Montana Supreme Court Upholds Preliminary Injunction Against Ban on Gender Affirming Care for Minors

In Cross v. State of Montana, (MT Sup. Ct., Dec. 11, 2024), the Montana Supreme Court upheld a trial court's preliminary injunction against enforcement of Montana's ban on medical or surgical treatment of minors for gender dysphoria.  The court said in part:

 ¶37 The statute’s impact on individual privacy rights triggers strict scrutiny review, which requires the State to demonstrate that “the legislation [is] justified by a compelling state interest and [is] narrowly tailored to effectuate only that compelling interest.” ...  Though the State has a compelling interest in “safeguarding the physical and psychological wellbeing of a minor,” a statute implicating their privacy rights must be narrowly tailored to serve that interest....  SB 99 affords no room for decision-making by a patient in consultation with their doctors and parents.  The statute is a complete ban, prohibiting individualized care tailored to the needs of each patient based on the exercise of professional medical judgment and informed consent.  

¶38 At this stage of the proceedings, the District Court conscientiously weighed the parties’ evidence.... Our role is not to reweigh conflicting evidence or to question a district court’s assessment of the strength of the evidence on a preliminary injunction appeal....

Justice McKinnon, joined by Justice Gustafson, filed a concurring opinion, saying in part:

I write separately because I believe Plaintiffs’ equal protection claim should likewise be addressed by the Court.

Justice Rice dissented in part, saying in part:

¶68 I concur with the Court’s holding affirming the District Court’s entry of a preliminary injunction enjoining SB 99’s medical restrictions.  A legislative prohibition of an approved medical procedure must satisfy the high bar of being narrowly tailored to serve a compelling state interest in addressing a bona fide health risk....

 ¶69 However, it should also be noted that both the medical and legal grounds regarding the subject treatment of minors addressed by SB 99 are moving under our feet, and the status quo itself is becoming a moving target, even as this litigation continues....

¶70 I would reverse the District Court’s enjoinder of the funding prohibition of SB 99...

Daily Montanan reports on the decision.

Supreme Court Denies Cert. In Dispute Over Standing to Challenge School Gender Identity Support Policy

On Monday, the U.S. Supreme Court denied review in Parents Protecting Our Children, UA v. Eau Claire Area School District, Wisconsin, (Sup. Ct., certiorari denied 12/9/2024). In the case, the U.S. 7th Circuit Court of Appeals held that a parents' organization lacked standing to challenge a school district's policy on Gender Identity Support for students. The Supreme Court denied certiorari over the dissents of Justices Kavanaugh, Alito and Thomas.  In a dissenting opinion written by Justice Alito and joined by Justice Thomas. Justice Alito said in part:

This case presents a question of great and growing national importance: whether a public school district violates parents’ “fundamental constitutional right to make decisions concerning the rearing of ” their children ... when, without parental knowledge or consent, it encourages a student to transition to a new gender or assists in that process. We are told that more than 1,000 districts have adopted such policies....

I am concerned that some federal courts are succumbing to the temptation to use the doctrine of Article III standing as a way of avoiding some particularly contentious constitutional questions....

Advocate reports on the Court's action.

2nd Circuit: Lawyers Have Standing to Challenge Bar Rule That Limits Comments on Transgender and Religious Subject Matter

In Cerame v. Slack, (2d Cir., Dec. 9, 2024), the U.S. 2nd Circuit Court of Appeals held that two Connecticut lawyers have standing to bring a pre-enforcement challenge to a state Rule of Professional Conduct which prohibits lawyers from engaging in harassing or discriminatory conduct against members of various protected classes in the practice of law. It bars harassment or discrimination on the basis of  race, sex, religion, national origin, ethnicity, disability, age, sexual orientation, gender identity, marital status or socioeconomic status. Commentary to the Rule defines discrimination as including harmful verbal conduct directed at an individual that manifests bias or prejudice. The attorneys allege that they often speak out on legal blogs, in articles and legal seminars in ways that could be construed as personally derogatory.  According to the court:

Moynahan and Cerame ... allege... that “[t]here are numerous examples of speech” fully protected by the First Amendment that members of the Connecticut bar will be reluctant to engage in, given the fear of a misconduct complaint...."  These include using “the pronoun associated with a transgender individual’s biological sex when addressing that individual”; using the term “‘gender preference’ rather than ‘gender orientation’”;  ... and publishing cartoons that “satiri[ze] or mock[]” “a religious deity”..... 

