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Supreme Court rules to preserve access to abortion medication

Case is Alliance for Hippocratic Medicine v. FDA

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The abortifacent drug mifepristone is marketed under the brand name Mifeprex (Photo courtesy of Danco Laboratories)

The U.S. Supreme Court ruled Thursday in a much-anticipated decision against efforts by conservative doctors and medical groups challenging access to mifepristone, one of two pharmaceuticals used in medication abortions. As a result of the high court’s decision, access to the drug won’t change.

Associate Supreme Court Justice Brett Kavanaugh, writing for the court, reversed a lower court decision that would have made it more difficult to obtain the drug, which is used in about two-thirds of U.S. abortions. The ruling however was narrow in scope as it only addressed what is known as legal standing in a case.

SCOTUSblog senior court reporter Amy Howe noted that Kavanaugh acknowledged what he characterized as the challengers’ “sincere legal, moral, ideological, and policy objections” to elective abortion “by others” and to FDA’s 2016 and 2021 changes to the conditions on the use of the drug.

But the challengers had not shown that they would be harmed by the FDA’s mifepristone policies, he explained, and under the Constitution, merely objecting to abortion and the FDA’s policies are not enough to bring a case in federal court. The proper place to voice those objections, he suggested, is in the political or regulatory arena.

“Under Article III of the Constitution, a plaintiff’s desire to make a drug less available for others does not establish standing to sue,” Kavanaugh wrote.

“We are pleased with the Supreme Court’s decision in this incredibly important case. By rejecting the Fifth Circuit’s radical, unprecedented and unsupportable interpretation of who has standing to sue, the justices reaffirmed longstanding basic principles of administrative law,” said Abigail Long, a spokesperson for Danco. “The decision also safeguards access to a drug that has decades of safe and effective use.”

The White House released a statement from President Joe Biden on Supreme Court Decision on FDA v. Alliance for Hippocratic Medicine:

“Today’s decision does not change the fact that the fight for reproductive freedom continues. It does not change the fact that the Supreme Court overturned Roe v. Wade two years ago, and women lost a fundamental freedom. It does not change the fact that the right for a woman to get the treatment she needs is imperiled if not impossible in many states.
 
It does mean that mifepristone, or medication abortion, remains available and approved. Women can continue to access this medication – approved by the FDA as safe and effective more than 20 years ago. 
 
But let’s be clear: attacks on medication abortion are part of Republican elected officials’ extreme and dangerous agenda to ban abortion nationwide. Since the overturning of Roe v. Wade, Republican elected officials have imposed extreme abortion bans in 21 states, some of which include zero exceptions for rape or incest. Women are being turned away from emergency rooms, or forced to go to court to plead for care that their doctor recommended or to travel hundreds of miles for care. Doctors and nurses are being threatened with jail time, including life in prison, for providing the health care they have been trained to provide. And contraception and IVF are under attack.
 
The stakes could not be higher for women across America. Vice President Harris and I stand with the vast majority of Americans who support a woman’s right to make deeply personal health care decisions. We will continue to fight to ensure that women in every state get the health care they need and we will continue to call on Congress to restore the protections of Roe v. Wade in federal law — that is our commitment.”

U.S. District Court for the Northern District of Texas Judge Matthew Kacsmaryk in Amarillo, Texas, in a ruling a year ago, waved aside decades of scientific approval, ruled that the U.S. Food and Drug Administration improperly approved mifepristone more than 20 years ago in 2000.

Kacsmaryk, appointed to the federal bench by former President Donald Trump, in his 67 page opinion wrote that the FDA’s two-decade-old approval violated a federal rule that allows for accelerated approval for certain drugs and, along with subsequent actions by the agency, was unlawful.

The suit, Alliance for Hippocratic Medicine v. FDA, was originally filed in the U.S. District Court for the North District of Texas in mid-November by Alliance Defending Freedom, an anti-abortion, anti-LGBTQ+ legal organization.

Applauding Kacsmaryk’s ruling, Erik Baptist, speaking for the Alliance Defending Freedom said in a statement: “By illegally approving dangerous chemical abortion drugs, the FDA put women and girls in harm’s way, and it’s high time the agency is held accountable for its reckless actions.”

