Justice Clarence Thomas has sparked controversy with his dismissal of medical expertise in transgender youth treatment.
According to The Hill, Thomas's concurring opinion in the Supreme Court's 6-3 decision upholding Tennessee's ban on gender-affirming care for minors has delighted conservatives who see it as validation of their broader critique of liberal influence in academic and medical institutions.
The conservative justice argued against automatically deferring to self-described experts in politically contentious debates. Thomas's scathing rebuke of the medical establishment has quickly become a rallying point for Republican leaders. Vice President J.D. Vance praised the opinion as "quite illuminating" in his debut post on Bluesky, going further to suggest that pharmaceutical companies are financially influencing scientists to promote these treatments for children.
The Supreme Court's decision represents a significant shift in the federal government's stance on transgender healthcare. President Trump's administration has abandoned the previous administration's defense of gender-affirming care, with his Justice Department dropping legal challenges to state bans and his Department of Health and Human Services declaring in May that there is a "lack of robust evidence" supporting such treatments.
This ruling has devastated families directly affected by these bans. Samantha Williams, mother of the transgender teen who challenged Tennessee's law, expressed deep fear about the implications in a New York Times opinion piece, writing, "Now that the Supreme Court has denied the rights of young people like my daughter and families like ours, what's next?"
Despite major American medical organizations maintaining that gender-affirming care is medically necessary, Thomas declared their positions legally irrelevant. He argued that deferring to these groups would allow "elite sentiment" to "distort and stifle democratic debate."
The Court's majority opinion, written by Chief Justice John Roberts, notably looked to European health authorities rather than American medical organizations for guidance. Roberts specifically cited health authorities in Finland, Norway, Sweden, and the United Kingdom, which have raised concerns about the potential harms of using puberty blockers and hormones for transgender minors.
The 2024 Cass Review from England received particular emphasis in the Court's decision. This influential report questioned the evidence base for transgender youth treatments and has been cited by conservatives as validation of their concerns about rushing into medical interventions.
The Court's reliance on European research comes as public trust in American health officials continues to decline. According to January polling from health nonprofit KFF, trust in state and local public health officials dropped by 10 percentage points to 54 percent, while trust in the CDC slipped 5 percentage points.
Alabama's attorney general's office celebrated Thomas's opinion, with Chief Counsel Katherine Green Robertson stating that Thomas "soundly put to rest the persistent sham that we should quiet down and 'trust the science' when it comes to life-altering experimentation on minors." The state had filed a friend-of-the-court brief urging justices not to rely on "unsupported appeals to 'expert' organizations."
This is not the first time the Supreme Court's use of research has sparked controversy. Justice Ketanji Brown Jackson faced criticism after citing a study in her 2023 dissent in the Harvard affirmative action case that was later contested by critics, with lawyer Ted Frank writing in the Wall Street Journal that "even Supreme Court justices are known to be gullible."
Studies supporting conservative positions have also faced scrutiny. Just before the Supreme Court considered access to abortion medication mifepristone, a medical journal retracted two studies claiming to show harms of the pill after finding their conclusions "invalidated in whole or in part."
The Supreme Court's decision aligns with a broader conservative movement challenging the authority of educational and medical institutions. Roger Severino, a Heritage Foundation vice president who ran Health and Human Services's civil rights office during Trump's first term, told supporters after the decision, "The vibe shift is real."
Conservative leaders view the ruling as consistent with public sentiment on transgender issues. Severino specifically referenced President Trump's campaign rhetoric against his opponent, noting that Trump's closing argument was "she is for they/them, and he is for you."
The Court's decision represents a significant victory for conservatives who have long campaigned against gender-affirming treatments for minors. While the justices maintain they aren't "political animals," their ruling has undeniably strengthened Republican positions in the ongoing cultural debate about transgender healthcare and the role of medical expertise in politically contentious issues.
