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Attorneys challenging Tennesse’s law banning sex-change medical procedures for children before the U.S. Supreme Court Wednesday struggled to make their case before skeptical judges. If the court upholds Tennessee’s law, that would add more support to a similar law here in New Hampshire.

The Biden administration’s Solicitor General Elizabeth Prelogar joined ACLU attorney Chase Strangio in challenging the law. They suffered a major setback when Strangio was forced to admit a commonly-used argument regarding sex-change treatment for minors and suicide is in fact false.

Both the Biden administration and the ACLU argue Tennessee’s ban, which is similar to the ban Gov. Chris Sununu signed into law this summer, violates the Equal Protection Clause of the United States Constitution. They argue that because hormone treatments can be given to minors struggling with the impacts of puberty to advance their sexual development — such as giving males testosterone — but these treatments can’t be used to change a child’s sex — giving testosterone to females — it is discriminating on the basis of sex.

Without those treatments, children deemed to be suffering from gender dysphoria will be at risk of suicide, according to Prelogar.

“Left untreated, gender dysphoria can result in severe physical and psychological harms. Those harms include ‘debilitating distress, depression, impairment of function, substance use, self-surgery to alter one’s genitals or secondary sex characteristics, self-injurious behaviors, and even suicide,’” Prelogar wrote in her brief to the Court. 

Alito confronted Prelogar with multiple studies that found no significant change in suicide rates, including research from Sweden and Great Britain. For example, he cited the United Kingdom’s Cass Review, which found little evidence to further the viewpoint that the benefits of transgender treatment are greater than the risks.

“I wonder if you would like to stand by the statement in your position, or if you think it would now be appropriate to modify that and withdraw your statement?” Alito asked.

Chase Strangio, the ACLU lawyer who was born a biological woman and now identifies as a man, conceded the facts show suicide among untreated transgender adolescents does not happen, but claimed untreated transgender kids think about suicide.

“Completed suicide is thankfully and admittedly rare,” Strangio said. 

The actual rarity of transgender-identifying adolescents committing suicide hasn’t stopped Democrats from using the trope to argue in favor of surgically altering children or allowing schools to socially transition kids behind their parent’s back.

New Hampshire Democratic Party Chairman Ray Buckley claimed transgender kids would kill themselves if schools were legally barred from hiding transitioning efforts from parents.

“[The children] will be kicked out or beaten (to death) or commit suicide,” Buckley wrote on social media.

Strangio also didn’t help the cause by appearing on CNN and suggesting that children as young as two years old know they were born in the wrong bodies.

“These are doctors who are wanting to treat their patients in the best way that they know how, based on the best available evidence to us,” Strangio said of doctors who give hormone treatments to young children. “And these are young people who may have known since they were two years old exactly who they are, who suffered for six or seven years before they had any relief.”

Given the Court’s 6-3 conservative majority, it is likely to side with Tennessee and uphold the ban. The conservative justices generally expressed skepticism that the medical science surrounding transgender adolescents is settled as more data comes in from Europe showing the harms of using surgery and hormone therapy on children, contradicting the current state of medicine in America.

Justice Brett Kavanaugh said the fact that the medical communities in progressive European countries are expressing reservations should give leaders in America pause.

“If it’s evolving like that and changing, and England’s pulling back and Sweden’s pulling back, it strikes me as a pretty heavy yellow light, if not red light, for this court,” Kavanaugh said.

The United States Supreme Court is set to hear arguments over whether states have the right to ban gender reassignment medical procedures for minors. It’s a case that could impact New Hampshire’s newly-passed law.

The American Civil Liberties Union and the Biden administration want to overturn the transgender surgery ban put in place by Tennessee. It outlaws doctors giving puberty-blocking medications to children whose parents identify them as transgender. The law also bans doctors from performing procedures like vaginoplasties, the surgical creation of a vagina from other parts of the body; phalloplasty, the surgical creation of a penis; and metoidioplasty, the transformation of a clitoris to a penis, on children.

