SCOTUS Appears Inclined to Uphold Tenn. Law on Transgender Care

Party of 'small government' wants to make healthcare decisions for your family by decree of 5 non-doctors

 

Could be interesting if they spent time addressing the respective arguments regarding the constitutional right of parents to raise their children in various ways, to include educationally and making medical decisions. That doesn't seem like a rational basis test to me, so how do we draw those lines? Also, there might be interesting analogies raised not only with parents/minors challenging states in an effort go get affirmative treatment they desire - but also in an effort to avoid various treatment that they don't want. Presumably, this could include other medications, treatments, surgeries, or vaccines.

 

Pandora’s Box there.

 

Trans people will get their own Plessy v. Ferguson.

 

Listening to a couple different opinions about this case, it comes down to limitations on parental rights by the state. Almost very state limits the age at which a child/young adult can get a tattoo. The best argument I have heard in favor of overturning the law is that there is no age requirement for elective plastic surgery in Tennessee and children under the age of 18 must have parental consent. I think there is a good response that most plastic surgery can be undone at a later date but I think it was a good point to make.

 

Child: I'm trans, and I want this healthcare.
Parents: I support my child's decision.
Psychologist: After working with this child for a long period of time, it's clear that this treatment will improve their quality of life, they want it, and they understand the consequences.
Physicians: We've spoken with the child about their options. We've spoken with the parents. They all support this treatment. We feel that based on this individual child's circumstances and needs and our understanding of the best practices and medical evidence that this is the best treatment for them.
OklahomaGator: Well, I disagree with you all, and my opinion is what should matter.

 

Interesting analogies.

I presume tattoos are not considered part of any recognized medical treatment, and that distinction might warrant affording less deference to minors, their parents, and their doctors. Even then, I wonder if the analysis and level of scrutiny applied would be different if a particular family claimed a religious or spiritual basis for a specific tattoo? Would the religious freedom argument create yet another wrinkle?

I can also imagine various arguments about plastic surgery for that matter. For example, when is a minor's condition/appearance sufficiently problematic to justify characterizing the surgery as non-elective versus elective, and who gets to make that call?

 

The first issue is labeling this as a "medical decision." It's clearly not a medical necessity. In terms of parental rights, there have been and always will be laws forbidding parents to commit abuse, neglect, among many other things against their children. This is more along the lines of a consent issue. That is, can a minor child consent to something that permanently alters their sexual organs? Well, as we know, we have age of consent laws for other things.

Is the United States arguing it's appropriate for adults to make decisions (i.e. provide consent on behalf of a minor) about what happens to a minor's sexual organs? Hmmm. Because surely they aren't arguing that a 12 year old kid can provide their own consent to such an operation. This seems like a really awful argument for our federal government to be making. It is truly tragic this is even before the SCOTUS, but this is what it has come to.

 

You have to be a real sicko to think gender affirming care for minors is okay.

 

You do realize that gender affirming care is not limited to gender reassignment surgery, right?

 

Since you raised questions about altering sexual organs very broadly, there are certainly those who oppose circumcisions on the bases that they are not medically necessary and that children cannot consent to them. I'm not sure that's a great analogy to the far more extreme case of gender reassignment surgery and the lasting impacts there. Having said that, my understanding is that the law at issue in this case bans a lot more than just surgeries and includes drugs, medications, and/or hormones which can lawfully be given to minors for other reasons but not as a part of gender dysphoria treatment. I think that might undermine the argument that the drugs are simply too inherently dangerous and might require a separate analysis which would afford a bit more deference to minors, their parents, and their doctors.

 

Surely the state has the right to set some minimum age requirement. What if your hypothetical child were, say, 8 years old? I can't imagine anyone taking the position that a child that young ought to be allowed to change his sex no matter what the parents, doctors and psychologists say. (In fact, I can't imagine doctors and psychologists even approving it.) And once one regains his or her sanity and agrees there should be some minimum age requirement, then the discussion turns to where it should be - what age should a child be in order to be allowed to become trans without needing the approval of anyone?

 

I'm aware it includes more than just surgeries. As if that changes anything materially. (it doesn't) A minor cannot consent to these treatments and so any adult who consents on their behalf for the purposes of altering a minor's sexual function is essentially committing statutory rape.

 

The bigger question here, I think, is does the state have a right to usurp parental rights for ALL medical decisions? That’s a dangerous and slippery slope.

 

Apparently you have conflated the term "gender affirming care" with gender affirming surgery. There is huge difference between the two.

 

Or he's just bigoted against transgender people.

 

I think you're assuming that to "become trans" a person starts with gender reassignment surgery. But that's the end of the process. They generally start by seeing a mental health practitioner and socially transition. That means the person goes by their preferred name and pronouns and adopts the dress of their internalized gender. Once they've done that for a certain amount of time and are sure they want to continue with their transition, their mental health practitioner will recommend them for pharmaceutical interventions and refer them to a physician who is a specialist. At a later point down the line comes the surgeries. The guidelines don't recommend gender reassignment surgery until a person is at least 18, and doctors rarely stray from those guidelines.

Should a child who is 8 years old be able to socially transition while seeing a mental health practitioner? Yes. What if an 8 year old child has cancer? Do we deny them treatment because they're too young? What if an 8 year old child injures themself and needs surgery to fix it? Do we deny that surgery due to their youth? No, we don't. We let 8 year olds access healthcare all the time. Nobody here is arguing for 8 year olds to have gender reassignment surgeries. The doctors won't do it. The mental health practitioners won't recommend it. But should they be able to access gender-affirming care? Yes.

And the question here isn't about a child accessing healthcare without needing anybody's approval. The question is whether a child can access healthcare with their own approval, their parents' approval, and the approval of their doctors and mental health practitioners. A law that says no, transgender children cannot, but other children can is discriminatory and should not stand. If you think that stance is insane, I'll happily wear my badge of insanity.

 

One other thing to keep in mind is that this case may not end up mattering as much as some people think. There are some people that have detransitioned that are now suing the hospitals and doctors that performed their surgeries. If the people are successful in their cases, there may be a move by medical malpractice insurers to no longer cover these procedures on their policies until a certain age. That would likely have a very large impact on what age someone is able to access these types of medical care.

 

Tell us what you know about parental rights in California regrading this specific issue?