Appellees argue that the commentary to Rule 8.4, providing that an attorney “does not violate paragraph (7) when the conduct in question is protected under the first amendment to the United States constitution,”  ...“unambiguously shows that the Rule does not proscribe protected speech”....

Although the First Amendment carve-out may make it more likely that the SGC will conclude that some speech that would otherwise fall within the text of Rule 8.4(7) is not in fact proscribed, the carve-out is not enough, on its own, to render Appellants’ fear of a misconduct complaint and its professional repercussions “imaginary or wholly speculative” for Article III purposes...

At this stage in the proceedings, Appellants have alleged plausibly that they intend to engage in speech proscribed, at least arguably, by a recently enacted, focused regulation.  This gives rise to a credible threat of enforcement.

Reuters reports on the decision.

Supreme Court Will Hear Arguments Today on Tennesse Ban of Gender Affirming Medical Treatment for Minors

The U.S. Supreme Court this morning will hear oral arguments in United States v. Skrmetti. The case involves a challenge to Tennessee's ban on chemical, hormonal and surgical treatments of minors for gender dysphoria. In the case, the U.S. 6th Circuit Court of Appeals rejected Equal Protection and Due Process challenges to the law. A central issue in today's arguments will be whether transgender classifications trigger heightened scrutiny. SCOTUSblog has an extensive discussion of the issues in the case. More than 80 amicus briefs have been filed in the case. Links to all of them and additional pleadings in the case are available at the SCOTUSblog case page for the case.

Oral arguments will be streamed live at this link beginning at 10:00 AM. Argument audio will be archived at this link. A written transcript of the oral arguments will be available later today at this link.

Ohio Governor Signs Transgender Bathroom Bill

AP reports that that on Tuesday Ohio Governor Mike DeWine signed Senate Bill 104, the Protect All Students Act (full text of bill). The Act requires public and most private elementary and secondary schools as well as all public and private colleges and universities to designate multiple occupancy restrooms, locker rooms, changing rooms and shower rooms for use either by the male biological sex or the female biological sex. No school may have a multi-occupancy facility designated as open to all genders, nor may a school permit a member of the female biological sex to share overnight accommodations with members of the male biological sex. Transgender individuals may use single occupancy restrooms or faculty restrooms.  According to AP, DeWine signed the bill out of public view and issued no statement regarding the signing.

Missouri Trial Court Upholds State's Ban on Gender Affirming Care for Minors

In Noe v. Parson, (MO Cir. Ct., Nov. 25, 2024), a Missouri state trial court upheld the constitutionality of Missouri's ban on gender transition surgery for minors and its 4-year moratorium on puberty-blocking drugs and cross-sex hormones for minors for the purpose of treating gender dysphoria. It also upheld the state's ban on the use of state Medicaid funds for gender transition procedures.  The decision, reflected in a 74-page opinion setting out extensive findings of fact and conclusions of law, comes in a facial challenge to Missouri's Save Adolescents from Experimentation (SAFE) Act. The court said in part:

This Court finds an almost total lack of consensus as to the medical ethics of adolescent gender dysphoria treatment....

Furthermore, the credible evidence shows that a vast majority of children who are diagnosed with gender dysphoria outgrow the condition....

Critically, Plaintiffs made the strategic decision to bring a facial challenge to the entirety of several provisions, meaning they must establish that "no set of circumstances exists under which the [provisions] would be valid."... They chose not to seek an as-applied exception, a carve-out exception, to the regulation. The Constitution does not permit a single judge to nullify the results of democratically enacted legislation where, as here, there is a medical dispute about the safety or efficacy of those interventions....

There is nothing arbitrary or irrational ... about putting in place a 4-year pause on interventions that medical authorities across the world have said lack any substantial evidentiary support....

Lambda Legal and ACLU of Missouri said they will appeal the decision. Missouri Independent reports on the decision.