Supporters of those bans note the surgeries are permanently disfiguring and difficult — if not impossible — to entirely reverse. Earlier this year, the Biden administration released a policy statement declaring its opposition to sex-change surgery for minors.

That was a reversal from the same Biden health officials whose original draft guidelines would have lowered the age minimums to 14 for hormonal treatments, 15 for mastectomies, 16 for breast augmentation or facial surgeries, and 17 for genital surgeries or hysterectomies.

In response to those aggressive actions by the federal government, states began passing laws banning the extreme procedures from being performed on children. Tennessee’s ban is similar to the law Gov. Chris Sununu signed this summer, HB 619.

“HB 619 ensures that life-altering, irreversible surgeries will not be performed on children,” Sununu said in his signing statement.

If the Biden administration and the ACLU are successful at the Supreme Court arguing against the Tennessee ban, HB 619 could be in trouble. However, conservative lawyer Ian Huyett with Cornerstone, said even if Tennessee wins, New Hampshire could still lose.

“The Tennessee case is about whether a state can ban gender transition therapy for minors under the federal Equal Protection Clause,” Huyett told NHJournal. “New Hampshire has a narrower ban on genital reassignment surgery on minors, RSA 332-M, that is similar to Tennessee’s law. A victory for Tennessee in this case could insulate that law from federal Equal Protection Clause challenges.

“However, our state courts in New Hampshire are the final authority on the New Hampshire Constitution—and they do not need to follow the federal courts. Our state courts could still hold that the state Constitution provides a right to chemically castrate minors, or a right to go into the locker rooms of the opposite sex. That could then be the law in New Hampshire for 10 years, regardless of what the US Supreme Court says,” according to Huyett.

The ACLU lawyer who will be arguing the case before the Supreme Court claimed Tuesday that children as young as two years old can “know” they were born in the wrong bodies.

“Our argument is that it treats people differently because of their sex,” attorney Chase Strangio — who was born female and now lives as a male — told CNN’s Jake Tapper. “These are young people who may have known since they were two years old who they are … It’s not the kids who are consenting to the treatment, it’s the parents who are consenting to the treatment.”

Strangio claimed years of medical data show gender reassignment surgeries and puberty blockers are good for transgender children.

“This is medical treatment that provides critical benefits to adolescents that need it,” Strangio said. 

However, the data does not actually show that children need gender reassignment. Great Britain banned puberty blockers for children after the National Health Service commissioned Dr. Hilary Cass to perform an independent review of medical treatment for children who identify as transgender. The Cass Report found a shocking lack of data to back up the life-changing treatments given to children.

“The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress,” the Cass Report states. 

Several other European countries, including Sweden, Norway, and France, are taking a more restrictive approach to gender-reassignment procedures as more data become available.

In the U.S., however, studies that raise questions about gender reassignment have been suppressed or left unpublished due to politics.

For example, the World Professional Association for Transgender Health, or WPATH, is the group that developed the SOC-8 guidelines for medical care for children for the federal Health and Human Services agency. 

WPATH is the group that recommends castrations as a medical treatment for men who identify as eunuchs. Even still, WPATH’s first draft of the SOC-8 guidelines included age limits for children seeking gender reassignment treatment. But Biden’s Surgeon General Rachel Levine, a transgender woman, reportedly pressured WPATH to remove age restrictions from the SOC-8 draft, court records show. 

WPATH was caught hiding evidence that did not support gender reassignment surgeries and other treatments for children in other instances, according to court records.

Dr. Karen Robinson, research team leader from Johns Hopkins University School of Medicine working on SOC-8, reported to HHS that WPATH was suppressing her research because it found there is no real evidence gender reassignment surgeries actually helped children. 

Robinson first reported to HHS that her researcher looked at the reported benefits of gender reassignment procedures and “found little to no evidence about children and adolescents.” At the same time she told HHS that WPATH was blocking her from publishing the report.

“[WPATH is] trying to restrict our ability to publish,” Robinson wrote to HHS.

