The Volokh Conspiracy
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Court Upholds Tennessee Restriction on Youth Gender Medicine
Off to a conference today, so I can't write about it in detail but the Court's syllabus on p. 1-5 seems to summarize the opinion (U.S. v. Skrmetti) well.
Here's one particularly interesting passage I noticed, from Justice Thomas's concurrence:
The Court rightly rejects efforts by the United States and the private plaintiffs to accord outsized credit to claims about medical consensus and expertise. The United States asserted that "the medical community and the nation's leading hospitals overwhelmingly agree" with the Government's position that the treatments outlawed by SB1 can be medically necessary. Brief for United States 35; see also Brief for Respondents in Support of Petitioner 5 (asserting that "[e]very major medical association in the United States" supports this position). The implication of these arguments is that courts should defer to so-called expert consensus.
There are several problems with appealing and deferring to the authority of the expert class. First, so-called experts have no license to countermand the "wisdom, fairness, or logic of legislative choices." FCC v. Beach Communications, Inc., 508 U. S. 307, 313 (1993). Second, contrary to the representations of the United States and the private plaintiffs, there is no medical consensus on how best to treat gender dysphoria in children. Third, notwithstanding the alleged experts' view that young children can provide informed consent to irreversible sex-transition treatments, whether such consent is possible is a question of medical ethics that States must decide for themselves. Fourth, there are particularly good reasons to question the expert class here, as recent revelations suggest that leading voices in this area have relied on questionable evidence, and have allowed ideology to influence their medical guidance.
Taken together, this case serves as a useful reminder that the American people and their representatives are entitled to disagree with those who hold themselves out as experts, and that courts may not "sit as a super-legislature to weigh the wisdom of legislation." Day-Brite Lighting, Inc. v. Missouri, 342 U. S. 421, 423 (1952). By correctly concluding that SB1 warrants the "paradigm of judicial restraint," Beach Communications, 508 U. S., at 314, the Court reserves to the people of Tennessee the right to decide for themselves.
Obviously, there's vastly more to the case, and even to Justice Thomas's opinion, than that: For instance, expert opinions may be relevant when constitutional rules do require the Court to determine whether, say, a law is narrowly tailored to a compelling government interest; Justice Thomas argues elsewhere in the opinion, as does the majority that he joins, that this test doesn't apply here. Still, the paragraphs I quoted above strike me as offering a helpful perspective into Justice Thomas's thinking, and perhaps that of some others as well.
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Sotomayor in dissent, once again, making policy arguments instead of legal ones, has a ton of anger and indignation over (effectively) maintaining the status quo, and her preferred policy is not something people want.
In fairness to my friends on the left, Alito is at least the same if not worse about it. Probably worse.
I have no problem with the discovery of new unenumerated rights, even ones that would have been laughed out of the room 200 years ago. Or 50.
I also have a soft spot in my heart for people who take their rights by force, and this includes running off to courts.
It has, however, been a productive path in recent years to assert things are so and so, then jump straight to social ostracism to clean up the resistance of conservative stragglers, well ahead of the actual state of debate in a democracy.
This would be original definitions of liberal and concervative, by the way, conservative values established tradition as hard-wrought wisdom that should not be overturned without sober debate, and liberal wants to overturn society to save it from itself.
As for the policy under debate, re-under-debate as of this AM, there's the libertarian heuristic: nunya
Nunya fuckin' business.
"I have no problem with the discovery of new unenumerated rights, even ones that would have been laughed out of the room 200 years ago. Or 50."
Agreed. I just don't think it's the job of the courts to be discovering them, and then forcing them on the rest of society. The judiciary seem to gradually be transforming themselves from the least dangerous branch, to the most.
And I don't think they have the firepower to back it up, in the end. They'll just lose their utility as judges if they keep it up.
" . . . if they keep it up." Keep what up? The high water mark for judicial activism (by which I mean substituting judges' own policy preferences for the policy choices made by the other branches) was decades ago. What unenumerated rights have the courts discovered in, say, the last ten or twenty years?
Same sex marriage? A right to not be executed if you're under 18 or retarded? There is quite a long list.
"The application of SB1...does not turn on sex. The law
does not prohibit certain medical treatments for minors of one sex
while allowing those same treatments for minors of the opposite sex. SB1 prohibits healthcare providers from administering puberty blockers or hormones to any minor to treat gender dysphoria, gender identity disorder, or gender incongruence, regardless of the minor’s sex..."
