In the upcoming Supreme Court case US v. Skrmetti, the state of Tennessee is submitting “expert” testimonies from four doctors who have previously been disregarded for bias, conspiratorial beliefs, and who deserve “very little weight,” according to an investigation from The Guardian.
The four doctors in question – Paul Hruz, James Cantor, Michael Laidlaw, and Stephen B. Levine – have been beloved by anti-trans lawyers and activists since they emerged with alleged professional critiques of the state of gender affirming care and transgender medicine.
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Their amicus briefs were sent in early October, along with a slew of others on both the sides of transgender rights and on behalf of Tennessee. Other briefs seen include those from America First Legal, the Florida House of Representatives, Women’s Liberation Front, and the Manhattan Institute.
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They have consistently advocated against gender-affirming care, especially for minors, with little evidence to support their claims, and they have ties to powerful far-right legal organizations like the Alliance Defending Freedom.
Hruz, for instance, has no history of treating transgender patients. He said in a 2017 deposition that he “intentionally [does] not treat transgender patients,” and said yes to a lawyer’s question that he has not treated any transgender patients for gender dysphoria. Additionally, when asked whether he has published any peer-reviewed research on gender dysphoria or transgender youth, he said, “The answer is no.”
He only bases his expert status on his reading of studies, despite having no mental health credentials to diagnose conditions like gender dysphoria. While these reviews are peer-reviewed, he has not contributed any direct research himself.
Hruz has ties to numerous anti-trans groups. He’s linked to the conservative organization American College of Pediatricians, which, contrary to its name, is not a leading organization of pediatricians but rather is a conservative advocacy organization that also opposes vaccine mandates and abortion rights. Hruz has also worked with numerous members of the anti-trans pseudoscience organization Society for Evidence-Based Gender Medicine.
In a 2023 opinion, U.S. District Judge James Moody Jr. accused him of testifying from a “religious doctrinal standpoint,” something backed by his numerous contributions to religious organizations, including those by the Catholic Medical Association. In the same 2017 deposition, he suggested that in response to a claim that treating gender dysphoria reduces suicide, “Some children are born in this world to suffer and die.” He denies saying this in an email to The Guardian, additionally claiming he does not have a fringe position and instead has one that aligns with European countries.
No European country has completely banned gender-affirming care for minors, with the United Kingdom coming closest in having heavy restrictions on puberty blockers.
According to The Guardian, he has been accused by other judges of “conspiratorial intimations,” “political hyperbole,” and being a “deeply biased advocate.”
Laidlaw has also been found to have minimal experience in the field of gender-affirming care. When asked in a 2022 deposition whether he has “performed any primary research regarding gender dysphoria,” he simply said “no.” He had a similar answer when asked if he published research on transgender people and gender identity. All he had published were reviews or opinion pieces, most of which were Letters to the Editor.
In this same deposition, he admitted to providing one trans patient a prescription of estrogen, but besides that he said he has not provided any patient with gender-affirming care. He similarly admitted he’s not treating any patient himself for gender dysphoria, nor has he ever conducted a “review of medical necessity as an insurance company employee or as an external reviewer.”
He previously was a member of the American College of Pediatricians, as well as the now-defunct group called the Pediatric and Adolescent Gender Dysphoria Working Group. This group was an organization of medical professionals aiming to defend a paper by Lisa Littman on Rapid-Onset Gender Dysphoria, a pseudoscientific concept that says gender dysphoria is a “social contagion” obtained rapidly. He worked alongside anti-trans doctors like Ray Blanchard and J. Michael Bailey.
In 2023, he was found to have been working alongside anti-trans advocates, medical professionals, and politicians in a secretive group that was drafting anti-trans legislation, according to leaked emails.
Laidlaw has made statements that have baffled judges. He has compared gender dysphoria treatments to eugenicist experiments from the Nazis and has been found by a judge to have a perspective that is “far off from the accepted view.”
Cantor has a similar record. In 2022, U.S. District Judge Liles C. Burke, a Trump appointee, found that he has “never provided care to a transgender minor under the age of sixteen,” he has “never diagnosed a child or adolescent with gender dysphoria” or treated one for gender dysphoria, has “no personal experience monitoring patients receiving transitioning medications” nor does he have “personal knowledge of the assessments or treatment methodologies used at any Alabama gender clinic.”
Due to this, his testimony was given “very little weight.”
While Cantor has published peer-reviewed research on transgender patients, the bulk of his work is in pedophilia research, specifically in advocacy for the pro-pedophile group Prostasia. He believes pedophilia is a sexual orientation that should be added to the LGBTQ+ acronym. During his time serving as an advisor for Prostasia, the group opposed legislation outlawing sex dolls that look like children.
He has defended J.K Rowling’s transphobia and regularly engages with the anti-LGBTQ+ LGB Alliance. In spite of his status as a “gay Jewish atheist Canadian citizen,” which he identified himself to The Guardian, he has been repeatedly paid by the Alliance Defending Freedom to serve as an expert to testify in court, something that he claims doubled his income.
Levine stands in contrast to the other three. While he is also funded by the Alliance Defending Freedom to serve as expert testimony in court cases, he has actual experience working with transgender people, as he co-founded a gender identity clinic at Case Western Reserve University.
However, his work is not without bias. He has worked with discredited conversion therapist Kenneth Zucker as well as Blanchard, who founded the pseudoscientific concept of autogynephilia, which suggests that trans women transition due to a fetish for femininity.
He also has promoted Rapid-Onset Gender Dysphoria and believes that one can discover the “causes” of being transgender through psychotherapy, which he suggests is because of bad parental relationships. He is also a member of anti-trans organizations Genspect and the Society for Evidence-Based Gender Medicine.
In a 2015 case, U.S. District Judge Jon S. Tigar said that Levine has relied on at least one false anecdote to advocate against gender-affirming care and that he “misrepresents the standards of care” and thus deserves “very little weight.” In a phone call with The Guardian, he denied fabricating this story, blaming instead the people who told it to him.
These four are some of the many influential individuals who will affect the future of transgender rights in this country. The Skrmetti will determine whether states have any right to restrict gender-affirming care for minors, with the potential to even impact how states can regulate gender-affirming care for adults as well.
Many hold anxiety about the way the Supreme Court will rule. Legislative researcher and activist Allison Chapman told LGBTQ Nation: “There is fear that losing Skrmetti could signal an end for all transgender rights. At minimum, it will legitimize a national attack on gender-affirming care for minors, and most likely adults.”
The impact will be long lasting. “This decision is unlikely to be overturned for 50+ years,” she said. “The outcome of the Skrmetti case will likely affect me for the rest of my life as a transgender person in the United States.”
Currently, members of the Supreme Court have not given any indication on how they will rule, though due to the prominent conservative leanings of the court, many suspect they will rule against transgender rights.
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