Report on U.S. Supreme Court Decision in *United States v. Skrmetti* and its Impact on Sustainable Development Goals

Executive Summary

The United States Supreme Court’s decision in United States v. Skrmetti, which upheld a Tennessee law banning gender-affirming medical care for minors, presents significant challenges to the advancement of several Sustainable Development Goals (SDGs). This report analyzes the Court’s ruling and its implications for SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), SDG 10 (Reduced Inequalities), and SDG 16 (Peace, Justice and Strong Institutions). The decision to apply a lower standard of judicial review for a law discriminating against transgender individuals marks a notable departure from established principles of equality and non-discrimination, which are central to the 2030 Agenda for Sustainable Development.

Case Analysis: Intersection of Law, Health, and Equality

The Tennessee Statute and its Conflict with SDG 3 and SDG 5

The case centered on a Tennessee statute that prohibits medical treatments intended to allow a minor to identify with a gender inconsistent with their sex assigned at birth. This directly impacts key SDGs:

• SDG 3: Good Health and Well-being: The law restricts access to specific healthcare services—puberty blockers and hormones—for treating gender dysphoria, thereby creating a barrier to essential medical care for a vulnerable group of young people.
• SDG 5: Gender Equality: The statute explicitly creates a classification system based on sex. It permits certain treatments for one sex while denying them to another if the purpose is gender transition. This legislative approach undermines the core principle of SDG 5, which is to end all forms of discrimination against all women and girls, a principle broadly interpreted to include discrimination based on gender identity.

Judicial Scrutiny and its Implications for SDG 10 and SDG 16

A primary issue was the constitutional standard of review for laws discriminating against transgender people. The outcome has direct relevance to the enforcement of non-discriminatory policies as promoted by SDG 10 and SDG 16.

1. Rejection of Heightened Scrutiny: Advocates argued for intermediate scrutiny, the standard used in sex discrimination cases, which aligns with SDG 10’s goal to reduce inequalities by eliminating discriminatory laws (Target 10.3). The Court’s majority rejected this, opting for the much lower standard of rational basis review.
2. Majority Rationale: The Court concluded the law did not classify based on sex or transgender status, but rather on “age” and “medical use.” This reasoning sidesteps the discriminatory impact on transgender individuals, weakening legal protections that are essential for achieving SDG 10 (Reduced Inequalities) and SDG 16 (Peace, Justice and Strong Institutions).
3. Dissenting Viewpoint: The dissent argued that the law is a clear example of sex discrimination, drawing parallels to the landmark civil rights case Loving v. Virginia. This perspective aligns with the mandate of SDG 16 to build effective, accountable, and inclusive institutions that ensure equal access to justice for all.

Broader Implications for the 2030 Agenda for Sustainable Development

Challenges to Foundational Principles of Equality

The Court’s reasoning in Skrmetti poses a risk to the legal frameworks that support progress on multiple SDGs.

• Impact on SDG 5 (Gender Equality): The decision’s logic, particularly its reliance on the 1974 case Geduldig v. Aiello, could be used to justify other forms of sex-based discrimination if they are framed as being rooted in “biological differences.” This threatens decades of progress in sex discrimination law, a cornerstone for achieving gender equality.
• Impact on SDG 10 (Reduced Inequalities): By upholding a law that explicitly targets a specific group for differential treatment, the decision contradicts the objective of Target 10.2: to empower and promote the social inclusion of all, irrespective of sex or other status. It institutionalizes inequality for transgender individuals under the law.

Future Outlook and Monitoring Progress

While the Skrmetti decision represents a setback, its long-term impact remains to be seen. The majority’s narrow and logically strained reasoning may limit its application in future cases. The Court has already agreed to hear subsequent cases involving the rights of transgender individuals, indicating that the legal questions surrounding sex discrimination and gender identity are far from settled. Continued monitoring of judicial and legislative developments is critical to assess progress toward achieving the non-discrimination and equality targets embedded within the Sustainable Development Goals.

Analysis of Sustainable Development Goals (SDGs) in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being – The article discusses a ban on gender-affirming medical care for minors, which directly relates to health services and well-being.
• SDG 5: Gender Equality – The core of the article is a legal debate on sex discrimination, gender identity, and the application of equal protection principles, which are central to gender equality.
• SDG 10: Reduced Inequalities – The case focuses on discrimination against a specific group (transgender people), addressing the broader theme of reducing inequalities and ensuring equal rights and opportunities for all.
• SDG 16: Peace, Justice and Strong Institutions – The article analyzes a Supreme Court decision, examining the role of judicial institutions in interpreting laws, upholding constitutional rights, and providing access to justice.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.8: Achieve universal health coverage, including… access to quality essential health-care services… for all.
     
