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Justice Department challenges Tennessee’s ban on gender-affirming care for minors

<i>Sarah Silbiger/Pool/Getty Images</i><br/>On April 26
Getty Images
Sarah Silbiger/Pool/Getty Images
On April 26

By Amy Simonson and Shawna Mizelle, CNN

The Justice Department on Wednesday filed a complaint challenging a recently enacted Tennessee bill that prohibits gender-affirming care for minors, saying it “denies necessary medical care to youth based solely on who they are.”

DOJ argues in its complaint that the legislation violates the Fourteenth Amendment’s Equal Protection Clause by discriminating on the basis of both sex and transgender status and asks the court to issue an immediate order to block the law from taking effect on July 1.

“SB 1 makes it unlawful to provide or offer to provide certain types of medical care for transgender minors with diagnosed gender dysphoria. SB 1’s blanket ban prohibits potential treatment options that have been recommended by major medical associations for consideration in limited circumstances in accordance with established and comprehensive guidelines and standards of care,” a news release from the department states. “By denying only transgender youth access to these forms of medically necessary care while allowing non-transgender minors access to the same or similar procedures, SB 1 discriminates against transgender youth.”

In a statement to CNN, Gov. Bill Lee said, “Tennessee is committed to protecting children from permanent, life-altering decisions. This is federal overreach at its worst, and we will work with Attorney General Skrmetti to push back in court and stand up for children.”

Senate Bill 0001, signed into law by the Republican governor last month, prohibits 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.”

The legislation specifies that minors who receive care cannot be held liable but lawsuits could be brought against their parents “if the parent of the minor consented to the conduct that constituted the violation on behalf of the minor.” It also grants the attorney general the authority to fine health care professionals who provide the care with a civil penalty of $25,000 per violation.

Gender-affirming care that began prior to July 1 is not considered a violation “provided that the treating physician must make a written certification that ending the medical procedure would be harmful to the minor,” though access to such care must conclude by March 31, 2024. The legislation expresses concern over long-term outcomes and questions whether minors are capable of making such consequential decisions.

Major medical associations agree that gender-affirming care is clinically appropriate for children and adults with gender dysphoria, which, according to the American Psychiatric Association, is psychological distress that may result when a person’s gender identity and sex assigned at birth do not align.

Though the care is highly individualized, some children may decide to use reversible puberty suppression therapy. This part of the process may also include hormone therapy that can lead to gender-affirming physical change. Surgical interventions, however, are not typically done on children and many health care providers do not offer them to minors.

US Attorney for the Middle District of Tennessee Henry Leventis said in a statement that SB 1 violates the constitutional rights of the state’s “most vulnerable victims.”

“Left unchallenged, it would prohibit transgender children from receiving health care that their medical providers and their parents have determined to be medically necessary. In doing so, the law seeks to substitute the judgment of trained medical professionals and parents with that of elected officials and codifies discrimination against children who already face far too many obstacles,” Leventis said.

Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division said in the news release that “no person should be denied access to necessary medical care just because of their transgender status.”

“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.

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