Supreme Court Orders Appeals Courts Review Transgender Health, Birth Certificate Rulings

The U.S. Supreme Court has ordered lower courts to reconsider several rulings involving transgender rights in healthcare and birth certificate cases following its June 18 decision upholding Tennessee's ban on gender-affirming care for minors. This landmark 6-3 ruling in United States v. Skrmetti found that such bans do not violate the 14th Amendment or discriminate based on sex or transgender status, thereby giving states broader authority to regulate medical procedures for transgender youth. As a result, appellate courts must review prior decisions that deemed state refusals to cover gender-affirming care under Medicaid and other government-sponsored insurance discriminatory, including cases from West Virginia, North Carolina, Idaho, and Oklahoma. The Supreme Court's directive affects multiple circuits, which now must reassess whether these exclusions constitute unlawful discrimination or violate federal statutes like the Medicaid Act and the Affordable Care Act. While the court's ruling primarily focused on minors' access to gender-affirming care, it left unresolved other contentious issues such as transgender participation in sports and care for adults. The decisions signal a judicial shift potentially reinforcing similar bans across various states, impacting the legal landscape for transgender rights nationwide.