Justice Sotomayor’s Words Should Be Read By All Catholic Leaders

The U.S. Supreme Court has upheld a Tennessee law that prohibits gender-affirming care to minors.  In the case of United States vs. Skrmetti, the legal arguments turned on interpretations of whether the Equal Protection Clause of the 14th Amendment to the U.S. Constitution applied to transgender youth seeking medical assistance with their gender identity.  The 6-3 majority of the Courts Justices said it did not.

Justice Sonia Sotomayor

In a dissent from the majority opinion, Justice Sonia Sotomayor included the following facts:

“Transgender adolescents’ access to hormones and puberty blockers (known as gender-affirming care) is not a matter of mere cosmetic preference. To the contrary, access to care can be a question of life or death. Some transgender adolescents suffer from gender dysphoria, a medical condition characterized by clinically significant and persistent distress resulting from incongruence between a person’s gender identity and sex identified at birth. (App. to Pet. for Cert. 251a–252a.) If left untreated, gender dysphoria can lead to severe anxiety, depression, eating disorders, substance abuse, self-harm, and suicidality. (See, e.g., Coleman, 23 Int’l J. Transgender Health, at S62.) Suicide, in particular, is a major concern for parents of transgender teenagers, as the lifetime prevalence of suicide attempts among transgender individuals may be as high as 40%. (App. to Pet. for Cert. 264a. Tragically, studies suggest that as many as one-third of transgender high school students attempt suicide in any given year.³⁾

“When provided in appropriate cases, gender-affirming medical care can meaningfully improve the health and wellbeing of transgender adolescents, reducing anxiety, depression, suicidal ideation, and (for some patients) the need for more invasive surgical treatments later in life.⁴ That is why the American Academy of Pediatrics, American Medical Association, American Psychiatric Association, American Psychological Association, and American Academy of Child Adolescent Psychiatry all agree that hormones and puberty blockers are “appropriate and medically necessary” to treat gender dysphoria when clinically indicated. (Id., at 285a.)^5?

That passage should shock Catholic leaders who oppose gender-affirming care for adolescents, especially when the youths’ parents and medical professionals recommend and support such decisions. While some Catholic leaders will cling to ideas about the fixed nature of the male/female binary, they must recognize that in holding to these ideas and trying to enshrine them in law, they are causing immeasurable human harm. 

—Francis DeBernardo, New Ways Ministry, June 19, 2025

Footnotes:

3 See M. Johns et al., Transgender Identity and Experiences of Vio- lence Victimization, Substance Use, Suicide Risk, and Sexual Risk Behaviors Among High School Students, 68 Morbidity and Mortality Weekly Rep. 67, 70 (2019).

4 The majority and JUSTICE THOMAS make much of recent changes to the routine provision of gender-affirming care to minors in Norway, Sweden, and England. Ante, at 3–4, 23; ante, at 13–14 (concurring opinion). While all three countries have committed to researching further the risks and benefits of prescribing puberty blockers and hormones to adolescents, none has categorically banned doctors from providing patients with all gender-affirming care where medically necessary. See Brief for Foreign Non-Profit Organizations as Amici Curiae 4–13.

5 Far from signaling that “self-proclaimed experts” can determine “‘the meaning of the Constitution,’” ante, at 6 (opinion of THOMAS, J.), this reference to the positions of major medical organizations is simply one piece of factual context relevant to the Court’s assessment of whether SB1 is substantially related to the achievement of an important government interest. See infra, at 10 (describing the intermediate scrutiny standard). Indeed, even JUSTICE THOMAS seems to recognize that some scientific and medical evidence (at least that which is consistent with his view of the merits) is relevant to the questions this case presents. See ante, at 9, 10, 14, 15, 20 (referencing the Cass Review and various peer-reviewed medical journals).