Latest news with #gendercare
CNN
19-06-2025
- Politics
- CNN
Analysis: With transgender care ruling, Chief Justice Roberts tries to avoid extremes
After Supreme Court oral arguments last December, it was clear conservative justices had the votes to uphold state bans on gender care for trans youths under age 18. The question was how far the decision would sweep to affect trans individuals in other situations. In the end, Chief Justice John Roberts used the power of his office to keep the opinion for himself. He penned a decision that affirmed state restrictions on puberty blockers and hormone therapy, but he declined to adopt the reasoning of some conservatives that could have made transgender people even more vulnerable to discrimination. Roberts, by virtue of his position as chief, assigns opinions when he is in the majority. He regularly keeps the most significant cases for himself, as he did in the controversy over President Donald Trump's assertion of immunity from prosecution last year. Yet Roberts, now in his 20th year in the center chair, also strategically assigns cases to restrain or otherwise influence the court's holding. On Wednesday, he fended off the more aggressive right-wing sentiment. In his seven-minute statement from the mahogany bench and in his written opinion, Roberts adopted a cut-and-dried tone. He eschewed the heat of the three liberal dissenters, as well as the conservatives who broke off to write their own statements. Justice Clarence Thomas, for example, insisted medical experts 'have surreptitiously compromised their medical recommendations to achieve political ends,' and Justice Amy Coney Barrett raised concerns about boys' and girls' sports teams. All told, Roberts appeared to try to lower the temperature on the combustible issue of trans rights – which Trump promised to curtail during his 2024 reelection bid. Since taking office again in January, multiple executive orders have targeted trans people, including servicemembers in the US military. The chief justice's 24-page opinion, to be sure, thoroughly rejected the challenge to a Tennessee law that forbids healthcare providers from providing hormones and other treatment for children under age 18 to transition or, as the law states, to 'identify with, or live as, a purported identity inconsistent with the minor's biological sex.' He said the classification related to age and medical use, rather than to sex, which would have meant it was more likely to violate the Constitution's equal protection guarantee. The disputed Tennessee law permits puberty blockers and hormones for minors to treat some conditions, such as a congenital defect or precocious puberty, but not to treat gender dysphoria – that is, the incongruence between one's gender identity and sex assigned at birth. Roberts referred to evolving medical assessment of potential harms associated with such treatment, primarily in European countries, as he emphasized that the Tennessee legislature had sufficient grounds for the regulation of medical treatment for minors. Advocates for the children and families in the high court case argued that hormone treatment can be crucial to the health and wellbeing of transgender adolescents. They contended the Tennessee law amounted to a type of sex discrimination that would have warranted a tougher standard of judicial review. Justice Sonia Sotomayor, speaking for the three liberal dissenters, lamented Roberts' approach. 'By retreating from meaningful judicial review exactly where it matters most, the Court abandons transgender children and their families to political whims.' Roberts declined to address whether transgender individuals would specifically merit heightened protection under the Constitution. Yet, Barrett and Thomas, along with Justice Samuel Alito, would have taken on that question, disfavoring trans individuals. (The remaining two conservative justices, Neil Gorsuch and Brett Kavanaugh, signed Roberts' opinion and wrote nothing more.) Barrett opened her separate statement by asserting that she would have ruled that transgender people do not constitute a class of people who deserve special protection in the law. 'Beyond the treatment of gender dysphoria, transgender status implicates several other areas of legitimate regulatory policy—ranging from access to restrooms to eligibility for boys' and girls' sports teams,' she wrote, joined by Thomas, and adding that if laws singling out transgender people required heightened constitutional scrutiny, 'then the courts will inevitably be in the business of closely scrutinizing legislative choices in all these domains.' In their own separate writings, Thomas and Alito reiterated their criticism of the court's 2020 case, Bostock v. Clayton County, which held that employees fired for being gay or transgender can sue under the prohibition on sex discrimination in Title VII of the 1964 Civil Rights Act. Roberts' opinion neither retrenched on Bostock nor extended it beyond the Title VII employment context to the case at hand. Cecillia