The U.S. Supreme Court’s fall term began on Monday with major cases on the docket including U.S. v Skrmetti, which could decide the fate of 24 state laws banning the use of puberty blockers and hormone treatments for transgender minors.

First, however, the justices dealt another blow to the Biden-Harris administration and reproductive rights advocates by leaving in place a lower court order that blocked efforts by the federal government to allow hospitals to terminate pregnancies in medical emergencies.

The U.S. Department of Health and Human Services had issued a guidance instructing healthcare providers to offer abortions in such circumstances, per the federal Emergency Medical Treatment and Labor Act, which kicked off litigation over whether the law overrides state abortion restrictions.

The U.S. Court of appeals for the 5th Circuit had upheld a decision blocking the federal government from enforcing the law via the HHS guidance, and the U.S. Department of Justice subsequently asked the Supreme Court to intervene.

The justices also declined to hear a free speech case in which parents challenged a DOJ memo instructing officials to look into threats against public school officials, which sparked false claims that parents were being labeled “domestic terrorists” for raising objections at school board meetings over, especially, COVID policies and curricula and educational materials addressing matters of race, sexuality, and gender.

Looking to the cases ahead, U.S. v. Skrmetti is “obviously the blockbuster case of the term,” a Supreme Court practitioner and lecturer at the Harvard law school litigation clinic told NPR.

The attorney, Deepak Gupta, said the litigation “presents fundamental questions about the scope of state power to regulate medical care for minors, and the rights of parents to make medical decisions for your children.”

The ACLU, which represents parties in the case, argues that Tennessee’s gender affirming care ban violates the Equal Protection Clause of the 14th Amendment by allowing puberty blockers and hormone treatments for cisgender patients younger than 18 while prohibiting these interventions for their transgender counterparts.

The organization notes that “leading medical experts and organizations — such as the American Medical Association, the American Psychiatric Association, and the American Academy of Pediatrics — oppose these restrictions, which have already forced thousands of families across the country to travel to maintain access to medical care or watch their child suffer without it.”

When passing their bans on gender affirming care, conservative states have cited the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization (2022), which overturned constitutional protections for abortion that were in place since Roe v. Wade was decided in 1973.

The ACLU notes “U.S. v. Skrmetti will be a major test of how far the court is willing to stretch Dobbs to allow states to ban other health care” including other types of reproductive care like IVF and birth control.

Also on the docket in the months ahead are cases that will decide core questions about the government’s ability to regulate “ghost guns,” firearms that are made with build-it-yourself kits available online, and the constitutionality of a Texas law requiring age verification to access pornography.

The latter case drew opposition from liberal and conservative groups that argue it will have a chilling effect on adults who, as NPR wrote, “would realistically fear extortion, identity theft and even tracking of their habits by the government and others.”

A group of 164 members of Congress filed an amicus brief on Tuesday urging the U.S. Supreme Court to defend transgender Americans’ access to medically necessary healthcare as the justices prepare to hear oral arguments this fall in U.S. v. Skrmetti.

Lawmakers who issued the 27-page brief include House Democratic Leader Hakeem Jeffries (N.Y.) House Democratic Whip Katherine Clark (Mass.), House Democratic Caucus Chairman Pete Aguilar (Calif.), U.S. Sens. Ed Markey (D-Mass.) and Jeff Merkley (D-Ore.), and Congressional Equality Caucus Chair U.S. Rep. Mark Pocan (D-Wis.), along with the caucus’s 8 co-chairs and 25 vice-chairs. Ranking members of the powerful House Judiciary and House Ways and Means Committees, U.S. Reps. Jerry Nadler (D-N.Y.) and Frank Pallone Jr. (D-N.J.), were also among the signatories.

The case, among the most closely watched this term, will determine whether Tennessee’s ban on gender-affirming care for minors, along with a similar law passed in Kentucky, violate the Equal Protection Clause of the 14th Amendment.

In their brief, the lawmakers urge the Supreme Court to treat with skepticism “legislation banning safe and effective therapies that comport with the standard of care” and to examine the role of “animosity towards transgender people” in states’ gender affirming care bans.

“Decisions about healthcare belong to patients, their doctors, and their families—not politicians,” Pocan said. “The law at issue in this case is motivated by an animus towards the trans community and is part of a cruel, coordinated attack on trans rights by anti-equality extremists. We strongly urge the Supreme Court to uphold the constitution’s promise of equal protection under the law and strike down Tennessee’s harmful ban.”

“For years, far-right Republicans have been leading constant, relentless, and escalating attacks on transgender Americans. Their age-old, discriminatory playbook now threatens access to lifesaving, gender-affirming care for more than 100,000 transgender and nonbinary children living in states with these bans if the Supreme Court uphold laws like Tennessee’s at the heart of Skrmetti fueled by ignorance and hate,” Markey said.

