U.S. Supreme Court Allows Gender-Affirming Care Ban for Minors to Go Into Effect in Idaho

On April 16, 2024, the United States Supreme Court allowed a law to go into effect which bans gender-affirming care for all minors in the state of Idaho.

The case, Labrador v. Poe,[1] involves HB 71, which was signed into law in Idaho in April of 2023.[2]

The “Vulnerable Child Protection Act,” the official title yet misnomer for HB 71, prohibits gender-affirming medical care for minors under the age of 18 in Idaho. It criminalizes the use of surgery, puberty blockers, and hormones for minors if this care is being used as part of a minor’s gender transition. It specifically targets medical providers with felony charges and punishment up to 10 years. The law was originally set to take effect on January 1, 2024.

The families of two transgender teenagers receiving gender-affirming care in Idaho, “Pam Poe” and “Jane Doe,” filed suit to prevent HB 71 from going into effect. The lawsuit asserts that the law violates the 14^th Amendment’s guarantee of equal protection under the law. On December 26, 2023, days before the law would have taken effect in Idaho, the United States District Court for the District of Idaho granted a preliminary injunction in favor of the families. The state of Idaho’s subsequent appeal was summarily denied by the Ninth Circuit Court of Appeals.

The state of Idaho then appealed to the United States Supreme Court for an emergency grant of a stay, requesting for the ban on gender-affirming care to go into effect for all minors within the state of Idaho except for the two plaintiffs.

On April 16, 2024, the Supreme Court granted this stay and allowed HB 71 to go into effect in Idaho.

This decision is disastrous, to say the least.

Gender-affirming care, as defined by the World Health Organization, is a term used to describe a spectrum of social, psychological, and medical interventions “designed to support and affirm an individual’s gender identity.”[3] It includes a myriad of ways to support a transgender person – using their chosen name and pronouns; supporting them in changing their physical appearance with a haircut or different clothes; allowing them to use the bathroom that makes them comfortable; and/or, facilitating a transgender person’s access to affirming healthcare. This care looks different for every transgender or gender non-conforming person – much like every cisgender person’s medical care differs from person to person. For transgender and gender non-conforming people, affirming care is intended to treat gender dysphoria and allow someone to align their physical appearance and presentation with their own gender identity. Losing access often leads to worsening gender dysphoria, anxiety, depression, or suicidality.

Providing gender-affirming care to children is widely supported by leading medical experiences and all major medical organizations in the United States, including the American Medical Association, the American Psychiatric Association, and the American Association of Pediatrics. Despite this support by medical professionals, gender-affirming care is widely misunderstood and demonized in the United States. Allowing codified misinformation to go into effect will prevent thousands of children from receiving important – and often lifesaving – healthcare from their own doctors.

In Pennsylvania, there are currently no state laws preventing gender-affirming healthcare. And, by executive order signed by Mayor Jim Kenney in 2023, Philadelphia is a designated safe haven for transgender and gender non-conforming people seeking gender-affirming care. Executive Order 4-23 provides that the City will take steps to protect anyone receiving gender-affirming care, and anyone providing this care. It also prohibits, in most circumstances, the use of Philadelphia’s resources to assist with any investigation or proceeding seeking to impose civil liability, criminal prosecution, or professional sanctions on those receiving or providing such care.

The Supreme Court’s decision and the impact felt in Idaho and beyond represent a dark reality for transgender and gender non-conforming minors. Gender-affirming care in any context is life-changing, especially for children and teenagers. Ensuring safe and legal access to medical care is important during every step of an individual’s transition, big or small.

[1] Accessible at https://www.supremecourt.gov/opinions/23pdf/23a763_8n5a.pdf#page=27.

[2] Accessible at https://legislature.idaho.gov/sessioninfo/2023/legislation/H0071/.

[3] Accessible at https://opa.hhs.gov/sites/default/files/2023-08/gender-affirming-care-young-people.pdf.