There is indeed a logic to this, but...in the Title XII (employment) context, the court did go further than this to indicate that ANY discrimination based on transgender status is always, automatically, and conclusively discrimination based on sex (however slight the hook, as we saw in the recent reverse-discrimination case...). Could it be that that's simply "more true" in employment contexts, or is it that that was statutory law whereas this would require extending Bostock-reasoning to a constitutional level?
The majority opined:
I hope that they are going down the road of "limiting" Bostock to its own ridiculous holding because they realize that it spawned specious arguments like the Plaintiffs made in this case.
The application equal protection clause is simply misplaced. Puberty blockers, testoterone, etc are not being banned due to sex. Those treatments can still be used for certain medical conditions, medical conditions which positive medical outcomes can be achieved from using those treatments. They are being banned for other medical and mental health conditions which result in negative medical outcomes in which biological factors cause negative medical outcomes. Its a very distinct difference.
Gorsuch, who authored Bostock v. Clayton County, 590 U.S. 644 (2020), was silent during oral argument in Skrmetti and did not author an opinion in that case. I assume he agreed with the way the majority opinion distinguished Bostock.
The majority cited Geduldig v. Aiello, 417 U.S. 484 (1974), which said that a restriction or ban on a type of medical care is not sex-based if members of that sex are in the group of those seeking such care and in the group of those not so seeking. Since not all transgender minors seek gender affirming care, the majority ruled that Tennessee's ban on such care is not sex-based and, thus, subject only to rational basis review (which it easily passed).
correct
Sex based vs biological factor based - while both categories have the same groups, the basis for the ban[s] is based on biological factors and the effect on medical outcomes, not based on the "sex" . Very much separate and distinct difference.
Why does Geduldig get any deference as a precedent? If I understand its principle as applied in that case, the Court considered non-coverage of pregnancy to *not* be sex-based discrimination as long as there is any woman who can't become (or perhaps even isn't currently?) pregnant.
Absurd.
The "as long as there is any woman" is your strawman, and you need a better argument for why it's absurd than "Absurd."
There's no doubt that the restriction has a disparate impact on women, but the 14th amendment does not prohibit disparate impact.
You could be forgiven for thinking this wacky criterion mine, but it is in fact the Court’s.
From the opinion (here I’m trusting ChatGPT):
“The program divides potential recipients into two groups—pregnant women and nonpregnant persons. While the first group is exclusively female, the second includes members of both sexes.”
..and this was the basis for their non-sex-based discrimination ruling.
Under this principle, if coverage of penile cancer were not provided and this fact were communicated in a way that didn’t mention men, that too would not be sex-based discrimination. Why? Because some men lack penises (through unfortunate accidents if nothing else).
If there is any coherent perspective from which the Court’s principle (as applied to either scenario, pregnancy or penile) can be said with a straight face to make sense, please enlighten me. Absent which, I’m sticking with absurd.
I know what the caselaw says; the strawman aspect of your comment is that there just has to be one non-pregnant woman.
Moreover, your new analogy is error. It’s not the theoretical possibility of men w/o penises that makes it non-discrimination; it’s the actual existence of many men w/o penile cancer that names it non-discrimination.
Paging not guilty....
Justice Thomas's concurrence goes out of its way to address issues that were not before the Court. That is not good judging.
The majority's conclusion that SB1 does not classify on the basis of transgender status, such that the Court need not address the District Court's finding transgender individuals to constitute a quasi-suspect class, is rank intellectual dishonesty.
Good to see the Supreme Court is in its "I did my own research" phase.
Is it doing its own research? Seems to me they are deliberately not making policy arguments and leaving it to the states, which is very much the opposite!
Its doesnt take much "own research" to know that the current fad medical treatment for gender confusion causes medical harm.
In bookkeeper_joe's case, it doesn't take any research for him to say anything!
To paraphrase Treasure of the Sierra Madre:
https://www.youtube.com/watch?v=VqomZQMZQCQ
Gender medicine? Fuck that euphemistic description for child mutilation.
Supposedly we have a consensus of experts in favor of child mutilation. We should identify those experts, and not defer to them on anything.
Really? They are banned in Europe for this purpose. Hardly sounds like a consensus.
The major medical and psychiatric associations are in favor of it. Sotomayor says it is "lifesaving medical treatment".
consensus of advocates, not experts.
I think it says something how no one here wants to engage with the facts of the case, but would prefer a substantially more fraught strawman.
That's a side that's winning the policy argument.
"Expert opinion" lost all credibility during COVID.
It is one thing if you have independent expert opinions coming to similar conclusions, but this is almost never the case in the highly stratified medical community of today. Very few doctors have the courage of their convictions when their medical license (and income) are at stake after a very expensive training process.