From Courts to Community Power: Trans Rights Advocates Respond to Skrmetti’s Fallout

In June, the US Supreme Court issued a devastating decision in United States v. Skrmetti, a case brought by three transgender youth, their families, and a Memphis-based medical provider challenging a Tennessee law banning gender-affirming hormone therapy for transgender youth. The court held that the law does not specifically target individuals based on sex or transgender status and therefore only warranted minimal judicial scrutiny—ultimately deeming the law constitutional.

“This ruling is a devastating, direct attack on the rights and well-being of Trans youth and their families, and a disgraceful failure by the Supreme Court,” Sean Ebony Coleman, founder of Destination Tomorrow, told NPQ. “[It] sets a dangerous precedent for the future of the Trans community.”

Legal scholars sharply criticized the decision, warning that it distorts equal protection law to serve a conservative political agenda. Scott Skinner-Thompson, a law professor at the University of Colorado, told NPQ that the majority opinion was “wrong” and highlighted the “ongoing de facto and de jure discrimination against transgender people as evidenced by the anti-trans laws sweeping the nation.” He added that such laws are “grounded in animus” and should be “constitutionally suspect under established doctrine.”

Although this ruling is a significant blow to the trans rights movement, with harmful consequences for the more than 100,000 trans youth living in one of the 27 states that have banned access to gender-affirming care, LGTBQ+ advocates aren’t giving up.

“It’s hard to say what the expected impact will be without devolving into panic and doom forecasting, but ultimately that is a lot of what we are being forced to prepare for,” Adam Herpolsheimer, a law and policy analyst at the Center for Public Health Law Research at Temple University’s Beasley School of Law, told NPQ.

The Immediate Impact of Skrmetti

The Skrmetti decision has quickly reshaped the legal landscape, paving the way for continued assaults on trans healthcare access nationwide. Despite groups like the ACLU—one of the advocacy groups that brought the case to the Supreme Court—initially framing the decision as narrow, applying only to Tennessee’s ban, its ripple effects have already proven far more widespread.

“Some [LGBTQ+ advocates] are still holding out hope that things will go back to how they were before Trump.…They don’t realize our reality has already changed.”

As Adam Polaski, communications and political director for the Campaign for Southern Equality, told NPQ, “The Skrmetti ruling means that the bans on gender-affirming care that have been in effect for one to two years in more than half of the states in the country will likely remain in effect for the foreseeable future.”

Following Skrmetti, the Supreme Court remanded several key transgender rights cases to lower courts, including challenges to bans on gender-marker changes on birth certificates and restrictions on gender-affirming care under public health insurance plans. Citing Skrmetti, the Seventh Circuit also recently agreed to revisit a case involving a bathroom ban for trans students in public schools.

“We have already seen the Supreme Court send three cases back to the lower courts to reconsider now that Skrmetti has been decided,” LGBTQ+ legislative researcher Allison Chapman told NPQ. “While we will have to wait for the lower courts to release additional opinions to determine the actual impact, clearly SCOTUS wants the case to have major broad impacts on transgender rights.”

After the decision, US Attorney General Pam Bondi issued more than 20 subpoenas to healthcare providers that treat transgender minors, ramping up legal scrutiny on gender-affirming care providers nationwide.

“We can expect this [ruling] to embolden [anti-trans lawmakers and the Trump administration]—we’re already seeing signs of that,” trans organizer Ash Lazarus Orr told NPQ.

Even before it was affirmed by the Supreme Court, states with bans on gender-affirming care, like Florida and Oklahoma, cited the lower court’s Skrmetti decision to justify extending bans to adults, arguing that the same constitutional logic applied. In fact, attorneys general in multiple states celebrated the ruling and used it to justify their own anti-trans laws. And since the ruling, Puerto Rico passed the harshest ban in any US territory, criminalizing care for anyone under 21.

The implications of this decision extend beyond youth healthcare or even the trans community, advocates warn. As activists have pointed out, this decision will likely be relied on in future attacks on reproductive rights and other forms of bodily autonomy, including access to contraception, abortion, and essential healthcare for marginalized communities.

“This ruling sets a chilling precedent: if they can come for trans rights, they can come for all of us,” Coleman told NPQ.

Lost Faith in the Law

For trans people, Skrmetti confirmed a painful truth: The law will not protect them. After victories like Obergefell v. Hodges on marriage equality in 2015, and Bostock v. Clayton County in 2020 on employment discrimination, many LGBTQ+ advocates hoped that the courts would continue to advance trans rights. With an openly anti-trans executive branch and an increasingly hostile Congress, many turned to the courts for protection. Instead, Skrmetti revealed that not only were the judiciary and legislature aligned against them—but so was the Supreme Court.

“Currently, we are facing an executive branch, a legislative branch, and a judicial branch that are all hell-bent on the oppression of transgender people,” Chapman said. “It genuinely feels like the whole country is against us, and one could argue that it’s even true.”

“It genuinely feels like the whole country is against us, and one could argue that it’s even true.”

While Skinner-Thompson noted that “other laws excluding transgender people may still be subject to heightened scrutiny depending on the statutory language,” many activists no longer believe the courts can be relied upon to protect the trans community.

“The systems [LGBTQ+ advocates] were trained to work within are no longer functioning. Some are still holding out hope that things will go back to how they were before Trump,” Orr told NPQ. “They don’t realize our reality has already changed.”