Certiorari Denied in Challenge To West Virginia's Ban on Transgender Girls on Girls' Sports Teams

The U.S. Supreme Court yesterday denied review in West Virginia Secondary School Activities Commission v. B. P. J., (Docket No. 24-44, certiorari denied 11/18/2024). (Order List.)  In the case the U.S. 4th Circuit Court of Appeals in a 2-1 decision held that the West Virginia Save Women's Sports Act violates Title IX on the facts of the case before it and remanded for further findings on whether the Act as applied to transgender girls violates the Equal Protection Clause.

UPDATE: The certiorari petition which the Court acted on here only raised the question of whether the Secondary School Activities Commission is a state actor. A cert. petition raising the Title IX and Equal Protection issues is still pending before the Court.

7th Circuit Vacates Injunction Against Indiana's Ban on Gender Transition Treatment for Minors

In K.C. v. Individual Members of the Medical Licensing Board of Indiana, (7th Cir., Nov. 13, 2024), the U.S. 7th Circuit Court of Appeals in a 2-1 decision reversed a federal district court's preliminary injunction against Indiana's ban on non-surgical gender transition procedures for minors. Rejecting the district court's conclusion that the treatment ban violates the Equal Protection Clause, the 7th Circuit majority held that the law need only meet the rational basis test. The court said in part:

The only way SEA 480 implicates sex at all is that the medical treatment at issue is sex specific—it denies each sex access to the other’s hormones. A physician could, if not for SEA 480, prescribe two medical treatments: one exclusively to girls with gender dysphoria—testosterone; and one exclusively to boys with gender dysphoria—estrogen.....

When a state regulates a “medical procedure that only one sex can undergo,” the courts apply rational-basis review “unless the regulation is a ‘mere pretex[t] designed to effect an invidious discrimination against members of one sex or the other.’”...

Bostock does not apply to every use of the word “sex” in American statutory and constitutional law. The case decided an interpretive question about Title VII’s reach. Title VII does not apply here, so neither does Bostock.

The majority also rejected the claim that the Indiana law violates the Due Process right of parents to make medical decisions for their children because it does not carve out an exception for treatment when a parent consents. The majority said in part:

SEA 480 is supported by a rational basis.... [P]rotecting minor children from being subjected to a novel and uncertain medical treatment is a legitimate end. And if Indiana had included a parental-consent provision, the exception would swallow the rule...

Finally the majority rejected the claim that the statute's ban on aiding and abetting violates physicians' free speech rights, saying in part:

... [W]hen the physicians and the state do not see eye-to-eye on treatment—and when the state validly regulates that treatment—the state must be able to preclude its physicians from using their authority to help the state’s citizens access the treatment. Otherwise, the physicians would hold a veto over the state’s power to protect its citizens. SEA 480’s secondary liability provision covers unprotected speech, and it reasonably relates to its primary liability provision, which itself is a reasonable regulation.

Judge Jackson-Akiwumi filed a dissenting opinion focusing primarily on the ban on Indiana physicians assisting minors in obtaining treatment in other states, saying in part:

The majority opinion holds that, insofar as the aiding and abetting provision regulates speech, it reaches only unprotected speech—either speech integral to unlawful conduct or speech incidental to regulated conduct. Our law, however, defies both conclusions....

So, Indiana can realize its objectives by enacting a law and punishing those who violate it; it cannot accomplish its objectives by punishing speech that somehow relates to the purpose of a state law, yet amounts to no criminal or civil primary violation.

ADF issued a press release announcing the decision.

6th Circuit Grants En Banc Rehearing in Challenge to School's Ban on Misgendering Fellow Students

In Parents Defending Education v. Olentangy Local School District, (6th Cir., Nov. 1, 2024), the U.S. 6th Circuit Court of Appeals sitting en banc vacated a decision issued in July by a 3-judge panel (see prior posting) and granted a rehearing en banc in a free speech challenge to a school district's anti-bullying and anti-harassment policies. At issue are policies that prohibit students from using pronouns that are inconsistent with another student’s gender identity if the use amounts to harassment. In a 2-1 decision in July, the panel rejected the challenge saying in part that "[T]he District’s position that students may communicate their belief that sex is immutable through means other than the use of nonpreferred pronouns, indicate that the District is not attempting to prohibit any viewpoints."

