Judges directed to reassess rulings on transgender health benefits and birth certificate matters following landmark Supreme Court decision
In a series of significant developments, lower court cases involving transgender rights, particularly concerning insurance coverage for gender-affirming care and birth certificate changes, are being re-examined following the U.S. Supreme Court's decision in *United States v. Skrmetti* on June 18, 2025.
The Supreme Court's ruling, which upheld Tennessee's ban on certain gender-affirming medical care for transgender minors, has had far-reaching implications. Notably, it has led to the reconsideration of appellate rulings in four states (Idaho, North Carolina, Oklahoma, and West Virginia) that were previously in favor of transgender individuals.
The 4th U.S. Circuit Court of Appeals in Richmond, Virginia, has been ordered to reconsider its ruling that West Virginia's and North Carolina's refusals to cover certain gender-affirming health care under government-sponsored insurance plans are discriminatory. Similarly, the 9th U.S. Circuit Court of Appeals in San Francisco must revisit Idaho's ban on certain surgical procedures for Medicaid recipients, and the 10th U.S. Circuit Court of Appeals in Denver will review its ruling blocking Oklahoma's ban on changing gender markers on birth certificates.
However, it's important to note that the Supreme Court's *Skrmetti* ruling was limited to Tennessee’s law banning gender-affirming care for minors and did not broadly rule on discrimination against transgender people in other contexts. As a result, many related legal battles continue in the lower courts.
For instance, the Supreme Court rejected an appeal from Kentucky transgender minors challenging that state’s ban on gender-affirming care, reflecting a growing trend of states enacting or enforcing such bans.
Here's a summary of the current status of these cases:
| Issue | Court Involved | Status | |-------------------------------|-------------------------------|---------------------------------------------| | Insurance coverage for transgender care (West Virginia, North Carolina) | 4th Circuit Court of Appeals (Richmond) | Ordered to rehear and reconsider the case | | Medicaid surgical bans (Idaho) | 9th Circuit Court of Appeals (San Francisco) | Ordered to rehear and reconsider the case | | Birth certificate gender changes (Oklahoma) | 10th Circuit Court of Appeals (Denver) | Ordered to rehear and reconsider the case | | Tennessee ban on gender-affirming care for minors | U.S. Supreme Court | Upheld ban; limited ruling to Tennessee only | | Kentucky ban on gender-affirming care for minors | U.S. Supreme Court | Appeal rejected |
While the Supreme Court’s decision in *Skrmetti* upheld Tennessee’s ban and delivered a setback for transgender youth seeking gender-affirming care, it did not conclusively resolve broader constitutional questions about transgender rights. These ongoing legal battles underscore the ongoing struggle for transgender rights in the United States.
Politics and general news continue to focus on the repercussions of the U.S. Supreme Court's decision in Skrmetti, as lower courts are ordered to reconsider appellate rulings in four states regarding insurance coverage for transgender care, Medicaid surgical bans, and birth certificate gender changes. Despite the Supreme Court upholding Tennessee's ban on gender-affirming care for minors, broader constitutional questions about transgender rights remain unresolved, with many related legal battles still being fought in the lower courts.
