Supreme Court Orders Appellate Courts To Review Rulings Involving Transgender Individuals After Skrmetti Decision

The high court tosses out several rulings involving transgender health care and birth certificates.

AP/Jon Elswick
The Supreme Court in Washington. AP/Jon Elswick

The Supreme Court is ordering lower courts to review decisions involving transgender individuals in light of its decision to uphold Tennessee’s ban on so-called gender-affirming care for minors.

Earlier this month, the court ruled in United States v. Skrmetti that Tennessee’s law banning gender-affirming procedures for minors does not violate the 14th Amendment. The justices said that the ban does not discriminate on the basis of sex or transgender status, giving the state more leeway to regulate medical procedures. 

In light of that decision, the court on Monday vacated a series of decisions by lower courts and ordered that judges revisit them in light of the Skrmetti decision. 

The Fourth U.S. Circuit Court of Appeals was ordered to review its ruling that decisions by West Virginia and North Carolina not to cover healthcare for transgender individuals on government-sponsored insurance were discriminatory. The Ninth U.S. Circuit Court of Appeals will have to reconsider a case stemming from Idaho’s ban on gender-affirming surgeries for Medicaid recipients. And the 10th U.S. Circuit Court of Appeals will have to reconsider its decision to block Oklahoma’s ban on individuals changing their genders on their birth certificates. 

The Skrmetti decision could bolster laws similar to Tennessee’s law.   

In May, plaintiffs who were challenging Alabama’s law barring transgender minors from receiving care dismissed their case without explanation. 

Florida is facing a challenge to its ban on gender-affirming care for minors that is pending before the 11th U.S. Circuit Court of Appeals, which has allowed the law to take effect until a decision is made. Meanwhile, the Seventh U.S. Circuit Court of Appeals allowed a similar Indiana law to take effect pending a decision in that case. The Supreme Court’s decision in Skrmetti could bolster the states’ arguments in favor of their restrictions. 

The Skrmetti decision is factoring into the Eighth U.S. Circuit Court of Appeals’ review of whether to revive Arkansas’s ban on gender-affirming healthcare. The state’s Save Adolescents From Experimentation Act of 2021 was blocked in June 2023. 

However, last year, the Eighth Circuit heard oral arguments about whether to revive the law, but so far has not issued a ruling. On Friday, the court ordered the parties in the case to present briefs “addressing only the equal protection claim in light of United States v. Skrmetti.”


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