     The article directly addresses this target by discussing Tennessee’s “ban on gender affirming care for trans minors.” This law explicitly restricts access to what is considered essential healthcare for individuals with “gender dysphoria, gender identity disorder, or gender incongruence,” thereby preventing a specific population from receiving necessary medical treatments like puberty-blockers and hormones.

2. SDG 5: Gender Equality

   • Target 5.1: End all forms of discrimination against all women and girls everywhere.
     
     While the target specifically mentions women and girls, its principle extends to ending all gender-based discrimination. The article’s central theme is whether the Tennessee law “unconstitutionally discriminates by conditioning the legality of treatments on their alignment with a minor’s assigned sex.” The legal battle, referencing cases like Bostock v. Clayton County, is about defining and prohibiting discrimination based on sex and gender identity.
   • Target 5.c: Adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality.
     
     The article analyzes the legal soundness and enforceability of laws related to gender equality. It scrutinizes the Supreme Court’s decision to uphold the Tennessee ban and questions its reasoning, noting that the majority’s logic “could endanger most of modern sex discrimination law, which prevents the state from penalizing individuals for acting in ways considered inconsistent with their sex.” This highlights the critical role of legislation and judicial interpretation in either strengthening or weakening gender equality.

3. SDG 10: Reduced Inequalities

   • Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex… or other status.
     
     The article focuses on the legal and social exclusion of transgender minors. The law in question targets a group based on their gender identity (“other status”). The legal challenge brought by “three trans teenagers, their parents, and a physician” is an attempt to fight for inclusion and equal treatment under the law.
   • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices.
     
     This target is at the heart of the article. The entire legal case, United States v. Skrmetti, is an effort to eliminate what the plaintiffs argue is a discriminatory law. The article details how the law creates inequality by allowing certain medical treatments for one purpose but not for another based on gender identity, and analyzes the Supreme Court’s failure to strike down this “discriminatory” practice.

4. SDG 16: Peace, Justice and Strong Institutions

   • Target 16.3: Promote the rule of law at the national… level and ensure equal access to justice for all.
     
     The article is a case study in the application of the rule of law and the pursuit of justice. It describes how plaintiffs used the legal system to challenge a state law, arguing it violated the “Equal Protection Clause of the U.S. Constitution’s 14th Amendment.” The analysis of the Supreme Court’s reasoning and the dissent’s arguments demonstrates the ongoing struggle to ensure equal access to justice and fair application of constitutional principles for marginalized groups.
   • Target 16.b: Promote and enforce non-discriminatory laws and policies for sustainable development.
     
     The central conflict discussed in the article is whether the Tennessee law is discriminatory. The plaintiffs and Justice Sotomayor’s dissent argue that it is, while the majority opinion concludes it is not. The article states, “The majority’s conclusion that the Tennessee ban does not discriminate based on sex is clearly infirm.” This directly engages with the challenge of promoting and enforcing non-discriminatory laws.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. For Targets 5.1, 10.3, and 16.b

   • Indicator: Existence of laws and policies that discriminate on the basis of sex and gender identity.
     
     The article explicitly identifies the Tennessee “ban on gender affirming care for trans minors” as such a law. The Supreme Court’s decision to uphold this ban is a key data point indicating a setback in eliminating discriminatory laws. Conversely, the reference to the 2020 decision in Bostock v. Clayton County, which extended Title VII protections, serves as an example of a positive indicator from the recent past.

2. For Target 3.8

   • Indicator: Legal or policy barriers to accessing essential healthcare services for specific population groups.
     
     The article provides a clear example of such a barrier. The Tennessee statute “outlaws puberty-blockers and hormones to treat ‘gender dysphoria, gender identity disorder, or gender incongruence.'” This directly measures a lack of access to essential health services for transgender minors in the state.

3. For Target 16.3

   • Indicator: Access to formal justice mechanisms for victims of discrimination.
     
     The article implies this indicator by describing the legal process itself. The fact that “three trans teenagers, their parents, and a physician, represented by the American Civil Liberties Union” were able to bring their case all the way to the Supreme Court shows that a mechanism for seeking justice exists and was accessed. The outcome of the case, however, reflects on the effectiveness of that mechanism in providing redress.

4. Table of SDGs, Targets, and Indicators

Source: theregreview.org