Forced to hide her true self, the transgender daughter of Joe Horras struggled with depression and anxiety until three years ago, when she began taking medication to block the onset of puberty. Gender-affirmation treatment helped the now 16-year-old find happiness again, her father said.
A decision by the US Supreme Court on Monday afternoon allowing Idaho to enforce its prohibition of this care for minors could endanger their well-being once again. Horras is struggling to figure out her next steps and is considering leaving Idaho, where she has lived her entire life, to move to another state.
“It would be devastating for her,” Horras, who lives in Boise, told The Associated Press. “If he doesn't have access to it, it will damage his mental health.”
Horras is among Idaho parents who are desperate for solutions after their transgender children lost access to the gender-affirming care they were receiving. The US Supreme Court decision allows the state to enact a 2023 law that subjects doctors to up to 10 years in prison if they provide hormones, puberty blockers or other gender-affirming care to people under 18 . A federal judge in Idaho had previously blocked the law in its entirety.
What was in the Supreme Court decision
The ruling will stand as lawsuits against the law move through lower courts, though the two transgender teenagers who sued to challenge the law will still be able to get care.
At least 24 states have adopted has banned care for gender-affirming minors in recent years, and most of them are facing legal challenges. Twenty other states are currently enforcing bans.
Monday's ruling was the first time the US Supreme Court has addressed the issue. The court's 6-3 ruling made clear whether the ban itself is constitutional. Instead, the justices delved into whether it's appropriate to suspend a law for everyone, or just those who request it, while it works its way through the courts.
In his concurring opinion, Justice Neil Gorsuch said “lower courts would be wise to consider” and limit the use of “blanket injunctions” that block all enforcement of laws that face challenges legal In a dissent, Justice Ketanji Brown Jackson said the court should not decide the fate of those shares without reading the legal briefs and hearing arguments on the issue.
What the ruling could mean for transgender youth in Idaho
Rights groups in Idaho are supporting families to make sure they are aware the measure has gone into effect. The American Civil Liberties Union of Idaho said it plans to hold a virtual event on Zoom with counselors and licensed legal experts to help people process the shock and answer any questions they may have about the law.
“Yesterday was really just an outpouring of fear, questions, people trying to figure out how this would affect them personally,” said Jenna Damron, a fellow advocate for the group. “Getting information quickly that is accurate is our first priority.”
Paul Southwick, ACLU of Idaho legal director, said the group wants families to know what their options are.
“Gender-affirming medical care is now immediately illegal for minors in the state of Idaho. However, care remains legal for adults, and it is also legal for minors to seek care out-of-state gender affirmation medical,” she said.
In Boise, Horras' 16-year-old daughter wears an estrogen patch and receives estrogen injections every six months. Her last injection was in December, and Horras now has two months to find a new out-of-state provider who can continue to administer the drug. The situation has left him scared, he said, and angry at the state politicians who passed the law last year.
“It's cruel,” he said.
Meanwhile, advocates worry that lower-income families can't afford to travel across state lines for care. Arya Shae Walker, a transgender man and activist from the small town of Twin Falls in rural southern Idaho, said he was concerned that people were changing the doses of their current prescriptions to make them last longer. Her advocacy group has already pulled information on its website about gender-affirming youth care providers in the area out of concern about potential legal ramifications.
The broader issue of banning gender-affirming child care could eventually be before the US Supreme Court again. Last year, a federal judge overturned Arkansas' ban on gender-affirming child care, while those in Kentucky and Tennessee were able to be enforced by an appeals court after to be suspended by judges of lower courts. The Montana law is not being enforced because of a ruling by 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 ruled Tuesday that West Virginia's ban on transgender sports violates a teen athlete's rights under Title IX, the federal civil rights law that prohibits sex-based discrimination in schools. Hours later, a judge suspended an Ohio law barring transgender girls from competing in girls' school sports. The law, which will take effect next week, also prohibits care for transgender youth who are gender-affirming.
Those who support the bans say they want to protect children and have concerns about the treatments themselves.
Major medical organizations, including the American Medical Association, the American Academy of Pediatrics, and the American Psychiatric Association, support gender-affirming care for youth. However, England is limiting the ability of under-16s to initiate a medical gender transition.
England's National Health Service recently consolidated a policy first published provisionally almost a year ago that sets a minimum age at which puberty blockers can be started, along with other requirements. NHS England says there is insufficient evidence about its long-term effects, including “broader sexual, cognitive or developmental outcomes”.
Medical professionals define gender dysphoria as the psychological discomfort experienced by those whose gender expression does not match their gender identity. Experts say gender affirmation therapy can lead to lower rates of depression, suicidal thoughts and suicide attempts among transgender people.
Chelsea Gaona-Lincoln, executive director of the Idaho-based advocacy group Add The Words, said to expect “a pretty horrific ripple effect.” But seeing her community come together in support has given her some hope.
“There are people coming together, and it's really important, especially for our young people, to feel seen and affirmed for who they are,” she said.
Southwick, the legal director of the ACLU of Idaho, said the 9th U.S. Circuit Court of Appeals is expected to hold a hearing this summer on his lawsuit challenging the law.
