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CV NEWS FEED // The U.S. Supreme Court heard oral arguments Dec. 4 on whether Tennessee’s law restricting sexual surgeries on minors, which mutilate or chemically sterilize, is constitutional.
Alabama Attorney General Steve Marshall, who filed an amicus brief in the case, argued in an op-ed in The Wall Street Journal that the Biden administration and the American Civil Liberties Union (ACLU) have weaponized flawed standards from the World Professional Association for Transgender Health (WPATH) to challenge such laws as Tennessee’s while concealing the lack of evidence supporting them.
Marshall highlighted that the Biden administration had previously sued Alabama over a similar law, allowing Alabama to uncover damning evidence during court-ordered discovery. This evidence revealed that WPATH’s “Standards of Care,” cited as authoritative in court challenges, were crafted not to reflect rigorous science but to support legal battles.
Emails among WPATH members disclosed that “evidence-based review” was deliberately avoided because it could reveal the lack of supporting data, undermining their policy goals. One author of the WPATH standards admitted they feared that “little or no evidence” would leave them in an “untenable position in terms of affecting policy or winning lawsuits.”
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WPATH’s internal communications showed extensive collaboration with advocacy lawyers to shape guidelines with legal utility. Marshall cited emails discussing the importance of crafting sections with input from “movement attorneys” and noted that the ACLU and Lambda Legal — now arguing against Tennessee — were consulted during the process. These same organizations argued the case at the Supreme Court, with vocally pro-transgender ACLU attorney Chase Strangio, representing the plaintiffs.
Marshall also accused the Biden administration of pressuring WPATH to align its guidelines with political priorities. In 2022, Rachel Levine, assistant secretary for health at the Department of Health and Human Services (HHS), reportedly influenced WPATH to drop proposed age minimums for puberty blockers and surgeries, worrying about political fallout. Although WPATH initially resisted “allowing US politics to dictate international professional clinical guidelines,” it ultimately complied.
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Marshall underscored the lack of credible evidence underpinning WPATH’s recommendations. He pointed to a review Johns Hopkins University conducted for HHS that found “little to no evidence about children and adolescents” supporting WPATH’s guidelines. WPATH reportedly tried to suppress the publication of these findings. Despite this, the administration and the ACLU have presented WPATH’s standards as a “medical consensus” to challenge Tennessee’s law as discriminatory under the 14th Amendment.
Marshall argued that Tennessee’s law does not discriminate because it applies equally to minors of both sexes. Therefore, it does not trigger heightened scrutiny under the Equal Protection Clause. He contended that federal courts erred by deferring to WPATH’s politicized guidelines and second-guessing Tennessee’s legislature. The Constitution, Marshall emphasized, grants states the authority to address complex policy issues like regulating irreversible procedures on minors.
He wrote, “Children suffering from gender dysphoria deserve better than sterilizing hormones and irreversible surgery — even if groups like WPATH and the current administration think otherwise.”
Marshall framed the case as a clash between democratically accountable legislators and ideological overreach by self-appointed experts. He urged the court to respect the role of elected representatives in crafting laws, particularly when protecting vulnerable children. By upholding Tennessee’s law, the justices could affirm that states have the right to protect minors from medical interventions that are unproven and harmful.
Marshall denounced what he called a “political, medical and legal scandal” surrounding WPATH’s standards and the administration’s reliance on them. He argued that these guidelines are less about science and more about advancing a radical agenda through the courts, bypassing democratic accountability. States like Tennessee and Alabama, he contended, are justified in protecting children from experimental procedures that lack robust evidence and carry lifelong consequences.