George Mason Law Students Sue Claiming "No-Contact" Order Violates Their Free Speech and Free Exercise Rights

Suit was filed last week in a Virginia federal district court by two Christian female law students at George Mason University contending that a "no-contact" order issued against them by the University's DEI Office violates their free speech and free exercise rights. The complaint (full text) in Ceranksoky v. Washington, (ED VA, filed 11/1,2024), relates that plaintiffs were ordered to avoid contact, including through social media, with a classmate (identified in the complaint only as Mr. Doe) who is the Law School's representative on the Graduate and Professional Studies Assembly. Through an online chat platform, Mr. Doe proposed having hygiene products available in men's rest rooms as well as in women's in order to accommodate transgender men. According to the complaint:

5. [Plaintiff posted] ... her concern that if GMU adopted a policy “allow[ing] biological females into male restrooms to access period products as ‘trans men,’” then that would mean “female bathrooms will welcome male occupants.” She asked her classmate to “recognize the concerns of biological female students” and how they would feel “considerably uncomfortable if there are males using private women’s spaces on campus.” She noted that “[w]omen have a right to feel safe in spaces where they disrobe.” ...

7. Their classmate, who had claimed to be their representative to the student government and initially promised to “advocate for all” students and viewpoints, responded by mocking their concerns and labeling their views as bigoted for questioning others’ gender identity. 

8. Two weeks later ... [plaintiffs] received no-contact orders from GMU’s Office of Diversity, Equity, & Inclusion (“DEI Office”), prohibiting them from having any contact with their classmate....

152....  Defendants have singled out Plaintiffs’ expression and prevented them from engaging in religious expression with Mr. Doe.

153. Defendants’ no-contact orders have also chilled Plaintiffs from engaging in religious expression with other students at the Law School or the rest of GMU....

175.  Plaintiffs are motivated by their sincerely held religious beliefs to speak on-campus on many topics from a Christian worldview. Plaintiffs believe their on-campus speech is a way to share the Gospel of Jesus Christ with non-Christians and a way to disciple and equip other Christians on campus to grow and mature in their faith.

ADF issued a press release announcing the filing of the lawsuit.

6th Circuit Hears Oral Arguments in Transgender Bathroom Access Case

On Tuesday, the U.S. 6th Circuit Court of Appeals heard oral arguments (audio of full oral arguments) in Doe No. 1 v. Bethel Local Board of Education, (6th Cir., Docket No. 23-3740). In the case, an Ohio federal district court (see prior posting) dismissed a wide-ranging group of challenges-- including due process, equal protection and free exercise challenges-- to a school board policy allowing students to use school bathrooms corresponding to their gender identity. Ohio Capital Journal reports on the oral arguments.

6th Circuit Hears Oral Arguments on DOE's Interpretation of Title IX to Include Gender Identity Discrimination

Yesterday the U.S. 6th Circuit Court of Appeals heard oral arguments (audio of full oral arguments) in State of Tennessee v. Cardona. In the case, a Kentucky federal district court barred enforcement against Tennessee, Kentucky, Ohio, Indiana, Virginia, and West Virginia of the Department of Education's rules that interpret Title IX's ban on sex discrimination to include discrimination against transgender students and faculty by institutions receiving federal financial assistance. Bloomberg Law reports on the oral arguments.

Volunteer Prison Minister's Challenge to Requirements for Addressing LGBTQ Inmates Is Rejected

In Kuenzi v. Reese, (D OR, Oct. 28, 2024), an Oregon federal district court rejected 1st Amendment challenges to an Oregon prison system rule requiring volunteers in prison facilities to sign an acknowledgement statement that calls for volunteers to use appropriate gender pronouns when addressing transgender, intersex and non-binary adults in custody.  Plaintiff, a former volunteer Christian minister in a women's correctional facility, contends that this requirement conflicts with her free exercise and free speech rights. She is no longer allowed to minister at the prison facility without signing the statement which conflicts with her religious belief that gender is an immutable characteristic determined by biology, and that homosexual conduct is sinful. The court concluded that the prison policy is neutral and generally applicable and that:

... the policy is rationally related to ODOC’s legitimate interest in “promot[ing] a respectful environment that reinforces prosocial norms for ODOC’s AICs.” 

It also concluded that:

Because Plaintiff was speaking as an employee and not as a private citizen, her speech falls outside the protections of the First Amendment.