Wang, national legal director of the American Civil Liberties Union Foundation, said of the court's Wednesday decision, 'It's a devastating loss for trans youth and their families who have lost their essential medical care, but it's significant that the opinion is cabined both on the record and on doctrine. We live to fight another day on other laws discriminating against transgender Americans, including our cases challenging Trump's animus-fueled policies. During oral arguments in December, Roberts foreshadowed his concern that legislators should play the leading role on trans rights: 'We might think that we can do just as good a job with respect to the evidence here as Tennessee or anybody else,' Roberts said at the time, 'but my understanding is that the Constitution leaves that question to the people's representatives rather than to nine people, none of whom is a doctor.' That statement recalled similar sentiment from 10 years ago when Roberts dissented as the five-justice majority declared a right to same-sex marriage. 'Five lawyers have closed the debate and enacted their own vision of marriage as a matter of constitutional law,' he wrote in that 2015 case of Obergefell v. Hodges. 'Stealing this issue from the people will for many cast a cloud over same-sex marriage, making a dramatic social change that much more difficult to accept. … Just who do we think we are?' That was unusually strident for the chief. Roberts felt so strongly about the case that it marked the first and only time he had dissented aloud from the courtroom bench. (Justices take that rare step when they want to call particular attention to their dissenting view, as Sotomayor did on Wednesday.) As Roberts referred to legislative control of policy, he avoided the dramatic flourish of 2015. 'This case carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field,' he wrote as he concluded his opinion in United States v. Skrmetti. '… (W)e leave questions regarding its policy to the people, their elected representatives, and the democratic process.' For as much as Roberts confined the decision to medical treatment for trans minors, the Trump administration has already signaled that it would try to use the Skrmetti case to augment its actions against transgender servicemembers. For the liberal dissenters, the current Trump agenda was in the foreground. As Justice Barrett questioned whether trans individuals had faced government discrimination, Sotomayor wrote, 'Transgender people have long been subject to discrimination in healthcare, employment, and housing, and to rampant harassment and physical violence. And directly citing Barrett's opinion, Sotomayor added, '(T)hose searching for more evidence of de jure discrimination against transgender individuals, need look no further than the present. The Federal Government, for example, has started expelling transgender servicemembers from the military and threatening to withdraw funding from schools and nonprofits that espouse support for transgender individuals.' Sotomayor, joined by Justices Elena Kagan and Ketanji Brown Jackson, pointed to 'the recent rise in discriminatory state and federal policies and the fact that transgender people are underrepresented in every branch of government,' and said the court majority had rendered 'transgender Americans doubly vulnerable to state-sanctioned discrimination.'
CNN
19-06-2025
- Politics
- CNN
Analysis: With transgender care ruling, Chief Justice Roberts tries to avoid extremes
After Supreme Court oral arguments last December, it was clear conservative justices had the votes to uphold state bans on gender care for trans youths under age 18. The question was how far the decision would sweep to affect trans individuals in other situations. In the end, Chief Justice John Roberts used the power of his office to keep the opinion for himself. He penned a decision that affirmed state restrictions on puberty blockers and hormone therapy, but he declined to adopt the reasoning of some conservatives that could have made transgender people even more vulnerable to discrimination. Roberts, by virtue of his position as chief, assigns opinions when he is in the majority. He regularly keeps the most significant cases for himself, as he did in the controversy over President Donald Trump's assertion of immunity from prosecution last year. Yet Roberts, now in his 20th year in the center chair, also strategically assigns cases to restrain or otherwise influence the court's holding. On Wednesday, he fended off the more aggressive right-wing sentiment. In his seven-minute statement from the mahogany bench and in his written opinion, Roberts adopted a cut-and-dried tone. He eschewed the heat of the three liberal dissenters, as well as the conservatives who broke off to write their own statements. Justice Clarence Thomas, for example, insisted medical experts 'have surreptitiously compromised their medical recommendations to achieve political ends,' and Justice Amy Coney Barrett raised concerns about boys' and