Additionally, Skrmetti shows that the far right’s strategy to pack the courts and then weaponize the law to undermine people’s civil rights is working. Far-right groups like the Federalist Society, the Heritage Foundation, and Alliance Defending Freedom not only praised the Court’s decision Skrmetti—but have also pivoted to targeting other hard-won LGBTQ+ legal protections.

“The Skrmetti ruling is such a massive shift that will impact the LGBTQI+ community. It gives states broad permission to ban gender-affirming care, even when that directly contradicts medical consensus and individual rights,” Orr said. “But the deeper impact is symbolic—it signals that the courts are no longer reliable protectors of LGBTQI+ rights. For many people who’ve spent years working within the legal and advocacy world, this moment is devastating and surreal.”

While some still see legal avenues as tools that continue to be used as a kind of harm reduction—helpful in securing injunctions or temporary relief to delay the worst effects of anti-trans laws—many advocates are abandoning the belief that the law can serve as a long-term solution.

Safe States, Shield Laws, and Federal Backlash

In the past, LGBTQ+ advocates emphasized that Skrmetti won’t affect trans people in so-called sanctuary states. Over the past two years, more than 14 states have passed shield laws to protect providers of gender-affirming care, and many trans people have relocated to these states for safer access.

Yet now, advocates question how long these protections will last as the Trump administration increasingly weaponizes executive power—through executive orders, agency investigations, and DOJ-led “fraud” probes—to target gender-affirming care nationwide.

“We have already seen the government take many cruel actions against transgender youth and their families, and we expect these to escalate further,” Polaski told NPQ. “We’re already seeing, for example, providers receiving subpoenas and facing investigations and threats from the federal government, leading to some clinics closing altogether.”

“We can’t afford to cling to a past that’s gone. We need to move forward with clarity and courage—and start building the future on our own terms.”

These attacks are already having a direct impact on trans people. Following Skrmetti, Children’s National Hospital in Washington, DC, announced it would halt gender-affirming care for minors by August 30, citing heightened legal and regulatory risks. On July 22, Children’s Hospital Los Angeles—the largest provider of gender-affirming care for trans youth in the United States—officially closed its program. While both clinics are located in states with shield laws, they have cited mounting federal pressure as the driving force behind their decisions.

Shield law states themselves have also been increasingly targeted by the Trump administration. As Orr points out, “States with shield laws are going to face significant pressure—be it from lawsuits, federal challenges, and political retaliation. Red states will likely try to criminalize parents, providers, and even trans people themselves for accessing care across state lines.”

Red states are also increasingly reaching outside of their borders to investigate providers, clinics, and families of transgender people—even those residing in shield states. The case of abortion access after the Supreme Court’s decision to overturn Roe v. Wade is illustrative here: The resulting interstate legal conflicts of a state-by-state patchwork of regulations threaten to erode the very protections shield laws aim to provide.

LGBTQ+ advocates are now raising alarm to the fact that it may only be a matter of time before the Trump administration moves to directly challenge or undermine state shield laws themselves.

“I believe it’s safe to assume [shield laws] will either be targeted in future legal actions with heavy reliance on Skrmetti or by additional executive orders,” Chapman said.

While advocates once looked to the Supreme Court to protect such laws—citing the constitutional right to travel and other fundamental freedoms—they are now far less certain. And the same right-wing think tanks that developed the legal arguments used in Skrmetti are now advancing similar arguments against shield laws, laying the groundwork for potential adoption by the Supreme Court.

Building New Strategies to Fight for Trans Rights

Despite growing threats, LGBTQ+ advocates are mobilizing quickly and thinking creatively about how to protect their communities without relying solely on the courts or state laws that may be challenged or undermined by the Trump administration.

“[We need to] shift our expectations and start preparing for a reality where rights don’t come from the law, but from community power,” Orr explained. “That looks like building underground networks for healthcare access. It means strengthening mutual aid and protecting providers.”

For example, the Campaign for Southern Equality has prioritized urgent support for families through its Trans Youth Emergency Project. The initiative assists families in locating healthcare providers unaffected by state or federal bans and offers $500 travel grants to help them access necessary gender-affirming care.

“This sort of practical support is going to be increasingly important as trans youth and their families experience increasingly challenging roadblocks and obstacles to care,” Polaski said. “We would really love to see this practical, tangible support centered in conversations about what it looks like to love and support the trans community.”

While direct services are critical, long-term success will also require stronger coalition building across movements.

“We must build cross-coalition support with other groups fighting for liberation and most importantly we need to remember that there is no transgender liberation until there is liberation for all oppressed groups,” Chapman told NPQ.

LGBTQ+ activists emphasize that while trans liberation may not come through the courts, it will still come—but only if we move forward with new strategies rather than returning to those that have repeatedly failed us.

“I’m left thinking a lot about Audre Lorde and the master’s tools never being enough to dismantle the master’s house,” Herpolsheimer told NPQ. “In that vein then, mobilization, action, and most importantly organization are all we have to offer in terms of resistance. Because that is the stage we are at now, resisting.”

Orr agreed, adding: “We can’t afford to cling to a past that’s gone. We need to move forward with clarity and courage—and start building the future on our own terms.”