“Transgender people deserve the same access to healthcare as everyone else,” said Nadler. “There is no constitutionally sound justification to strip from families with transgender children, and their doctors, the decision to seek medical care and give it to politicians sitting in the state capitol. I trust parents, not politicians, to decide what is best for their transgender children.”

Pallone warned that if Tennessee’s ban, S.B. 1, is “allowed to stand, it will establish a dangerous precedent that will open the floodgates to further discrimination against transgender Americans.”

“Unending attacks from MAGA extremists across the nation are putting trans youth at risk with hateful laws to ban gender-affirming care,” said Merkley author of the Equality Act. “Let’s get politicians—who have no expertise in making decisions for patients—out of the exam room. The Court must reject these divisive policies, and Congress must pass the Equality Act to fully realize a more equal and just union for all.”

Also filing an amicus brief on Tuesday was the Gender Research Advisory Council + Education (GRACE), a transgender-led nonprofit that wrote, in a press release, “Skrmetti  is critically important to the transgender community because approximately 40% of trans youth live in the 25 states that have enacted such bans.”

The group argued laws like Tennessee’s S.B. 1 are cruel, discriminatory, and contradict “the position of every major medical association that such treatments are safe, effective and medically necessary for adolescents suffering from gender dysphoria.”

GRACE’s brief includes 28 families “who hope to share with the Court that they are responsible, committed parents from a variety of backgrounds who have successfully navigated their adolescent’s transition.”

“These parents sought medical expertise for their children with diligence regarding the best care available and input from experienced physicians and mental health professionals and they have seen firsthand the profound benefits of providing medically appropriate care to their transgender children,” said GRACE Board Member and brief co-author Sean Madden.

Left unchecked, this may start with the transgender community, but it certainly won’t end there,” added GRACE President Alaina Kupec. “Next it could be treatments for HIV or cancer.”

Two decades after Massachusetts became the first state to legalize same-sex marriage, a new study reveals both significant progress and ongoing challenges for married LGBTQ couples in the U.S., with a growing sense of insecurity about the future of their rights.

The Williams Institute at UCLA School of Law surveyed 484 married same-sex couples from all 50 states and D.C. The study, released Monday, marks the 20th anniversary of legal same-sex marriage in the U.S.

Researchers found that 93 percent of respondents cited love as a primary reason for marrying, with 75 percent also mentioning legal protections. Over 83 percent reported positive changes in their sense of security, and 74.6 percent noted improved life satisfaction since marrying.

However, the study also highlighted persistent discrimination and growing concerns about the future. About 11 percent of couples who had a wedding reported facing prejudice during the planning process.

Alarmingly, nearly 80 percent of respondents expressed concern about the potential overturning of the 2015 Obergefell v. Hodges decision, which legalized same-sex marriage nationwide. This anxiety has been exacerbated by initiatives like Project 2025, a conservative policy blueprint that some fear could roll back LGBTQ rights if implemented.

The possibility of a former President Donald Trump victory in the upcoming election has further intensified these concerns. Many respondents cited Trump’s previous U.S. Supreme Court appointments and his statements on LGBTQ issues as reasons for their apprehension. One participant stated, “The thought of another Trump presidency keeps me up at night. We’ve come so far, but it feels like our rights could be stripped away at any moment.”

The current political climate has 29 percent of respondents considering moving to another state, with 52.9 percent citing socio-political concerns as a primary reason. This reflects a growing sense of insecurity among LGBTQ couples about their rights and freedoms.

Brad Sears, founding executive director of the Williams Institute, noted, “The data clearly show that marriage equality has had a profound positive impact on same-sex couples and their families. However, it also reveals ongoing challenges and serious concerns about the future of these rights in light of current political trends and the upcoming election.”

Christy Mallory, legal director at the Williams Institute and lead author of the study, added, “This research provides crucial insights into the lived experiences of same-sex couples two decades after marriage equality began in the U.S. The high level of concern about potential loss of rights underscores the continued importance of legal protections and public support for LGBTQ+ equality.”

The study found that 30 percent of surveyed couples have children, with 58.1 percent of those parents reporting that marriage provided more stability for their families. However, many of these families now worry about the security of their legal status in the face of potential policy changes and shifting political landscapes.

As the nation reflects on two decades of marriage equality, the study underscores both the transformative power of legal recognition and the ongoing need for vigilance in protecting LGBTQ+ rights. The findings highlight the complex reality faced by same-sex couples in America today: Celebrating hard-won progress while grappling with uncertainty about the future, particularly in light of upcoming political events and potential shifts in leadership.