What journalists should know in advance of the U.S. v. Skrmetti U.S. Supreme Court decision

• Context on the case
• Reporting best practices
• Questions to help inform your reporting
• Context on potential case outcomes

Context on the case

U.S. v. Skrmetti is a challenge to a Tennessee law that bans medical practitioners from providing certain medical care for trans youth. The law, if upheld, would restrict doctors from providing care such as puberty-delaying medications, hormones, or surgery for the purposes of “enabling the minor to identify with, or live as, a purported identity inconsistent with the minor’s sex; or treating purported discomfort or distress from a discordance between the minor’s sex and asserted identity.” 

The plaintiffs say the law is discriminatory because it allows doctors to administer the same care for youth who are not trans. If and how the Equal Protection Clause of the Fourteenth Amendment applies will be central to the court’s upcoming decision. 

The case also raises questions about when the state can override parents’ judgment when it comes to making decisions for and about their children. Prevailing medical consensus supports transgender medical care’s efficacy and prioritizes patients, their families, and their doctors — not politicians or government officials — in making decisions about the proper care for trans youth, in line with age-appropriate best practices and evidence-based, peer-reviewed research.

Despite this, Tennessee and at least 26 other state governments have approved bans on this type of medical care for transgender minors. These restrictions reflect the stated political intentions of conservative leaders, including members of the Trump administration, to restrict access to trangender medical care for both youth and adults. Efforts to curtail transgender medical care at the federal level are also ongoing: A provision in the recently passed House budget bill would bar the use of Medicaid funding for transition-related medical care for patients of any age.

The Supreme Court’s decision in this case will have transformative implications for LGBTQ+ rights, parental authority, and the limits of state power in regulating medical care.

Reporting best practices

• Trans people — not their parents, children, friends, colleagues, or critics — should be at the heart of stories written about them. Ensure that your stories aren’t centered on cisgender sources’ voices and assumptions.
• Responsible reporting on health care for trans people, including youth, should include proper context on the political forces behind efforts to restrict such care. Do not quote false or unproven statements and do not quote non-experts on technical topics as if they were experts.
• Avoid misconceptions and misinformation about how common it is for people of any age to receive medical care as part of their gender transition. As KFF notes, “among transgender and nonbinary people who transition, many do so without any medical intervention.”
• Similarly: Avoid repeating misinformation about the risks or dangers of gender-related medical care without fact-checking. For example, hormone therapy does not guarantee sterilization; very young children are not eligible for transition-related surgeries; transition-related surgery is incredibly rare for older teens and rare for adults; and puberty-delaying medications have been prescribed to young patients for reasons unrelated to transgender identity for decades. 
• Consider the spillover effects of anti-trans laws and policies. Laws that restrict the rights of transgender people can also impact the lives of those who are not trans. Be sure to accurately convey the full stakes.
• Be cautious citing the U.S. Department of Health and Human Services’ recent report, completed within three months of its commission and with no named authors, on gender-related medical care for trans youth. As the American Academy of Pediatrics has noted, the document “misrepresents the current medical consensus and fails to reflect the realities of pediatric care.” In contrast, a similar report commissioned by the Republican-led legislature in Utah took more than two years to complete and concluded that gender-related health care leads to “positive mental health and psychosocial functioning outcomes.”
• “Trans issues” is a euphemism. Avoid using it. Do not collapse anti-trans sentiment, laws, and policies into a single catch-all. Report on specific anti-trans politics and policies; describe what particular “issue” is at play.

Familiarize yourself with additional reporting best practices in the TJA Stylebook and Coverage Guide.

Questions to help inform your reporting

• How will the Supreme Court’s decision impact access to medical care for trans youth in Tennessee and beyond? How will existing state-level protections for this care be affected? 
• How might the court’s decision impact access to medical care for trans adults nationwide? What will happen to the institutions that currently provide this care, if care for minors is banned? 
• In what ways might the court’s decision relate to or reflect other issues of bodily autonomy and governmental regulation?
• What other ongoing or pending legal cases might the court’s decision impact? 
• Which people or organizations are the most appropriate, informed sources to describe the needs and concerns of trans youth and trans communities?
• How do politics factor into this legal matter, given that conservative governments in other countries have led similar efforts to remove transgender civil rights protections?
• What will the outcome of this case say about the state and future of LGBTQ+ equality across the country?
• How will trans people and their allies respond, both in-community and externally?

Context on potential case outcomes

The decision could also raise more specific legal and political questions, according to lawyers following the case. Those questions vary depending on the ruling.

• The Supreme Court could uphold the Tennessee law, either by deciding that this case does not involve discrimination based on gender identity or transgender status, or that those are not classifications that require specific legal protection. This would echo the court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization, which overturned 50 years of federally protected abortion access and shifted the authority to regulate abortion back to individual states. What are the consequences of a legal decision that opens the door for health care laws to discriminate against trans individuals (including trans adults) as long as there is a rational basis for doing so?
• If the Supreme Court does not uphold the ruling, it could send the case back to the lower courts to evaluate the Tennessee law under heightened scrutiny. That would involve classifying trans people as a protected class. This decision could potentially mirror the decision in Loving v. Virginia, in which the court found anti-miscegenation laws to be racial discrimination (a comparison drawn by Justice Ketanji Brown Jackson during oral arguments). What implications would this have for ongoing litigation over legislation restricting trans people’s civil rights?

Editor’s note: This is a developing story. We may update this post with further guidance. This guidance was last updated on June 4 at 6:15 p.m. ET.