WPATH was simply enforcing its policy that all SOC-8 researchers write articles that “use the Data for the benefit of advancing transgender health in a positive manner,” according to court records.

Several members of the Hillsboro-Deering High School Girls Soccer team refused to play against the Kearsarge team Tuesday due to safety concerns over Kearsarge’s star athlete, biological male Maelle Jacques.

“This isn’t about transgenderism. This is about biology for us and the increased physical risk when playing a full contact sport against the opposing sex” said Heather Thyng, mother of a Hillsboro-Deering player.

At least five girls on the varsity squad skipped the game at Kearsarge Regional High School, according to Hillsboro-Deering parent Betsy Harrington. With 17 varsity players on the roster, Hillsboro-Deering was forced to use JV players in order to play the game. 

“The Hillsboro girls can’t even get down the field without any of their best players. It’s one-sided,” Harrington told NHJournal.

Jacques played goal for most of the game, but was pulled off their field with 10 minutes left after having nothing to do. 

“No one ever got near [Maelle,] so I guess they’ll never be in any danger if there’s enough girls to always have a weak team,” Harrington said. “If every game has a few girls refusing to play, we will never know the ability of the Kearsarge team. They have an advantage I hadn’t thought about. It’s that they get to always play a crippled team without all of their players.”

Thyng stood by her daughter’s decision since players like Jacques should not be competing against girls, she said.

“We believe, my daughter included, that refusing to compete is the best way to push back on this issue, and we are hoping parents will be more willing to put themselves out there knowing they don’t have to be the first or the only family within our community to do so,” Thyng said.

Thyng is concerned that her daughter and other players could be hurt playing against Jacques, a nearly 6-foot tall biological male. Scenarios like tonight’s soccer game, where girls would be forced to play contact sports against biological males, were supposed to be a thing of the past after Gov. Chris Sununu signed HB 1205 this summer.

The law requires all school athletes from 5th grade through high school to compete on teams that correspond to their biological sex at birth. But the Kearsarge School Board voted this summer to ignore the law in order to allow Jacques to keep playing.

Jacques is well known in New Hampshire high school sports, having already won first place in the girls high jump competition earlier this year, beating every female in the New Hampshire Interscholastic Athletic Association (NHIAA) indoor track and field championship.

Two New Hampshire transgender students, Parker Tirrell and Iris Turmelle, are challenging the law in federal court and have so far won an injunction to allow them to play on girls’ teams. But that order does not apply to any other student in the state, including Jacques.

The team’s coaches told Tyng that neither her daughter nor any other player who boycotts the game will suffer retaliation as a result. “The coaches reassured me they told the girls there would be no negative repercussions for anyone who refuses to compete. They said they understood the increased risk and would be paying attention to the aggressiveness of the game, and if anyone was getting hurt or play was too rough, they were prepared to end the game, Thyng said.

The Bow School District is facing a First Amendment lawsuit from parents who were punished for taking part in a silent protest at a girls’ soccer game. The parents were hit with a no trespass order when they wore pink “X” wristbands to the game earlier this month.

This story was updated after the game was played.

United States District Court Judge Landya McCafferty ruled Tuesday that the state’s new law protecting girls school sports from male competitors is a clear case of discrimination.

“This issue ‘is not even a close call,’” McCafferty wrote in her ruling. “HB 1205, on its face, discriminates against transgender girls.”

McCafferty’s ruling is based on the controversial premise that males who identify as females are girls in the same way that biological females are, and they are protected by the same antidiscrimination laws designed to protect biological females. The issue is almost certain to eventually be addressed by the U.S. Supreme Court.

As a result, high school freshmen Parker Tirrell and Iris Turmelle, two biological males who identify as female, are allowed to play girls sports pending the outcome of their lawsuit against the state.

McCafferty’s injunction against HB 1205 only applies to Tirrell and Turmelle at this time. McCafferty’s statements in court and her rulings so far, however, indicate she’s likely to overturn the law soon.

