition transformed his understanding of gender identity and his priorities as a parent.
“One cold February Sunday night, I got a call that he was near suicide at college in Dayton, Ohio,” Colby said. “So I jumped in my car and drove down, and that started a years-long process of helping my son transition and become the person he was always meant to be.”
Colby, who said he’s been a Republican since working on Ronald Reagan’s 1984 presidential campaign, criticized his party’s push to ban gender-affirming care.
“Yes, I’m a Republican, but first and foremost, I’m a parent and a dad,” he said. “Being transgender is a real thing, and if it’s a real thing, in my view, it transcends any political ideology.”
He called Tennessee’s law and others like it a “one-size-fits-all government mandate” that disregards families’ needs and professionals’ medical expertise. All major medical associations support gender-affirming care as proven, effective, and necessary medical care.
“I believe government should not be creating barriers to opportunities for transgender people,” Colby said. “They have the right to achieve the American dream just like everyone else.”
The plaintiffs argue that Tennessee’s law discriminates based on sex by banning treatments only when they are intended to affirm a gender identity different from the one assigned at birth. Similar treatments remain legal for cisgender minors for other medical conditions, such as precocious puberty.
“This law targets transgender youth, banning treatments solely because they allow someone to live in a way inconsistent with their sex assigned at birth,” said Chase Strangio, the ACLU attorney representing the family. “That’s classic sex discrimination.”
Related: Meet the transgender lawyer leading a bold fight to show Supreme Court justices that trans lives matter
Strangio, who will be the first out transgender lawyer to argue before the Supreme Court, will share argument time with attorneys from the U.S. Department of Justice, which has also joined the fight against the law. He said the Supreme Court must hold Tennessee’s law to the same constitutional standard as other laws that classify based on sex.
The outcome of U.S. v. Skrmetti could have far-reaching consequences. Currently, 23 states have enacted laws restricting gender-affirming care for minors. Advocates warn that if the Supreme Court upholds Tennessee’s law, it could encourage states to impose even stricter bans, including on care for transgender adults.
“This case is not just about trans kids; it’s about whether our courts will uphold equal protection under the law,” said Sasha Buchert, director of Lambda Legal’s Nonbinary and Transgender Rights Project, which is co-counsel in the case.
Colby, meanwhile, hopes his experience as a parent will resonate with lawmakers and the public alike.
“I hope that the promise of America extends to transgender people like my son and other young people,” he said.
As arguments begin on Wednesday, families, advocates, and supporters will rally outside the Supreme Court. The decision, expected next year, could become a defining moment in the fight for transgender rights and access to healthcare in the United States.
For Williams, the goal is simple: to ensure his daughter can grow up without barriers imposed by the state.
“We are asking for her freedom to be herself without fear,” he said.
