What The Idaho Trans Supreme Court Ruling Means For Trans People Nationwide

The ruling is complicated and is more about broad injunctions than it is about trans people. Still, it will have an immediate impact for trans youth in Idaho and could have national repercussions.

Photo by Adam Michael Szuscik on Unsplash

On Monday, news broke that the Supreme Court of the United States will allow Idaho to enforce its ban on gender-affirming care for transgender youth, a felony ban that makes trans care punishable by up to 10 years in prison for doctors who provide it to those under 18. The ruling was not based on the merits of gender-affirming care or its constitutionality; rather, it addressed broad injunctions and a lower court's ability to block a law fully at the earliest stages — a pet issue for some conservative justices who chose to take decisive action when transgender lives were at stake. The immediate impact of the ruling is clear: transgender individuals will be barred from obtaining gender-affirming care in Idaho, except for only two plaintiffs, despite no rationale for how a ban is supposed to work for everyone but those two plaintiffs when doctors are broadly barred from providing care. In other states where anti-trans laws are being litigated, the impacts are more nebulous, and the ruling could impact many other issues as well.

The case in question stems from a challenge to Idaho’s felony ban on gender-affirming care. In December 2023, a federal judge ruled that the ban was likely unconstitutional, ruling in favor of two transgender minor plaintiffs using pseudonyms. The judge stated that the right to obtain medically necessary care for your children is “deeply rooted in this nation’s history and traditions,” using the logic from the anti-abortion Dobbs decision against transgender care bans as an apparent preemptive strike at such language being utilized to justify bans on trans care should the case ever reach the Supreme Court. The judge then issued a broad preliminary injunction that prevented the state from enforcing the law on anyone while the court process played out.

It was the breadth of the injunction that came under dispute in the Supreme Court, not issues directly related to the constitutionality of transgender care. Attorneys for the state of Idaho argued that the injunction was too broad and that the state should be allowed to enforce the law on everyone except for the plaintiffs. This would force anyone seeking care to seek individual exceptions and rulings from federal courts, an expensive endeavor. On the other hand, attorneys for the plaintiffs pointed out that the broad injunction was necessary: the plaintiffs were using pseudonyms to preserve their anonymity. Without a broad preliminary injunction, doctors would be unlikely to continue offering care, thus making it impossible for the plaintiffs to access that care even with a ruling in their favor, and in doing so, they would have to forfeit their anonymity.

The majority of the court sided with reversing the injunction and allowing the law to go into effect for everyone but the plaintiffs, with a plurality signing onto Justice Gorsuch's opinion stating that the ability of judges to issue broad preliminary injunctions should be muted. They had little to say about the constitutionality of the law itself, except for Justices Kavanaugh and Barrett, who wrote in their separate concurrence that they believe the state may a likelihood of success on the merits [Update: Law Dork's Chris Geidner states that the "merits" here, as Kavanaugh described it in his opinion, are about the scope of the injunction, and so it may not necessarily signal Kavanaugh and Barrett's votes on the challenges to the gender-affirming care bans]. Instead, the real impact of this case will likely be on justices issuing broad preliminary injunctions to block statewide laws in the early stages of a constitutional challenge; it should not immediately impact any anti-trans laws being decided on the merits.

Of course, this provides little consolation to transgender young people in Idaho, who will have to go without access to their medication in the state even though two courts have ruled that the law blocking them is likely unconstitutional. It also raises questions about other broad preliminary injunctions nationwide on transgender topics: we likely cannot expect each student to take their school to federal court every time they want to challenge an individual bathroom ban in their local high school, for instance.

These questions have a significant impact on transgender individuals but will not only affect transgender people. They will arise anytime a state passes a law that is broadly enjoined at the preliminary stage by lower courts. This issue has surfaced in many other cases, from ghost guns to the mifepristone case, where sometimes broad preliminary injunctions are viewed favorably by the same justices who just ruled negatively on them for transgender individuals.

The impact of the ruling will likely be initially muted for transgender people nationwide. While it will have a significant impact in Idaho, there are no cases currently pending on transgender healthcare where a broad federal preliminary injunction is in place, other than in Idaho. The case in Arkansas, for instance, has moved well beyond the preliminary injunction stage and has been ruled unconstitutional on the merits. However, numerous other cases are still being litigated, and states are enjoined on a wide range of topics, many of which have been broadly enjoined while awaiting a final constitutional ruling on the law. It remains to be seen if any of these broad injunctions are similarly challenged.

It is also important to note that this will not impact any rulings made under state-level litigation. For instance, in Montana, a ban on gender-affirming care is enjoined from enforcement using the state constitution’s right to seek "safety, health, and happiness in all lawful ways," as well as an explicit right to privacy. Meanwhile, in Ohio, a state challenge is currently underway using a provision in the state constitution that bars the state from issuing penalties for obtaining or providing healthcare. These state challenges will be insulated from anything that happens at the Supreme Court level.

Still, the ruling will mean further hardship for transgender youth in Idaho, and could signal that the Supreme Court is willing to take drastic action when it comes to transgender healthcare, even if that action is not directly related to the merits of the healthcare bans themselves. The Supreme Court could address the issue on the merits at any time, and it seems increasingly likely that it will in the near future.