Erin Hawley, a senior attorney for the conservative group Alliance Defending Freedom who argued the case at the Supreme Court, said the opinion was “disappointing,” but told reporters in a press gaggle after the ruling that the explicit mention of conscience protections was a victory.

“The Supreme Court was crystal clear that pro life doctors do have federal conscience protections, even in emergency situations,” Hawley said. “So that’s a huge win for the pro-life cause. The Supreme Court clearly said that our doctors are entitled to those federal conscious protections that are based on their religious beliefs.”

The case now returns to the lower courts, and the dispute over access to the drug likely is not over. 

SCOTUSblog also reported that Nancy Northrup, the president and CEO of the Center for Reproductive Rights, praised the decision but conceded that the dispute could continue even after Thursday’s ruling. She, too, noted that the three states “could still attempt to keep the case going, including taking it back up to the Supreme Court,” and she warned that access to mifepristone “is still at risk nationwide.”

The Hill notes that for instance, the same district court in Texas that originally ruled against the FDA said a group of three red states—Missouri, Idaho and Kansas— can intervene in the lawsuit.

“I would expect the litigation to continue with those states raising different standing arguments than made by our doctors,” ADF’s Hawley told reporters.

Equality California, the nation’s largest statewide LGBTQ+ civil rights organization, emailed the Blade the following statement from Executive Director Tony Hoang in response to a unanimous ruling by the United States Supreme Court:

“We appreciate today’s unanimous decision to uphold access to the abortion drug mifepristone, authored by a conservative Justice. This ruling reinforces the critical importance of maintaining accessible reproductive healthcare and highlights the necessity of safeguarding these rights from baseless legal attacks.

However, it is imperative to recognize that the Court should never have accepted this case. The so-called Alliance for Hippocratic Medicine lacked the standing to initiate this challenge. Moreover, federal conscience exemptions already exist for healthcare providers who object to offering abortion-related care. 

Medication abortions involving mifepristone constitute the majority of abortions in America, including those sought by LGBTQ+ people. Our community understands the necessity of bodily autonomy and the right to make decisions regarding our own medical care, including reproductive care. Patients deserve access to the medications they need, and providers should be able to deliver that care without unwarranted interference from extremist courts or politicians.   

Attacks on abortion do not end with this decision; millions of people nationwide are still unable to get abortion care and abortion opponents remain focused on their end goal of a nationwide abortion ban. 

Equality California will continue to work with our legislative partners in Sacramento and Washington, D.C., as well as organizational allies, like Planned Parenthood, to help protect and expand access to abortion and reproductive healthcare.”

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U.S. Supreme Court

Supreme Court rejects Kim Davis’s effort to overturn landmark marriage ruling

Justices declined to revisit the Obergefell decision

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Kim Davis at 2015 Values Voters Summit. (Washington Blade photo by Michael Key)

The U.S. Supreme Court has declined to hear an appeal from Kim Davis, the former Rowan County, Ky., clerk best known for refusing to issue marriage licenses to same-sex couples after the landmark 2015 Obergefell v. Hodges decision legalized same-sex marriage nationwide.

Following the Obergefell ruling, Davis stopped issuing marriage licenses altogether and has since filed multiple appeals seeking to challenge same-sex marriage protections. The court once again rejected her efforts on Monday.

In this latest appeal, Davis sought to overturn a $100,000 monetary award she was ordered to pay to David Moore and David Ermold, a same-sex couple to whom she denied a marriage license. Her petition also urged the court to use the case as a vehicle to revisit the constitutional right to same-sex marriage.

The petition, along with the couple’s brief in opposition, was submitted to the Supreme Court on Oct. 22 and considered during the justices’ private conference on Nov. 7. Davis needed at least four votes for the court to take up her case, but Monday’s order shows she fell short.

Cathy Renna, the director of communications for the National LGBTQ Task Force, a non-profit organization that works towards supporting the LGBQ community through grassroots organizing told the Washington Blade:
“Today’s decision is not surprising given the longshot status of Davis’s claim, but it’s a relief that the Supreme Court will not hear it, given the current make up of the court itself. We hope that this settles the matter and marriage equality remains the law of the land for same-sex couples.”

