Supreme Court Orders Lower Courts to Revisit Transgender Health Plan and Birth Certificate Cases

The US Supreme Court on Monday directed lower courts to revisit several rulings involving transgender Americans in light of its June 18 decision in US v. Skrmetti, which upheld Tennessee’s ban on puberty blockers and hormone therapy for trans youth.

The justices vacated rulings that had blocked state policies excluding gender-affirming care from public health insurance programs. They also overturned a 10th Circuit Court of Appeals decision that allowed a lawsuit to proceed against Oklahoma’s 2021 executive order banning changes to the sex designation on birth certificates.

The Skrmetti ruling, decided 6-3, concluded that Tennessee’s law did not violate the Constitution’s equal protection clause because it did not constitute discrimination based on sex or transgender status. While the court did not directly address other laws affecting transgender people, its reasoning opened the door for states to regulate gender-related issues with broader discretion.

One of the cases now heading back to the lower courts involves Oklahoma’s restriction on changing gender markers on birth certificates. The second involves health insurance plans in North Carolina and West Virginia that exclude coverage for gender-affirming care, including surgeries.

In 2023, a federal appeals court ruled that those exclusions violated the 14th Amendment, but the Supreme Court’s new directive requires that these decisions be reviewed again under the precedent set by Skrmetti.

The court did not act on other pending cases involving state bans on transgender athletes participating in sports according to their gender identity.

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