Suit Challenges HIPPA Rules Barring Reporting of Out-of-State Abortions

As previously reported, in April of this year the Department of Health and Human Services issued new privacy rules under HIPPA designed to protect women (and those who assist them) who travel out of state for an abortion that is not legal in their state of residence. Yesterday, suit was filed in a Texas federal district court challenging the rules.  The complaint (full text) in Purl v. U.S. Department of Health and Human Services, (ND TX, filed 10/21/2024), alleges that the new privacy rules cover not only abortion, but also hormone and drug interventions for gender dysphoria and surgical procedures on an individual's reproductive system. The complaint alleges in part:

5. ... [T]he 2024 Rule purports to limit the circumstances when a HIPAA-covered entity can share information with government agencies, such as state child-welfare agencies and law enforcement agencies, both state and federal.  

6. HIPAA-covered entities that share information in contravention of HHS’s regulations incur criminal liability. 

7. Yet the HIPAA statute explicitly preserves government authority to investigate and to require disclosures concerning abuse. 

8. The 2024 Rule lacks statutory authority and is arbitrary and capricious. As such, the Court should vacate and set aside the Rule and preliminarily and permanently enjoin its enforcement....

ADF issued a press release announcing the filing of the lawsuit.

Parents Must Be Given Right to Opt 1st Graders Out of Instruction on Transgender Issues

In a 94-page opinion in Tatel v. Mt. Lebanon School District, (WD PA, Sept. 30, 2024), a Pennsylvania federal district court held that a first-grade teacher violated parents' substantive due process and free exercise rights by introducing students to transgender issues without first giving parents the right to opt their children out of that instruction. The court said in part:

Concerns about undercutting parental authority are heightened when the children are in first grade and the person trying to influence them is their teacher.... The students’ confusion in this case illustrates how difficult it is for a first-grader when a teacher’s instruction conflicts with their Parents’ religious and moral beliefs. The heart of parental authority on matters of the greatest importance within their own family is undermined when a teacher tells first-graders their parents may be wrong about whether the student is a boy or a girl....

... Defendants failed to provide Tatel and Melton notice and the ability to opt their children out of Williams’ transgender agenda, even though Tatel’s and Melton’s objections to the instruction were based on their religious beliefs.  Defendants ratified the lack of parental notice and opt out rights, while providing parental notice and the ability to opt out for numerous other secular or religious reasons.... 

Defendants did not establish a compelling basis for refusing to provide notice and opt out rights for parents of first-graders affected by Williams’ transgender instruction.  ...

Refusing to allow notice and opt outs for religious and fundamental parental rights objections to transgender topics, i.e., forcing young children to be exposed to particular instruction over the objections of unwilling parents, while permitting notice and opt outs for other sensitive topics – is not neutral and constitutes an improper use of governmental authority....

EEOC Rules on Accommodating Abortions and Barring Transgender Discrimination Burden Religious Exercise of Catholic Diocese

In Catholic Benefits Association v. Burrows, (D ND, Sept. 23, 2024), a North Dakota Catholic diocese and a Catholic organization supporting Catholic employers challenged rules of the Equal Employment Opportunity Commission promulgated under the Pregnant Workers Fairness Act, as well as Enforcement Guidance issued by the agency relating to discrimination on the basis of gender identity.  In the case, a North Dakota federal district court issued a preliminary injunction barring the EEOC from enforcing against plaintiffs requirements that they accommodate employees' abortions or infertility treatments that are contrary to the Catholic faith. It also enjoined the EEOC from enforcing anti-harassment provisions in a way that would require plaintiffs to speak or refrain from speaking in favor of abortion, fertility treatments, or gender transition when such is contrary to the Catholic faith; require plaintiffs to use pronouns inconsistent with a person's biological sex; or allow person to use private spaces reserved for the opposite sex. The court said in part:

It is a precarious time for people of religious faith in America. It has been described as a post-Christian age.... One indication of this dire assessment may be the repeated illegal and unconstitutional administrative actions against one of the founding principles of our country, the free exercise of religion.  

The current suit falls into a long line of cases that should be unnecessary in a country that was built on the concept of freedom of religion. Unfortunately, these cases are essential for faithful individuals where government mandates run counter to core religious beliefs. One would think after all this litigation, the government would respect the boundaries of religious freedom. Instead, it seems the goal may be to find new ways to infringe on religious believers’ fundamental rights to the exercise of their religions....

