U.S. Supreme Court
Supreme Court begins fall term with major gender affirming care case on the docket
Justices rule against Biden admin over emergency abortion question

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.”
U.S. Supreme Court
Supreme Court to consider bans on trans athletes in school sports
27 states have passed laws limiting participation in athletics programs

The U.S. Supreme Court on Thursday agreed to hear two cases involving transgender youth challenging bans prohibiting them from participating in school sports.
In Little v. Hecox, plaintiffs represented by the ACLU, Legal Voice, and the law firm Cooley are challenging Idaho’s 2020 ban, which requires sex testing to adjudicate questions of an athlete’s eligibility.
The 9th U.S. Circuit Court of Appeals described the process in a 2023 decision halting the policy’s enforcement pending an outcome in the litigation. The “sex dispute verification process, whereby any individual can ‘dispute’ the sex of any female student athlete in the state of Idaho,” the court wrote, would “require her to undergo intrusive medical procedures to verify her sex, including gynecological exams.”
In West Virginia v. B.P.J., Lambda Legal, the ACLU, the ACLU of West Virginia, and Cooley are representing a trans middle school student challenging the Mountain State’s 2021 ban on trans athletes.
The plaintiff was participating in cross country when the law was passed, taking puberty blockers that would have significantly reduced the chances that she could have a physiological advantage over cisgender peers.
“Like any other educational program, school athletic programs should be accessible for everyone regardless of their sex or transgender status,” said Joshua Block, senior counsel for the ACLU’s LGBTQ and HIV Project. “Trans kids play sports for the same reasons their peers do — to learn perseverance, dedication, teamwork, and to simply have fun with their friends,” Block said.
He added, “Categorically excluding kids from school sports just because they are transgender will only make our schools less safe and more hurtful places for all youth. We believe the lower courts were right to block these discriminatory laws, and we will continue to defend the freedom of all kids to play.”
“Our client just wants to play sports with her friends and peers,” said Lambda Legal Senior Counsel Tara Borelli. “Everyone understands the value of participating in team athletics, for fitness, leadership, socialization, and myriad other benefits.”
Borelli continued, “The U.S. Court of Appeals for the Fourth Circuit last April issued a thoughtful and thorough ruling allowing B.P.J. to continue participating in track events. That well-reasoned decision should stand the test of time, and we stand ready to defend it.”
Shortly after taking control of both legislative chambers, Republican members of Congress tried — unsuccessfully — to pass a national ban like those now enforced in 27 states since 2020.
U.S. Supreme Court
Supreme Court upholds ACA rule that makes PrEP, other preventative care free
Liberal justices joined three conservatives in majority opinion

The U.S. Supreme Court on Friday upheld a portion of the Affordable Care Act requiring private health insurers to cover the cost of preventative care including PrEP, which significantly reduces the risk of transmitting HIV.
Conservative Justice Brett Kavanaugh authored the majority opinion in the case, Kennedy v. Braidwood Management. He was joined by two conservatives, Chief Justice John Roberts and Justice Amy Coney Barrett, along with the three liberal justices, Sonia Sotomayor, Elena Kagan, and Ketanji Brown-Jackson.
The court’s decision rejected the plaintiffs’ challenge to the Affordable Care Act’s reliance on the U.S. Preventative Services Task Force to “unilaterally” determine which types of care and services must be covered by payors without cost-sharing.
An independent all-volunteer panel of nationally recognized experts in prevention and primary care, the 16 task force members are selected by the secretary of the U.S. Department of Health and Human Services to serve four-year terms.
They are responsible for evaluating the efficacy of counseling, screenings for diseases like cancer and diabetes, and preventative medicines — like Truvada for PrEP, drugs to reduce heart disease and strokes, and eye ointment for newborns to prevent infections.
Parties bringing the challenge objected especially to the mandatory coverage of PrEP, with some arguing the drugs would “encourage and facilitate homosexual behavior” against their religious beliefs.
U.S. Supreme Court
Supreme Court rules parents must have option to opt children out of LGBTQ-specific lessons
Mahmoud v. Taylor case comes from Montgomery County, Md.

The U.S. Supreme Court on Friday ruled that public schools must give advance notice to parents and allow them the opportunity to opt their children out of lessons or classroom instruction on matters of gender and sexuality that conflict with their religious beliefs.
Mahmoud v. Taylor was decided 6-3 along party lines, with conservative Justice Samuel Alito authoring the majority opinion and liberal Justices Sonia Sotomayor, Elena Kagan, and Ketanji Brown-Jackson in dissent.
Parents from diverse religious backgrounds sued to challenge the policy in Maryland’s Montgomery County Public Schools when storybooks featuring LGBTQ characters were added to the elementary school English curriculum in 2022.
The school board argued in the brief submitted to the Supreme Court that “the storybooks themselves do not instruct about gender or sexuality. They are not textbooks. They merely introduce students to characters who are LGBTQ or have LGBTQfamily members, and those characters’ experiences and points of view.”
Advocacy groups dedicated to advancing free speech and expression filed amicus briefs in support of the district.
PEN America argued the case should be viewed in the context of broader efforts to censor and restrict what is available and allowable in public schools, for instance by passing book bans and “Don’t Say Gay” laws.
The ACLU said the policy of not allowing opt-outs is religion-neutral, writing that the Supreme Court should apply rational basis review, which requires only that the school district show that its conduct was “rationally related” to a “legitimate” government interest.
LGBTQ groups also objected to the challenge against the district’s policy, with many submitting amici briefs including: the National Center for Lesbian Rights, GLAD Law, Family Equality, COLAGE, Lambda Legal, the Leadership Conference on Civil and Human Rights, PFLAG., and the National Women’s Law Center.
The Human Rights Campaign did not submit a brief but did issue a statement by the group’s President Kelley Robinson: “LGBTQ+ stories matter. They matter so students can see themselves and their families in the books they read–so they can know they’re not alone.”
“And they matter for all students who need to learn about the world around them and understand that while we may all be different, we all deserve to be valued and loved,” she said. “All students lose when we limit what they can learn, what they can read, and what their teachers can say. The Supreme Court should reject this attempt to silence our educators and ban our stories.”
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