Intersex, Trans, and the Irrationality of Gender-Affirming-Care Bans

The U.S. Supreme Court is poised to address the constitutionality of state laws banning gender-affirming care for transgender youth. This Article provides a comprehensive legal analysis of these bans, uncovering a disturbing normative paradox: despite claiming to protect minors by banning gender-affirming care, these laws simultaneously endorse coercive medical interventions through clauses that permit such procedures for intersex infants. This internal contradiction turns the Court’s search for the bans’ rational basis into an exercise in irrationality, demonstrating their failure to meet even the most basic standard of constitutional scrutiny. The Article first challenges prevailing legal narratives by considering the legal interests of trans and intersex minors as distinct yet interconnected. It then argues that the internal incoherence of gender-affirming-care bans amounts to legislative irrationality. This analysis reveals that the statutes’ only rational aim is an illegitimate one: an intent to enforce binary understandings of sex and gender on minors’ bodies, jeopardizing their health and well-being in contravention of core constitutional safeguards. Finally, the Article extends its doctrinal argument by offering a complementary normative vision, grounded in reproductive justice and critical disability studies, for minors’ bodily self-determination.