Human Rights Campaign President Kelley Robinson released the following statement:

“Today, love won again. When public officials take an oath to serve their communities, that promise extends to everyone — including LGBTQ+ people. The Supreme Court made clear today that refusing to respect the constitutional rights of others does not come without consequences.

Thanks to the hard work of HRC and so many, marriage equality remains the law of the land through Obergefell v. Hodges and the Respect for Marriage Act. Even so, we must remain vigilant.

It’s no secret that there are many in power right now working to undermine our freedoms — including marriage equality — and attack the dignity of our community any chance they get. Last week, voters rejected the politics of fear, division, and hate, and chose leaders who believe in fairness, freedom, and the future. In race after race, the American people rejected anti-transgender attacks and made history electing pro-equality candidates up and down the ballot.

And from California to Virginia to New Jersey to New York City, LGBTQ+ voters and Equality Voters made the winning difference. We will never relent and will not stop fighting until all of us are free.”

The Log Cabin Republicans, a organization dedicated to conservative LGBTQ people, praising the Court’s decision.

“After months of hand-wringing and fear-mongering by Gay Inc., Democrats, and the media, the conservative majority on the Supreme Court sided with the American people and common sense and declined to revisit marriage equality,” Interim Executive Director Ed Williams said in a statement. “Just like Justice Amy Coney Barrett hinted at earlier this year, Obergefell is settled. Marriage equality has been, and will continue to be, the law of the land.”

This story is developing and will be updated as more information becomes available.

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LGBTQ legal leaders to Supreme Court: ‘honor your precedent, protect our families’

Experts insist Kim Davis case lacks merit

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Protesters outside of the Supreme Court fly an inclusive Pride flag in December 2024. (Washington Blade Photo by Michael Key)

The U.S. Supreme Court considered hearing a case from Kim Davis on Friday that could change the legality of same-sex marriage in the United States.

Davis, best known as the former county clerk for Rowan County, Ky., who defied federal court orders by refusing to issue marriage licenses to same-sex couples — and later, to any couples at all — is back in the headlines this week as she once again attempts to get Obergefell v. Hodges overturned on a federal level.

She has tried to get the Supreme Court to overturn this case before — the first time was just weeks after the initial 2015 ruling — arguing that, in her official capacity as a county clerk, she should have the right to refuse same-sex marriage licenses based on her First Amendment rights. The court has emphatically said Davis, at least in her official capacity as a county clerk, does not have the right to act on behalf of the state while simultaneously following her personal religious beliefs.

The Washington Blade spoke with Karen Loewy, interim deputy legal director for litigation at Lambda Legal, the oldest and largest national legal organization advancing civil rights for the LGBTQ community and people living with HIV through litigation, education, and public policy, to discuss the realistic possibilities of the court taking this case, its potential implications, and what LGBTQ couples concerned about this can do now to protect themselves.

Loewy began by explaining how the court got to where it is today.

“So Kim Davis has petitioned the Supreme Court for review of essentially what was [a] damages award that the lower court had given to a couple that she refused a marriage license to in her capacity as a clerk on behalf of the state,” Loewy said, explaining Davis has tried (and failed) to get this same appeal going in the past. “This is not the first time that she has asked the court to weigh in on this case. This is her second bite at the apple at the U.S. Supreme Court, and in 2020, the last time that she did this, the court denied review.”

Davis’s entire argument rests on her belief that she has the ability to act both as a representative of the state and according to her personal religious convictions — something, Loewy said, no court has ever recognized as a legal right.

“She’s really claiming a religious, personal, religious exemption from her duties on behalf of the state, and that’s not a thing.”

That, Loewy explained, is ultimately a good thing for the sanctity of same-sex marriage.

“I think there’s a good reason to think that they will, yet again, say this is not an appropriate vehicle for the question and deny review.”

She also noted that public opinion on same-sex marriage remains overwhelmingly positive.

“The Respect for Marriage Act is a really important thing that has happened since Obergefell. This is a federal statute that mandates that marriages that were lawfully entered, wherever they were lawfully entered, get respect at the federal level and across state lines.”