girls' sports teams. All told, Roberts appeared to try to lower the temperature on the combustible issue of trans rights – which Trump promised to curtail during his 2024 reelection bid. Since taking office again in January, multiple executive orders have targeted trans people, including servicemembers in the US military. The chief justice's 24-page opinion, to be sure, thoroughly rejected the challenge to a Tennessee law that forbids healthcare providers from providing hormones and other treatment for children under age 18 to transition or, as the law states, to 'identify with, or live as, a purported identity inconsistent with the minor's biological sex.' He said the classification related to age and medical use, rather than to sex, which would have meant it was more likely to violate the Constitution's equal protection guarantee. The disputed Tennessee law permits puberty blockers and hormones for minors to treat some conditions, such as a congenital defect or precocious puberty, but not to treat gender dysphoria – that is, the incongruence between one's gender identity and sex assigned at birth. Roberts referred to evolving medical assessment of potential harms associated with such treatment, primarily in European countries, as he emphasized that the Tennessee legislature had sufficient grounds for the regulation of medical treatment for minors. Advocates for the children and families in the high court case argued that hormone treatment can be crucial to the health and wellbeing of transgender adolescents. They contended the Tennessee law amounted to a type of sex discrimination that would have warranted a tougher standard of judicial review. Justice Sonia Sotomayor, speaking for the three liberal dissenters, lamented Roberts' approach. 'By retreating from meaningful judicial review exactly where it matters most, the Court abandons transgender children and their families to political whims.' Roberts declined to address whether transgender individuals would specifically merit heightened protection under the Constitution. Yet, Barrett and Thomas, along with Justice Samuel Alito, would have taken on that question, disfavoring trans individuals. (The remaining two conservative justices, Neil Gorsuch and Brett Kavanaugh, signed Roberts' opinion and wrote nothing more.) Barrett opened her separate statement by asserting that she would have ruled that transgender people do not constitute a class of people who deserve special protection in the law. 'Beyond the treatment of gender dysphoria, transgender status implicates several other areas of legitimate regulatory policy—ranging from access to restrooms to eligibility for boys' and girls' sports teams,' she wrote, joined by Thomas, and adding that if laws singling out transgender people required heightened constitutional scrutiny, 'then the courts will inevitably be in the business of closely scrutinizing legislative choices in all these domains.' In their own separate writings, Thomas and Alito reiterated their criticism of the court's 2020 case, Bostock v. Clayton County, which held that employees fired for being gay or transgender can sue under the prohibition on sex discrimination in Title VII of the 1964 Civil Rights Act. Roberts' opinion neither retrenched on Bostock nor extended it beyond the Title VII employment context to the case at hand. Cecillia Wang, national legal director of the American Civil Liberties Union Foundation, said of the court's Wednesday decision, 'It's a devastating loss for trans youth and their families who have lost their essential medical care, but it's significant that the opinion is cabined both on the record and on doctrine. We live to fight another day on other laws discriminating against transgender Americans, including our cases challenging Trump's animus-fueled policies. During oral arguments in December, Roberts foreshadowed his concern that legislators should play the leading role on trans rights: 'We might think that we can do just as good a job with respect to the evidence here as Tennessee or anybody else,' Roberts said at the time, 'but my understanding is that the Constitution leaves that question to the people's representatives rather than to nine people, none of whom is a doctor.' That statement recalled similar sentiment from 10 years ago when Roberts dissented as the five-justice majority declared a right to same-sex marriage. 'Five lawyers have closed the debate and enacted their own vision of marriage as a matter of constitutional law,' he wrote in that 2015 case of Obergefell v. Hodges. 'Stealing this issue from the people will for many cast a cloud over same-sex marriage, making a dramatic social change that much more difficult to accept. … Just who do we think we are?' That was unusually strident for the chief. Roberts felt so strongly about the case that it marked the first and only time he had dissented aloud from the courtroom bench. (Justices take that rare step when they want to call particular attention to their dissenting view, as Sotomayor did on Wednesday.) As Roberts referred to legislative control of policy, he avoided the dramatic flourish of 2015. 