Tirrell and Turmelle, represented by GLAD and the New Hampshire ACLU, brought the lawsuit soon after Gov. Chris Sununu signed the bill into law this summer. HB 1205 requires New Hampshire student-athletes to play on sports teams that correspond to the biological sex recorded on their birth certificates.

The requirement that students stick with their biological sex at birth for sports teams is an obvious legal mechanism to discriminate against transgender girls, the judge claimed.

“Indeed, transgender girls are the only group whom the Act bars from playing on the team associated with their gender identity. HB 1205’s ‘disparate treatment of transgender girls because they are transgender is clear on the face of the statute,’ and this ‘singling out of transgender females is unequivocally discrimination,’” McCafferty wrote.

HB 1205 supporters have said the bill aimed to protect the integrity of girls sports and prevent biologically male transgender students from gaining a competitive advantage over biological girls. The bill also sought to protect girls from being injured by biologically male athletes.

But McCafferty notes that neither Tirrell nor Turmelle are likely to have any physical advantage over their prefigured teammates. Both children are receiving female hormone therapy and are not expected to undergo normal male physical development. 

“Neither Parker nor Iris have undergone male puberty. Neither of them will undergo male puberty. Both have received hormone therapy to induce female puberty, and both have developed physiological changes associated with female puberty. It is uncontested that there is no medical justification to preclude Parker and Iris from playing girls’ sports,” McCafferty wrote.

Instead, McCafferty relies largely on an expansive reading of the 2020 U.S. Supreme Court’s Bostock v. Clayton County decision regarding sex-based dress codes in the workplace. However, Justice Neil Gorsuch, writing for the majority, explicitly stated that the ruling only applied to the case the Court was addressing at the time.

“The employers worry that our decision will sweep beyond Title VII to other federal or state laws that prohibit sex discrimination. And, under Title VII itself, they say sex-segregated bathrooms, locker rooms, and dress codes will prove unsustainable after our decision today. But none of these other laws are before us; we have not had the benefit of adversarial testing about the meaning of their terms, and we do not prejudge any such question today. Under Title VII, too, we do not purport to address bathrooms, locker rooms, or anything else of the kind.”

Michael Garrity, spokesman for the New Hampshire Department of Justice, said the agency is considering the next appropriate step.

“We are currently reviewing the court’s decision and are in the process of evaluating the implications of the ruling. We remain dedicated to providing a safe environment for all students. The state will continue to consider all legal avenues to ensure that we uphold both the law and our commitment to student welfare,” Garrity said.

“She cannot get back the life that was stolen from her.”

And that’s why Amanda Stewart of Jaffrey is suing her former endocrinologist Dr. John Turco, along with Dartmouth-Hitchcock Health and others, who she says misled her into inappropriate “gender-affirming” surgeries and treatments that left her in pain and have ruined her life.

“Instead of protecting and properly treating Amanda, who was and remains an extremely vulnerable and unstable individual, these doctors and health care providers, and the organizations and facilities at which they worked, harmed her deeply under the pretense of providing so-called ‘gender-affirming  care,’” according to the lawsuit filed in Hillsborough Superior Court — South last week.

The suit names Turco, Dartmouth-Hitchcock, St. Joseph’s Hospital, Cheshire Medical Center, Monadnock Family Services, and several individual doctors for years of alleged malpractice Stewart says have “harmed her deeply.”

“She will never be able to conceive and bear a child. Even if she could conceive a child, she would never be able to breastfeed her child. She lives in daily pain from the effects of the unnecessary surgeries and years of taking enormous amounts of cross-sex hormones,” according to the lawsuit. “She will never look the same and has to deal daily with severe alterations to her female body, such as bone structure and unwanted body and facial hair. She cannot get back the life that was stolen from her.”

Josh Payne, with the Texas law firm Campbell Miller Payne, said Stewart wants the healthcare system held accountable for misleading her for more than a decade and changing her life for the worse.

“Amanda’s story is a heart-wrenching representation of the negligence and lack of proper procedure in the practice of so-called ‘gender-affirming care,’” Payne said.