“Public opinion around marriage has changed so dramatically … even at the state level, you’re not going to see the same immediate efforts to undermine marriages of same-sex couples that we might have a decade ago before Obergefell came down.”

A clear majority of U.S. adults — 65.8 percent — continue to support keeping the Obergefell v. Hodges decision in place, protecting the right to same-sex marriage. That support breaks down to 83 percent of liberals, 68 percent of moderates, and about half of conservatives saying they support marriage equality. These results align with other recent polling, including Gallup’s May 2025 estimate showing 68 percent support for same-sex marriage.

“Where we are now is quite different from where we were in terms of public opinion … opponents of marriage equality are loud, but they’re not numerous.”

Loewy also emphasized that even if, by some chance, something did happen to the right to marry, once a marriage is issued, it cannot be taken back.

“First, the Respect for Marriage Act is an important reason why people don’t need to panic,” she said. “Once you are married, you are married, there isn’t a way to sort of undo marriages that were lawfully licensed at the time.”

She continued, explaining that LGBTQ people might feel vulnerable right now as the current political climate becomes less welcoming, but there is hope — and the best way to respond is to move thoughtfully.

“I don’t have a crystal ball. I also can’t give any sort of specific advice. But what I would say is, you know, I understand people’s fear. Everything feels really vulnerable right now, and this administration’s attacks on the LGBTQ community make everybody feel vulnerable for really fair and real reasons. I think the practical likelihood of Obergefell being reversed at this moment in time is very low. You know, that doesn’t mean there aren’t other, you know, case vehicles out there to challenge the validity of Obergefell, but they’re not on the Supreme Court’s doorstep, and we will see how it all plays out for folks who feel particularly concerned and vulnerable.”

Loewy went on to say there are steps LGBTQ couples and families can take to safeguard their relationships, regardless of what the court decides. She recommended getting married (if that feels right for them) and utilizing available legal tools such as estate planning and relationship documentation.

“There are things, steps that they can take to protect their families — putting documentation in place and securing relationships between parents and children, doing estate planning, making sure that their relationship is recognized fully throughout their lives and their communities. Much of that is not different from the tools that folks have had at their disposal prior to the availability of marriage equality … But I think it behooves everyone to make sure they have an estate plan and they’ve taken those steps to secure their family relationships.”

“I think, to the extent that the panic is rising for folks, those are tools that they have at their disposal to try and make sure that their family and their relationships are as secure as possible,” she added.

When asked what people can do at the state and local level to protect these rights from being eroded, Loewy urged voters to support candidates and initiatives that codify same-sex marriage at smaller levels — which would make it more difficult, if not impossible, for a federal reversal of Obergefell to take effect.

“With regard to marriage equality … states can be doing … amend state constitutions, to remove any of the previous language that had been used to bar same-sex couples from marrying.”

Lambda Legal CEO Kevin Jennings echoed Loewy’s points in a statement regarding the possibility of Obergefell being overturned:

“In the United States, we can proudly say that marriage equality is the law,” he said via email. “As the Supreme Court discusses whether to take up for review a challenge to marriage equality, Lambda Legal urges the court to honor what millions of Americans already know as a fundamental truth and right: LGBTQ+ families are part of the nation’s fabric.

“LGBTQ+ families, including same-sex couples, are living in and contributing to every community in this country: building loving homes and small businesses, raising children, caring for pets and neighbors, and volunteering in their communities. The court took note of this reality in Obergefell v. Hodges, citing the ‘hundreds of thousands of children’ already being raised in ‘loving and nurturing homes’ led by same-sex couples. The vows that LGBTQ+ couples have taken in their weddings might have been a personal promise to each other. Still, the decision of the Supreme Court is an unbreakable promise affirming the simple truth that our Constitution guarantees equal treatment under the law to all, not just some.”

He noted the same things Loewy pointed out — namely that, at minimum, the particular avenue Davis is attempting to use to challenge same-sex marriage has no legal footing.

“Let’s be clear: There is no case here. Granting review in this case would unnecessarily open the door to harming families and undermine our rights. Lower courts have found that a government employee violates the law when she refuses to grant marriage licenses to same-sex couples as her job requires. There is no justifiable reason for the court to revisit settled law or destabilize families.”

