A lawsuit deciding the fate of healthcare for transgender children in Tennessee is set to go before the Supreme Court on Friday.
The Tennessee General Assembly has been the cause of several lawsuits brought by civil rights groups and advocates. In 2024 alone, the American Civil Liberties Union tracked 34 anti-LGBTQ bills in the state legislature. And while there may only be one case set to go before the U.S. Supreme Court, there is no shortage of litigation over the rights of transgender people in Tennessee.
L.W. v. Skrmetti arose out of a challenge to a 2023 law banning gender-affirming care for transgender minors. Not only does the law ban surgery intended to cure gender dysphoria — an extremely rare procedure — it also forbids the prescription of hormone blockers, a practice major health organizations have cited as important to the health and well-being of minors who experience gender dysphoria.
The law passed along party lines and almost immediately met a legal challenge from the ACLU on behalf of a 15-year-old, along with her parents and doctor.
While U.S. District Court Judge Eli Richardson, a Trump appointee, initially blocked the law’s enforcement, a three-judge panel in the Sixth Circuit Court of Appeals overturned his ruling in July, becoming the first federal court to allow a ban on gender-affirming care. The law required transgender youth receiving gender-affirming care to end their treatment nine months after the law went into effect. That deadline was March.
The law now awaits a decision from the U.S. Supreme Court. It has been scheduled to go to conference a few times now, so a delay would not be unexpected. A cert petition has not yet been granted.
The case would be the first of its kind to go before the Supreme Court. However, a ruling over an Idaho law that bans gender-affirming care for minors could be an indicator of where the judges sit on this issue. That ruling did not actually address whether or not these bans are constitutional but instead addressed “universal injunctions,” a newer term being used by conservative leaders to describe courts striking down laws.
The three liberal justices dissented, which allowed Idaho’s ban to go into effect for everyone except the two transgender minors who sued.
The Tennessee case is just the first of several pieces of upcoming litigation over transgender rights.
Jane Doe v. The Tennessee Department of Safety and Homeland Security
The newest lawsuit over transgender rights was also brought by the ACLU, this time on behalf of a transgender woman who was denied the ability to change her driver’s license to reflect her gender identity.
The denial was based on a new rule from TDSHS banning transgender people from changing the gender marker on their licenses. While there is not a statute on the books, a law passed in 2023 defined “sex” in the Tennessee code as “a person’s immutable biological sex as determined by anatomy and genetics existing at the time of birth and evidence of a person’s biological sex.”
When the law passed, advocates argued that it would cause this exact scenario.
The lawsuit challenging the application of this rule was filed in Davidson County Chancery Court on Tuesday and will likely end up before a three-judge panel.
Kayla Gore et. al. v. the State of Tennessee
A dispute over a 1977 law banning residents from changing their sex designation on their birth certificate is set to go before the Sixth Circuit Court of Appeals for oral arguments on May 2.
Richardson also presided over this case in the U.S. District Court, and dismissed it in June, writing that for the purpose of a birth certificate, sex is defined as “external genitalia at the time of birth,” and could not be changed to match someone’s gender identity.
This case first hit the courts back in 2019, when attacks on transgender rights were not quite as popular in Republican state legislatures. At the time, Kansas and Ohio were the only states with similar statutes. And while those states have since found the laws unconstitutional, a crop of others have implemented similar laws as the slate of anti-LGBTQ legislation has intensified.
A three-judge panel will hear oral arguments on May 2.
Patient 1 et al v. Vanderbilt University Medical Center
In a rare instance of litigation that only indirectly involves the state, Vanderbilt University Medical Center patients have brought a class action lawsuit against the healthcare provider.
Attorney General Jonathan Skrmetti began an investigation into VUMC and gender affirmation treatment at the hospital. During that investigation, Vanderbilt provided the state with a list of 106 transgender patients who had received treatment from the hospital, along with all of their records. The plaintiffs’ complaint alleges that some of the people on that list were not even patients of the VUMC Transgender Clinic itself.
Under HIPAA, a medical provider may only turn over protected health information if “de-identified information could not reasonably be used.” The suit alleges that Vanderbilt turned over some of the most sensitive information possible, including pictures of genitalia, gender identity unknown to others, private communication with clinicians, sexual history, identity of intimate partners and more.
On March 25, Davidson County Chancellor dismissed four counts, allowing six to move forward. A hearing to establish class certification is set for May 6.
D.H. v. Williamson County Board of Education
This suit challenges a Tennessee law passed in 2021 that banned transgender students, faculty and staff at schools from using the bathroom that aligns with their gender identity.
The suit was filed in 2022 on behalf of a young transgender girl who was 8 years old at the time. She alleges that while a Williamson County School was initially supportive of her transition, the enforcement of this state law led her to receive differential treatment. The case argues that the law and policy breaches the equal protection clause.
A similar suit over the same law previously had been filed on behalf of two students in Wilson County, but was dismissed when both children moved out of state with their families, citing the onslaught of attacks on transgender rights by the state legislature.
In September, U.S. District Judge William Campbell, another Trump appointee, denied a motion to dismiss this case. The suit now has entered the discovery phase, when the parties will begin asking each other for relevant documents and policies. A bench trial is set for August 2025.