What to know about the gender-affirming healthcare case as the Supreme Court prepares to weigh in | WHAT

The U.S. Supreme Court said Monday it will hear arguments on the constitutionality of state bans on gender-affirming care for transgender minors.

The problem has become serious in recent years. While transgender people have gained greater visibility and acceptance in many ways, half of states have pushed back with laws banning certain health care services for transgender children.

What you need to know about the problem:

What is gender-affirming care?

Gender-affirming care includes a range of medical and mental health services to support a person’s gender identity, even if it differs from the sex assigned at birth.

The services are offered to treat gender dysphoria, the discomfort someone may have because their assigned sex and gender identity do not match. The condition has been linked to depression and suicidal thoughts.

Gender-affirming care includes counseling and treatment with puberty-blocking medications and hormone therapy to bring about physical changes. Those for transgender men ensure, among other things, that menstruation stops, facial and body hair increases and the voices become deeper. The hormones used by transgender women can have effects such as slowing the growth of body and facial hair and increasing breast growth.

Gender affirming care can also include surgeries, including surgeries to transform genitals and the chest. These operations are rarely offered to minors.

What laws do states pass?

Over the past three years, 26 Republican-controlled states have passed laws restricting gender-affirming care for minors. Most laws ban puberty blockers, hormone treatments and surgery for people under 18. Some laws include provisions that allow people already receiving treatment to continue.

The laws also make exceptions for gender-affirming treatments that are not part of gender transition, such as drugs to stop breast growth in boys and excessive facial hair in girls.

One of the laws – in Arkansas – was struck down by a federal court and is not enforced.

Meanwhile, at least fourteen Democratic-controlled states have passed laws intended to protect access to gender-affirming care.

The gender-affirming healthcare legislation is a key part of a broader set of laws and policies that have emerged in Republican-controlled states that are reining in the rights of transgender people. Other policies, adopted in the name of protecting women and girls, ban transgender people from school bathrooms and sports matches that match their gender.

What have courts said so far?

Most bans have faced legal challenges, and most are not yet far down the legal pipeline.

The Arkansas law is the only one that has been completely struck down, but the state has asked a federal appeals court to overturn that ruling.

The 6th U.S. Circuit Court of Appeals, a step below the Supreme Court, ruled last year that Kentucky and Tennessee can continue to enforce their bans despite legal challenges. The Supreme Court has agreed to hear the Tennessee case during its term beginning later this year.

The U.S. Supreme Court ruled in April that Idaho can enforce the ban as long as lawsuits over it continue. A lower court had stayed the case.

What does the medical community think?

Every major U.S. medical group, including the American Academy of Pediatrics and the American Medical Association, has opposed the bans, saying gender-affirming treatments may be medically necessary and supported by evidence.

But around the world, medical experts and government health officials are not on the same page. Some European countries have warned against overdiagnosis of gender dysphoria in recent years.

In England, the state-funded National Health Service commissioned a study into gender identity services for children and adolescents, with retired pediatrician Dr. Hilary Cass was appointed to take charge. The final version of the Cass Review, published in April, found “no good evidence on the long-term outcomes of interventions to manage gender-related problems.”

The English health service stopped prescribing puberty blockers to children with gender dysphoria outside a research setting, following recommendations from Cass’s interim report.

The World Professional Association for Transgender Health and its U.S. affiliate issued a statement in May saying they were deeply concerned about the process, content and impact of the review. deserve and causes enormous suffering and harm to both young patients and their families.”