'This case carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field,' he wrote as he concluded his opinion in United States v. Skrmetti. '… (W)e leave questions regarding its policy to the people, their elected representatives, and the democratic process.' For as much as Roberts confined the decision to medical treatment for trans minors, the Trump administration has already signaled that it would try to use the Skrmetti case to augment its actions against transgender servicemembers. For the liberal dissenters, the current Trump agenda was in the foreground. As Justice Barrett questioned whether trans individuals had faced government discrimination, Sotomayor wrote, 'Transgender people have long been subject to discrimination in healthcare, employment, and housing, and to rampant harassment and physical violence. And directly citing Barrett's opinion, Sotomayor added, '(T)hose searching for more evidence of de jure discrimination against transgender individuals, need look no further than the present. The Federal Government, for example, has started expelling transgender servicemembers from the military and threatening to withdraw funding from schools and nonprofits that espouse support for transgender individuals.' Sotomayor, joined by Justices Elena Kagan and Ketanji Brown Jackson, pointed to 'the recent rise in discriminatory state and federal policies and the fact that transgender people are underrepresented in every branch of government,' and said the court majority had rendered 'transgender Americans doubly vulnerable to state-sanctioned discrimination.'
CTV News
28-05-2025
- Health
- CTV News
Canadian Medical Association files lawsuit challenging gender-care legislation
Aerial shot of the Alberta legislature on Monday, May 26, 2025. (Cam Wiebe/CTV News Edmonton) The Canadian Medical Association (CMA) and three Alberta physicians are pursuing a judicial review of Bill 26, known as the province's gender-care legislation. A statement from the CMA said the bill directs physicians on how to deliver gender-affirming care to people under 18, down to which medications they can use. 'This is a historic and unprecedented government intrusion into the physician-patient relationship and requires doctors to follow the law rather than clinical guidelines, the needs of patients and their own conscience,' said the statement issued Wednesday morning. The CMA said it has filed an application with the Court of King's Bench for the judicial review of Bill 26, the Health Statutes Amendment Act, 2024 and its proposed changes to the Health Professions Act R.S.A 2000. Bill 26 was introduced on Oct. 31, 2024, to preserve choice for minors identifying as transgender while refocusing the health-care system, according to the province. 'Medicine is a calling. Doctors pursue it because they are compelled to care for and promote the well-being of patients,' said CMA president Joss Reimer in a statement. 'When a government bans specific treatments, it interferes with a doctor's ability to empower patients to choose the best care possible. The CMA said the legislation renders physicians powerless in providing independent expertise, clinical guidance and treatment options when it comes to gender-affirming care. Jake Donaldson, a Calgary-based family physician who provides gender-affirming care to about 40 adolescents, said the legislation has put him and his colleagues in a state of 'moral crisis.' 'These patients are a vulnerable group that already face significant and disproportionate discrimination, violence and mental health challenges,' said Donaldson in a CMA statement. 'Bill 26 commands physicians to stand on the sidelines and watch them suffer.' Since the bill and other transgender legislation was introduced, advocacy groups and families have protested and taken legal action against the province, arguing that Bill 26 violates gender-diverse young people's section 7 right to security of the person, their section 12 right to be free from cruel and unusual treatment and their section 15 right to equality. Part of Bill 26 prohibits gender-affirming 'top' surgeries for minors which went into effect when the bill received royal assent in December 2024. The legislation also bans puberty blockers and hormone therapy for those with gender dysphoria. Egale Canada and Skipping Stone, both LGBTQ2S+ advocacy groups, have requested for an injunction to block the denial of health care for gender diverse youth while the bill faces a constitutional test. Sarah Hoffman, NDP shadow minister of health, said she is pleased to see doctors stand with their patients in opposing UCP law. 'When medical experts and parents agree on safe medical treatment, the government shouldn't be preventing it,' said Hoffman in an emailed statement. 'The new CMA legal challenge to Bill 26 is about defending parental and human rights.' CTV News Edmonton reached out to the Ministry of Justice for comment.