The CBA has detailed its sincerely held beliefs about human sexuality and procreation.... This belief includes a witness that these actions are immoral.... At the very least its actions would violate the retaliation provision because the employee would be fired for violating the Catholic faith by asking for an accommodation for the conduct at issue here. Because the interpretations of PWFA and Title VII threaten litigation for adhering to sincerely held beliefs, these guidelines and the underlying statutes place a substantial burden on the exercise of religion.

News From the States reports on the decision. [Thanks to several readers for the lead.] 

6th Circuit Rules on Christian Plaintiffs' Standing to Challenge Michigan's Civil Rights Acts

In Christian Healthcare Centers, Inc. v. Nessel, (6th Cir., Sept. 20, 2024), a Christian membership-based medical service ministry and two Catholic K-12 schools challenged prohibitions on sexual orientation and gender-identity discrimination under Michigan's public accommodation law (EAA) and its Elliot-Larsen Civil Rights Act. The U.S. 6th Circuit Court of Appeals found that plaintiffs had standing to seek an injunction only as to some of their challenges. The court summarized its holding:

In these three related cases, Plaintiffs allege that Michigan’s laws chill their speech and conduct in violation of the First and Fourteenth Amendments.  The district court dismissed each case for want of standing, reasoning that no Plaintiff had shown that Michigan’s laws arguably proscribed its speech or conduct and that, in the alternative, there was no credible threat that Michigan would enforce its laws against any Plaintiff.

We agree only in part....

We express no view regarding the merits of any claim, the appropriate resolution on remand of the motions for preliminary relief, or what conclusions might be warranted concerning any issue after discovery.  We hold only that (a) no Plaintiff has established standing to challenge the EAA, (b) Christian Healthcare has plausibly established standing to challenge the ELCRA’s public-accommodation provision, employment provision, and the publication clauses of each provision, (c) Sacred Heart has plausibly established standing to challenge the same provisions, the ELCRA’s education provision, and the publication clause of that provision, and (d) St. Joseph has failed to plausibly establish standing.

Judge Murphy filed a concurring opinion.

Factual Issues Remain in Chaplain's Suit Over Ouster for Anti-Trans Blog Post

 In Fox v. City of Austin, (WD TX, Sept. 4, 2024), a Texas federal district court refused to grant summary judgment to either side on several claims in a suit brought by a volunteer chaplain for the Austin, Texas fire department.  Plaintiff was fired because of his blog posts saying that God created each person as male or female, that sex is immutable and that it is unfair to allow males to compete in women's sports. Applying the balancing test in the Supreme Court's Pickering decision, the court concluded that there is a genuine dispute of material fact as to the extent of the disruption that the blog posts caused within the Fire Department.  Thus, the court refused to grant summary judgment on plaintiff's free speech retaliation claim, his free exercise claim and his claim under the Texas Religious Freedom Restoration Act. The court did dismiss plaintiff's claim that his free speech rights were violated when the Department requested that plaintiff write an apology note and it found that the fire chief had qualified immunity in the claim against him for damages.

Parents Sue Over School Policy That Places Students Together on Overnight Trips on Basis of Gender Identity

Suit was filed this week in a Colorado federal district court by parents of Jefferson County, Colorado school children challenging the district's policy of assigning students and counselors on overnight school trips to room together on the basis of shared gender identity rather than biological sex. The complaint (full text) in Wailes v. Jefferson County Public Schools, (D CO, filed 9/4/2024), alleges that the policy violates parents' right to control the upbringing and education of their children, students' right of bodily privacy, and the free exercise rights of both parents and students.  The complaint, which asks that Plaintiff students in the future not be placed in accommodations with transgender students, says in part:

346. Parent Plaintiffs have a sincere religious belief that they must teach their children to practice modesty and protect their children’s modesty. This requires that their children not undress, use the restroom, shower, complete other intimate activities, or share overnight accommodations with the opposite sex. 

347. Parent Plaintiffs have a sincere religious belief that God created all people in His image as male and female. Genesis 1:27; Genesis 5:2. 

348. Parent Plaintiffs believe that a person’s sex is binary and fixed at conception. They do not believe a person can change their sex....

412. Student Plaintiffs’ sincerely held religious beliefs require them to avoid intimate exposure, or the risk of intimate exposure, of their own bodies or intimate activities to the opposite sex.