Stewart had a troubled early life, starting when her mother died when she was 14. Stewart, who is autistic, struggled with anxiety, depression, and loneliness throughout her teen years, according to the lawsuit. That was made worse when she ended up in a group home for a period of time, according to the lawsuit.

She started seeing Turco in 2007 when she was 22, and he immediately started pushing gender-affirming care without proper consent or full disclosure of the potential impacts, according to the lawsuit. Start’s lawsuit claims Turco never gave her any other choice.

“Defendants recognized that Amanda was mentally fragile and suffering, such that she would not be an appropriate candidate for so-called gender transition medicalization under any criteria, but they proceeded to medicalize and operate on her anyway,” the lawsuit states. “Indeed, on or about December 11, 2007, Dr. Turco wrote to a counselor Amanda had seen and a primary care doctor for Amanda, stating, ‘I am really worried that [Amanda] does mostly suffer at the present time from some psychological issues other than [her] gender identity issues.’”

But Turco soon had her taking massive quantities of testosterone, bringing her level far above those of biological men, according to the lawsuit. 

“[I]n July 2011, Dr. Turco noted that Amanda’s testosterone level was ‘very high at 2,640 ng/dl with the normal adult male range being 241-827,’” the lawsuit states.

Stewart suffered several mental health crises, some resulting in stays in the New Hampshire Hospital, as her physiological symptoms worsened while taking testosterone, the lawsuit states. Throughout her time with Turco, he made several notes that her symptoms improved when she stopped taking the hormone, and yet he continued to prescribe it in high dosages, according to the lawsuit. 

She would go on, under Turco’s care, to get a double mastectomy as well as a hysterectomy and oophorectomy, to remove her uterus, ovaries, and fallopian tubes. She also had a procedure to close her vagina, according to the lawsuit.

Turco is known as a progressive advocate promoting sex reassignment procedures, receiving a “Lifetime Achievement Award” for social justice from Dartmouth last year.

But according to the lawsuit, Turco and other doctors who saw Stewart ignored the medical standards for gender-affirming care, such as the “Benjamin criteria,” which state cross-sex hormones “should not be administered without adequate psychological and medical assessment before and during treatment” and that problems should be well-controlled. 

“Yet these criteria were not remotely met in Amanda’s case according to the medical records produced prior to Plaintiff filing this lawsuit. “Amanda was not receiving testosterone with adequate psychological and medical assessment before and during treatment, and her problems were not well-controlled,” the lawsuit states.

These procedures were done without the psychological referrals necessary under the Benjamin criteria standards, according to the lawsuit. In fact, both surgeons who performed the procedures noted her impaired mental state when they saw her prior to the surgeries, according to the lawsuits.

Turco did not begin to question if Stewart was mentally competent to make decisions about her gender until 2016, after years of testosterone treatment and the surgeries. That was when Stewart had stopped taking the testosterone and stopped identifying as a man.

“Dr. Turco also noted that Amanda was not then living as a ‘transmale.’ Dr. Turco noted his belief that Amanda’s ‘underlying psychological issues’ made it ‘very hard for [her] to understand, evaluate and implement exactly what is [her] gender identity.’ Despite these observations, Dr. Turco continued to prescribe testosterone to Amanda,” the lawsuit states.

None of the doctors or counselors who saw Stewart questioned the care until she saw psychologist Dr. Carey Bluhm in 2019. At the time, Turco and staff at Dartmouth were pushing her to get more surgery.

“Dr. Bluhm expressed to Dr. Turco’s office his concerns that Amanda had Asperger’s and admitted to having ‘delusional events.’ Dr. Bluhm also expressed ‘reservations’ about additional plastic surgery procedures Dartmouth-Hitchcock staff had been meeting with Amanda about,” the lawsuit states.

Turco began acknowledging in 2021 that Stewart is, in fact, a woman despite the surgeries. In 2022, after she was taken to the hospital with suicidal ideation, Turco noted the testosterone treatments had “complications.”

Dartmouth Health did not respond to a request for comment.