The Independent
15-05-2025
- Health
- The Independent
Rise in children's gender care waiting list across England and Wales
The number of children awaiting gender care in England and Wales has risen by 12% in a year, with 157 of those on the waiting list aged under 10. Average waiting times have also grown to more than two years for a child to get a first appointment at a specialist NHS clinic. There were 6,225 children on the national waiting list at the end of March – up from 5,560 at the same point a year earlier, data obtained by the PA news agency showed. The British Psychological Society said the numbers show that 'demand is currently outpacing supply' and warned it is 'essential' for children to get professional care and support 'before they reach crisis point'. Health Secretary Wes Streeting last year branded waiting times 'unacceptable', acknowledging the 'enormous distress' they can cause. Responding to the latest figures, NHS medical director for specialised services Professor James Palmer said he understands it 'can be really difficult' for children and their families waiting to be seen. Two children's gender hubs, led by London's Great Ormond Street Hospital (Gosh) and Alder Hey Children's Hospital in Liverpool, opened in April 2024. This followed the closure of the Gender Identity Development Service (Gids) run by the Tavistock and Portman NHS Foundation Trust. A third service has since opened Bristol while another is planned for the East of England 'later this spring', according to the Department of Health and Social Care (DHSC). The aim is for there to eventually be up to eight specialist children's gender clinics covering the seven NHS regions in England. Of those on the national waiting list – which covers England and Wales because the latter does not have its own dedicated children's gender clinic – 157 children were aged under 10, according to a Freedom of Information request by PA. Fewer than 10 children were aged under five years old, NHS England said, adding that it would not give an exact number as this could breach confidentiality because of people being potentially identifiable in smaller groups. There is no minimum age requirement for gender care, with the NHS previously saying they want to ensure parents of very young children are given support where necessary. Waiting times for a first appointment have also risen, to an average of 116 weeks at the end of March from an average of 100 weeks at the end of May last year. Dr Roman Raczka, president of the British Psychological Society, said: 'It is essential that children, young people and their families can access the professional care and support they need, before they reach crisis point. 'Demand is currently outpacing supply. This contributes to a range of broader challenges which face children and young people's services that require further investment.' Some 250 patients transferred from Gids have been seen by new services, and it is understood each of the new clinics is designed to see 25 patients a month. Following the Cass Review last year which concluded children had been let down by a lack of research and evidence on medical interventions in gender care, NHS England announced a new plan which requires new referrals into the clinics to have been seen by a GP and mental health specialist or paediatrician first. Guidance expected to be published later this month will see the health service move away from a 'medical model' in favour of a 'holistic' approach to children's gender care, as per recommendations from the Cass Review. According to leaked plans reported last month, children who have gender dysphoria will be tested for neurodevelopmental conditions including autism and ADHD (Attention-Deficit/Hyperactivity Disorder). Prof Palmer said: 'We know it can be really difficult for children and young people and their families who are waiting to be seen by our new holistic gender services, and that's why it has been so important that we put a new system in place to ensure that, while they're waiting, they can access mental health support if they need it. 'The NHS is now almost halfway through its planned expansion of regional services, and we are seeing significantly fewer referrals as children are first assessed by paediatric or mental health experts and provided with care in NHS services that are more appropriate to their needs.' Puberty blockers are not prescribed on the NHS to children for the treatment of gender dysphoria, after a ban last year was made permanent in December with the agreement of devolved governments across the UK. Plans remain in place to set up a clinical trial into the use of puberty blockers this year, although no patients have yet been recruited while ethical and regulatory approval is awaited. A DHSC spokesperson said: 'We are working with NHS England to reform children's gender services in line with the recommendations from the Cass review, to provide children with timely, holistic support. 'We've opened three new children and young people's gender services with a fourth anticipated to open later this spring. These new services will increase clinical capacity and reduce waiting times, so patients can be seen sooner and closer to home.'