He also addressed members of the LGBTQ community who might be feeling fearful at this moment:

“To our community, we say: this fight is not new. Our community has been fighting for decades for our right to love whom we love, to marry and to build our families. It was not quick, not easy, not linear. We have lived through scary and dark times before, endured many defeats, but we have persevered. When we persist, we prevail.”

And he issued a direct message to the court, urging justices to honor the Constitution over one person’s religious beliefs.

“To the court, we ask it to honor its own precedent, to honor the Constitution’s commands of individual liberty and equal protection under the law, and above all, to honor the reality of LGBTQ families — deeply rooted in every town and city in America. There is no reason to grant review in this case.”

Kenneth Gordon, a partner at Brinkley Morgan, a family law firm that works with individuals and couples, including same-sex partners, to meet their legal and financial goals, also emphasized the importance of not panicking and of using available documentation processes such as estate planning.

“From a purely legal standpoint, overturning Obergefell v. Hodges would present significant complications. While it is unlikely that existing same-sex marriages would be invalidated, particularly given the protections of the 2022 Respect for Marriage Act, states could regain the authority to limit or prohibit future marriage licenses to same-sex couples. That would create a patchwork of laws across the country, where a couple could be legally married in one state but not recognized as married if they moved to or even visited another state.

“The legal ripple effects could be substantial. Family law issues such as adoption, parental rights, inheritance, health care decision-making, and property division all rely on the legal status of marriage. Without uniform recognition, couples could face uncertainty in areas like custody determinations, enforcement of spousal rights in medical emergencies, or the ability to inherit from a spouse without additional legal steps.

“Courts generally strive for consistency, and creating divergent state rules on marriage recognition would reintroduce conflicts that Obergefell was intended to resolve. From a legal systems perspective, that inconsistency would invite years of litigation and impose significant personal and financial burdens on affected families.”

Finally, Human Rights Campaign President Kelley Robinson issued a statement about the possibility of the Supreme Court deciding to hear Davis’s appeal:

“Marriage equality isn’t just the law of the land — it’s woven into the fabric of American life,” said Robinson. “For more than a decade, millions of LGBTQ+ couples have gotten married, built families, and contributed to their communities. The American people overwhelmingly support that freedom. But Kim Davis and the anti-LGBTQ+ extremists backing her see a cynical opportunity to attack our families and re-litigate what’s already settled. The court should reject this paper-thin attempt to undermine marriage equality and the dignity of LGBTQ+ people.”

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Supreme Court rules White House can implement anti-trans passport policy

ACLU, Lambda Legal filed lawsuits against directive.

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(Bigstock photo)

The U.S. Supreme Court on Thursday said the Trump-Vance administration can implement a policy that bans the State Department from issuing passports with “X” gender markers.

President Donald Trump once he took office signed an executive order that outlined the policy. A memo the Washington Blade obtained directed State Department personnel to “suspend any application where the applicant is seeking to change their sex marker from that defined in the executive order pending further guidance.”

The White House only recognizes two genders: male and female.

The American Civil Liberties Union in February filed a lawsuit against the passport directive on behalf of seven trans and nonbinary people.

A federal judge in Boston in April issued a preliminary junction against it. A three-judge panel on the 1st U.S. Circuit Court of Appeals in September ruled against the Trump-Vance administration’s motion to delay the move.

A federal judge in Maryland also ruled against the passport policy. (Lambda Legal filed the lawsuit on behalf of seven trans people.)

 “This is a heartbreaking setback for the freedom of all people to be themselves, and fuel on the fire the Trump administration is stoking against transgender people and their constitutional rights,” said Jon Davidson, senior counsel for the ACLU’s LGBTQ and HIV Project, in a statement. “Forcing transgender people to carry passports that out them against their will increases the risk that they will face harassment and violence and adds to the considerable barriers they already face in securing freedom, safety, and acceptance. We will continue to fight this policy and work for a future where no one is denied self-determination over their identity.”

Justices Ketanji Brown Jackson, Elena Kagan, and Sonia Sotomayor dissented.

The Supreme Court ruling is here.

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