413. Student Plaintiffs’ sincerely held religious beliefs also require them to avoid intimate exposure, or the risk of intimate exposure, to the body or intimate activities of someone of the opposite sex....

415. Student Plaintiffs have a sincere religious belief that God created all people in His image as male and female. Genesis 1:27; Genesis 5:2. 

416. Student Plaintiffs believe that a person’s sex is binary and fixed at conception. They do not believe a person can change their sex.

ADF issued a press release announcing the filing of the lawsuit. 

11th Circuit Denies En Banc Rehearing in Alabama's Ban on Gender-Affirming Treatment of Minors

In August 2023, the U.S. 11th Circuit Court of Appeals vacated a district court's preliminary injunction against Alabama's ban on hormone blockers and cross-sex hormones to treat minors with gender dysphoria, holding that the statute is only subject to rational basis review. (See prior posting.) Now, in Eknes-Tucker v. Governor of the State of Alabama, (11th Cir., Aug. 28, 2024), a majority of the 11th Circuit voted not to grant an en banc rehearing in the case. However, that decision generated a series of concurring and dissenting opinions spanning 173 pages.

Chief Judge William Pryor concurred in the denial but filed an opinion to respond to the dissenting opinion of Judge Jordan. The Chief Judge said in part:

The doctrine of substantive due process does violence to the text of the Constitution, enjoys no historical pedigree, and offers judges little more than shifting and unilluminating standards with which to protect unenumerated rights.... [U]nelected judges with life tenure enjoin enforcement of laws enacted by elected representatives following regular procedures, all in the name of fundamental rights that the Constitution never names but allegedly secures....

Judge Lagoa filed a concurring opinion, saying in part:

The propriety of the medications at issue is a quintessential legislative question, not a constitutional one.  Judges Jordan and Rosenbaum would have this Court end the debate by judicially fencing off these questions from state legislatures.  But our experience with the intersection of the Constitution and these types of issues suggests that this is a misguided effort. See Roe v. Wade.... 

Judge Rosenbaum’s and Judge Wilson’s dissents also disagree with our equal-protection holding, arguing that the Act discriminates based on sex and transgender status....  But the Act applies equally to everyone regardless of their sex or transgender status.  And transgender status is not a classification protected by the Equal Protection Clause.

Judge Wilson, joined by Judge Jordan, filed a dissenting opinion, saying in part:

This case presents numerous questions “of exceptional importance” worthy of en banc review.... Seeing that this case implicates the contours of substantive due process, fundamental rights, and equal protection, it is difficult to envision issues of greater importance.

Judge Jordan, joined by Judges Rosenbaum and Jill Pryor, filed a dissenting opinion, saying in part:

In this case, the panel characterized the liberty interest in part by asking whether there is a history of recorded uses of transitioning medications for transgender individuals (e.g., puberty blockers and cross-sex hormone treatments) as of 1868, when the Fourteenth Amendment was ratified....

The panel’s decision necessarily means that the fundamental right of parents to obtain medical treatment for their children extends only to procedures and medications that existed in 1868, and not to modern advances like the polio vaccine...,, cardiac surgery..., organ transplants..., and treatments for cancer like radiation ... and chemotherapy...

Judge Rosenbaum, joined by Judge Jill Pryor and in part by Judge Jordan, filed a dissenting opinion, saying in part:

... [P]arents’ liberty interest in directing that their child receive well-established, evidence-based, non-experimental medical treatment, subject to medically accepted standards and a physician’s independent examination and medical judgment, is a fundamental right, “deeply rooted in this Nation’s history and tradition, and implicit in the concept of ordered liberty, such that neither liberty nor justice would exist if they were sacrificed”....

We ... receive no medical training in law school.  We don’t go through residencies or fellowships.  We don’t engage in medical research.  And we don’t practice medicine at all.  In fact, many of us went into the law because, among other reasons, we weren’t good at math or science.  Given our lack of medical expertise, we have no business overriding either the medical consensus that transitioning medications are safe and efficacious or clinicians’ ability to develop individualized treatment plans that follow the governing standards of care....

... [T]he Act discriminates based on two quasi-suspect classifications: sex and transgender status.  So either classification requires us to apply intermediate scrutiny.  When we do that, the Act cannot survive.