A few weeks ago, I attended the Supreme Court’s oral arguments in United States v. Skrmetti, a landmark transgender discrimination case that could have lasting impacts on the personal freedoms of transgender people and our families nationwide.

The energy outside the Court was intense, as the grounds were filled with hundreds of advocates. I saw reporters conducting interviews, and parents holding signs pleading for the ability to care for their transgender children. As the head of a nonprofit working to end suicide among LGBTQ+ youth – I was especially moved to see so many young people who showed up with handwritten signs to defend their own rights

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“It’s not very comfortable being trapped in (your body) because it just doesn’t feel like you,” she said.

The courtroom was surprisingly quiet but just as intense. The lawyers and justices exchanged arguments back and forth like a tennis match. After more than two hours of argument, the one thing I can’t stop thinking about is Ryan – one of the young plaintiffs in the case. 

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Solicitor General Elizabeth Prelogar began and ended her argument with the story of Ryan, a young transgender man living in Tennessee who struggled with gender dysphoria before he had access to the medication at issue in this case. He threw up most mornings before school and considered becoming mute because hearing the sound of his own voice was so distressing. 

After lengthy, careful evaluation and consultation with Ryan’s doctor, his parents determined that they would start him on medication to affirm his gender. The results were life-changing. This medication saved Ryan’s life, allowed him to feel comfortable in his skin, and gave him the chance to thrive. But now, the Tennessee law before the Court threatens young people like Ryan from accessing this essential care. 

As a parent of twin boys, I couldn’t help but think of my own children when I heard Ryan’s story. I can’t imagine what it would be like to see my boys struggle like that – or to find treatments that are proven to work and that the doctors know from experience are tried and true only to later see those life-saving medications taken away.

Sadly, this is exactly what many parents of transgender youth across the country are facing today, as roughly half of all U.S. states have banned essential health care for transgender young people.

For the past several years, people’s lack of familiarity with transgender people has been weaponized for political purposes. Fewer than one in three Americans say they personally know someone who is transgender, so it is understandable when people have questions or are even skeptical of treatments they think are new. 

But while politicians have turned private, individual medical decisions into a slew of national news headlines over the past few years, this type of care is nothing new.

The medical care for transgender people being argued about before the Supreme Court is based on more than four decades of scientific research and medical expert guidance, and it is backed by every major medical and mental health association in the U.S. This care has been recommended and routinely offered to transgender patients for decades, and the overwhelming majority of people who receive it are satisfied with it and go on to lead happy, healthy lives. 

It’s also critical to note that this care can be, quite literally, life-saving.

Transgender and nonbinary youth face higher rates of suicide risk compared to their peers. This is not because they are inherently prone to suicide risk but rather because they continue to be mistreated and discriminated against by other people – and by policies like the one in this case that threaten the very medication that is consistently associated with significantly lower rates of depression and suicide among transgender and nonbinary youth. 

Let’s say you know absolutely nothing about transgender and nonbinary people or the health care that some of us need. It’s reasonable to want more information about these treatments and to confirm there are reasonable guardrails. But banning life-saving health care outright isn’t about medicine or young people’s health. It’s discrimination, plain and simple. Young people like Ryan deserve better.

While Ryan’s story was heartbreaking, there were moments during today’s arguments that gave me hope. Seeing the first openly transgender lawyer address the Court was a transformative moment. The Justices were parrying with someone impacted by the consequences of this case.

There is no better way to demonstrate that, for all the abstract legal arguments, this case is about real lives and real people. It’s about our friends, family members, and neighbors.

For the first time in the history of the Supreme Court, the legal discussion was with us and not just about us. There is nothing more powerful than that.

Jaymes Black (they/she/he) is the Chief Executive Officer of The Trevor Project, the leading suicide prevention and crisis intervention organization for LGBTQ+ young people.

Editor’s note: This article mentions suicide. If you need to talk to someone now, call the Trans Lifeline at 1-877-565-8860. It’s staffed by trans people, for trans people. The Trevor Project provides a safe, judgement-free place to talk for LGBTQ+ youth at 1-866-488-7386. You can also call the National Suicide Prevention Lifeline at 1-800-273-8255.

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