Struggling to conceal her true identity, Joe Horras' transgender daughter battled with depression and anxiety until three years ago, when she started taking medication to halt the onset of puberty. The gender-affirming treatment brought back happiness to the now-16-year-old, as shared by her father.
A recent ruling by the U.S. Supreme Court that permits Idaho to enforce its prohibition on such care for minors could once again put her well-being at risk. Horras is now in a race to determine the next course of action and is contemplating leaving Idaho, the state he has always called home, to relocate to a different state.
"The consequences would be catastrophic for her," expressed Horras, a resident of Boise, in a statement to The Associated Press. "Without access to that treatment, it will have a detrimental impact on her mental health."
Horras is just one of many Idaho parents in a state of desperation as their transgender children have been stripped of the gender-affirming care they were receiving. The recent decision by the U.S. Supreme Court allows the state to implement a law from 2023 that exposes physicians to a maximum of 10 years in prison if they offer hormones, puberty blockers, or any other gender-affirming care to individuals under 18 years old. Previously, a federal judge in Idaho had blocked the law in its entirety.
Supreme Court's Decision on Gender-Affirming Care Ban
The Supreme Court's ruling on the ban of gender-affirming care for minors will remain in effect as lawsuits against the law continue in lower courts. However, the two transgender teens who initiated the legal challenge will still be able to access the care they need.
Over two dozen states have implemented bans on gender-affirming care for minors in recent years, with many of them facing legal opposition. Currently, twenty states are enforcing these bans.
This marks the first time the U.S. Supreme Court has addressed this issue. The 6-3 ruling by the court did not directly address the constitutionality of the ban itself. Instead, the justices delved into the question of whether it is appropriate to halt enforcement of a law for everyone or solely for those involved in the legal challenge as it moves through the judicial system.
Justice Neil Gorsuch, in his concurring opinion, advised lower courts to be cautious and restrict the use of "universal injunctions" that block the enforcement of laws facing legal disputes. On the other hand, Justice Ketanji Brown Jackson dissented, arguing that the court should not make decisions on such matters without reviewing legal briefs and hearing arguments on the subject.
Impact of Recent Legislation on Transgender Youth in Idaho
As the new measure takes effect in Idaho, rights groups are stepping up to support families and ensure they understand the implications. The American Civil Liberties Union of Idaho has announced plans to host a virtual event on Zoom, featuring licensed counselors and legal experts, to help individuals process the news and address any concerns they may have regarding the law.
"Yesterday witnessed an outpouring of fear and confusion, with people seeking clarity on how this will impact them personally," stated Jenna Damron, the advocacy fellow for the group. "Our primary focus right now is to disseminate accurate information as quickly as possible."
Paul Southwick, the legal director for ACLU of Idaho, emphasized the importance of informing families about their available options.
"Gender-affirming medical care for minors is now prohibited in Idaho. However, such care remains legal for adults, and minors can still access gender-affirming medical services outside the state," Southwick explained.
In Boise, Horras, a parent, shared his concerns about the new law. His 16-year-old daughter, who currently uses an estrogen patch and receives injections every six months, will need to find a new provider out of state within the next two months to continue her treatment. Horras expressed his fear and frustration towards the state lawmakers who approved the legislation last year.
"It's a cruel situation," he remarked.
Advocates, meanwhile, worry that lower-income families won't be able to afford to travel across state lines for care. Arya Shae Walker, a transgender man and activist in the small city of Twin Falls in rural southern Idaho, said he was concerned that people would alter the doses of their current prescriptions in order to make them last longer. His advocacy group has already taken down information on its website on gender-affirming care providers for young people in the area out of concern of potential legal consequences.
The broader issue of bans on gender-affirming care for minors could eventually be before the U.S. Supreme Court again. Last year, a ban on gender-affirming care for minors in Arkansas was shot down by a federal judge, while those in Kentucky and Tennessee were allowed to be enforced by an appeals court after being put on hold by lower-court judges. Montana's law is not being enforced because of a ruling from a state judge.
Laws barring transgender youth from playing on sports teams that align with their gender identity are also being challenged across the country. An appeals court on Tuesday ruled that West Virginia's transgender sports ban violates the rights of a teen athlete under Title IX, the federal civil rights law that prohibits sex-based discrimination in schools. Hours later, an Ohio law that bars transgender girls from girls scholastic sports competitions was put on hold by a judge. Set to take effect next week, the law also bans gender-affirming care for transgender youth.
Those who support the bans say they want to protect children and have concerns about the treatments themselves.
Major medical organizations such as the American Medical Association, the American Academy of Pediatrics, and the American Psychiatric Association support gender-affirming care for youth. Despite this, England is imposing restrictions on individuals under 16 who wish to undergo a medical gender transition.
The National Health Service England has recently solidified a policy, initially introduced on an interim basis almost a year ago, that establishes a minimum age for the commencement of puberty blockers, among other criteria. NHS England cites insufficient evidence regarding the long-term effects of these treatments, including impacts on sexual, cognitive, and broader developmental outcomes.
Gender dysphoria is defined by medical professionals as the psychological distress experienced by individuals whose gender expression does not align with their gender identity. Experts highlight that gender-affirming therapy can result in decreased rates of depression, suicidal thoughts, and suicide attempts among transgender individuals.
Chelsea Gaona-Lincoln, the executive director of the Idaho-based advocacy group Add The Words, expressed concern about the potential negative repercussions of these limitations. However, she finds solace in witnessing her community coming together to show support, particularly for young individuals who need to feel acknowledged and validated.
Southwick, the legal director of ACLU of Idaho, mentioned that the 9th U.S. Circuit Court of Appeals is expected to convene a hearing this summer regarding the organization's lawsuit challenging the law.
