The discussion of data on suicide rates among minors experiencing gender dysphoria was one of the most significant moments, Skrmetti said, during oral arguments in United States v. Skrmetti, a case testing whether the 14th Amendment’s equal protection clause precludes state law barring children under the age of 18 from undergoing transgender hormone and puberty-blocking procedures.

“The rhetoric often suggests, ‘If you don’t let kids do this, they are going to hurt themselves,’ and nobody wants that,” Skrmetti told the Washington Examiner hours after defending the law known as Tennessee’s Senate Bill 1, or SB1.

“To have a public acknowledgment of what the research says, that these procedures do not impact the suicide rate, is really significant. Regardless of the legal outcome here, that’s a huge win for protecting kids from making a horrifying mistake,” he said.

The Court’s ‘Public Acknowledgment’

At one point during the nearly three-hour arguments, Justice Samuel Alito and ACLU attorney Chase Strangio homed in on the Cass Report, a British review of transgender medical studies.

Justice Alito cited page 195 of the report, which concluded “There is no evidence that gender-affirmative treatments reduce suicide.”

Strangio acknowledged the point.

“What I think that is referring to is there is no evidence in some — in the studies that this treatment reduces completed suicide,” Strangio said.

The ACLU lawyer argued, though, that the reason there was not evidence about completed suicides is that it is a “very small population of individuals with studies that don’t necessarily have completed suicides within them.”

Strangio also argued there was more conclusive evidence in longer-term studies that the procedures lead to an overall reduction in suicidality, meaning that not just suicide attempts but also suicidal thinking or attempt, saying that is a “positive outcome to this treatment.”

This exchange marked a pivotal moment in the case, where several Republican-appointed justices questioned the Biden administration’s reliance on medical claims to challenge Tennessee’s law banning transgender procedures for minors.

Strangio’s role in the case was to advocate the respondents from Tennessee, who were parents and their children who opposed the state’s law. The ACLU attorney agreed with the position of the DOJ throughout the roughly half-hour Strangio advocated to the justices.

Justice Brett Kavanaugh, another Republican-appointed justice, echoed concerns about rushing to constitutionalize an area of ongoing medical debate.

“It strikes me as a pretty heavy yellow light, if not red light, for this court to come in … when the rest of the world … is pumping the brakes on this kind of treatment because of concerns about the risks,” Kavanaugh said.

Background on the first transgender case

The landmark case examines Tennessee’s law barring minors from accessing medical treatments, such as puberty blockers and hormone therapy, aimed at affirming a gender identity inconsistent with their sex.

Chief Justice John Roberts also appeared skeptical of the government’s position, noting that Sweden and the United Kingdom have restricted similar treatments due to insufficient evidence of long-term benefits and concerns over risks.

Meanwhile, liberal justices likened the bans to historical discrimination, with Justice Ketanji Brown Jackson controversially comparing them to bans on interracial marriage.

Karen Loewy, senior counsel and director of Constitutional Law Practice for Lambda Legal, said she believed the ACLU and the Biden administration made a “persuasive” argument to the high court.

It was a “comprehensive argument to the Supreme Court underscoring the real and deep harm of Tennessee’s discriminatory ban on medical care for transgender youth, a ban unsupported by either science or law,” Loewy added.

Broader Implications

Skrmetti emphasized the importance of clarity in public discourse about the risks and benefits of transgender procedures.

“I think it’s terrible for kids when you set an expectation that [suicide] is a viable course for them to take,” he said. The acknowledgment of inconclusive data surrounding that rhetoric, he argued, could have far-reaching implications for debates surrounding medical care and the mental health of transgender youth.

As nearly half of U.S. states have implemented similar laws, the case has become a flashpoint in the broader cultural and legal battles over transgender issues, federalism, and medical ethics.

The court’s eventual decision, expected by June of next year, could set a significant precedent for how states regulate transgender procedures involving minors.

The Washington Examiner contacted the ACLU for comment.