Daily Mail
14-05-2025
- Health
- Daily Mail
Soaring numbers of children waiting for specialist gender care on the NHS - with 157 aged under ten-years-old
Soaring numbers of children in England and Wales are waiting for specialist gender care on the NHS, with 157 aged under ten-years-old. Average waiting times have grown to more than two years for a child to get a first appointment at a specialist health service clinic. There were 6,225 kids on the national waiting list at the end of March – up 12 per cent from 5,560 at the same point a year earlier, new figures reveal. The British Psychological Society warned that 'demand is currently outpacing supply' and stressed it is 'essential' for children to get professional care and support 'before they reach crisis point'. Health Secretary Wes Streeting last year branded waiting times 'unacceptable', acknowledging the 'enormous distress' they can cause. Responding to the latest figures, NHS medical director for specialised services Professor James Palmer said he understands it 'can be really difficult' for children and their families waiting to be seen. Two children's gender hubs, led by London's Great Ormond Street Hospital (Gosh) and Alder Hey Children's Hospital in Liverpool, opened in April 2024. This followed the closure of the Gender Identity Development Service (Gids) run by the Tavistock and Portman NHS Foundation Trust. A third service has since opened Bristol while another is planned for the East of England 'later this spring', according to the Department of Health and Social Care (DHSC). The aim is for there to eventually be up to eight specialist children's gender clinics covering the seven NHS regions in England. Of those on the national waiting list – which covers England and Wales because the latter does not have its own dedicated children's gender clinic – 157 children were aged under 10, according to a Freedom of Information request. Fewer than 10 children were aged under five years old, NHS England said, adding that it would not give an exact number as this could breach confidentiality because of people being potentially identifiable in smaller groups. There is no minimum age requirement for gender care, with the NHS previously saying they want to ensure parents of very young children are given support where necessary. Waiting times for a first appointment have also risen, to an average of 116 weeks at the end of March from an average of 100 weeks at the end of May last year. Dr Roman Raczka, president of the British Psychological Society, said: 'It is essential that children, young people and their families can access the professional care and support they need, before they reach crisis point. 'Demand is currently outpacing supply. This contributes to a range of broader challenges which face children and young people's services that require further investment.' Some 250 patients transferred from Gids have been seen by new services, and it is understood each of the new clinics is designed to see 25 patients a month. Following the Cass Review last year which concluded children had been let down by a lack of research and evidence on medical interventions in gender care, NHS England announced a new plan which requires new referrals into the clinics to have been seen by a GP and mental health specialist or paediatrician first. Guidance expected to be published later this month will see the health service move away from a 'medical model' in favour of a 'holistic' approach to children's gender care, as per recommendations from the Cass Review. According to leaked plans reported last month, children who have gender dysphoria will be tested for neurodevelopmental conditions including autism and ADHD (Attention-Deficit/Hyperactivity Disorder). Prof Palmer said: 'We know it can be really difficult for children and young people and their families who are waiting to be seen by our new holistic gender services, and that's why it has been so important that we put a new system in place to ensure that, while they're waiting, they can access mental health support if they need it. 'The NHS is now almost halfway through its planned expansion of regional services, and we are seeing significantly fewer referrals as children are first assessed by paediatric or mental health experts and provided with care in NHS services that are more appropriate to their needs.' Puberty blockers are not prescribed on the NHS to children for the treatment of gender dysphoria, after a ban last year was made permanent in December with the agreement of devolved governments across the UK. Plans remain in place to set up a clinical trial into the use of puberty blockers this year, although no patients have yet been recruited while ethical and regulatory approval is awaited. A DHSC spokesperson said: 'We are working with NHS England to reform children's gender services in line with the recommendations from the Cass review, to provide children with timely, holistic support. 'We've opened three new children and young people's gender services with a fourth anticipated to open later this spring. These new services will increase clinical capacity and reduce waiting times, so patients can be seen sooner and closer to home.'
