ACLU trans attorney admits before Supreme Court there’s no evidence child sex changes help prevent suicide

The Supreme Court heard oral arguments on Wednesday in the case of the United States v. Skrmetti, or what can just be called the Tennessee trans case. Tennessee banned the practice of medical sex changes for minors in the state. Activists with the ALCU and the Biden-Harris Department of Justice took up a suit against Tennessee, saying that banning child sex changes is discrimination on the basis of sex. In questioning, Justice Samuel Alito spoke to ACLU trans attorney Chase Strangio, bringing up the Cass Report and concerns about suicidality.

He opened up the Cass Report, which was completed after an in-depth investigation into the UK National Health Service's gender treatment for minors, showing that there was evidence that sex changes to treat gender dysphoria does not reduce incidents of suicide. That so-called trans youth are more likely to commit suicide should they not be given medical sex change treatment has been a persistent argument by trans activists who insist that drugs and surgeries must be available to children and teens who claim to be the opposite sex.

"A lot of categorical statements have been made this morning in argument and in the briefs about medical questions that seem to me to be hotly disputed, and that's a bit distressing. One of them has to do with the risk of suicide. Do you maintain that the procedures and medications in question reduce the risk of suicide?" Alito asked.

"I do Justice Alito, maintain that the medications in question reduce the risk of depression, anxiety and suicidality," Strangio said, "which are all indicators of potential suicide."

"Do you think that's clearly established? Do you think there's reason for disagreement about that?" Alito asked.

"I do," Strangio said. "I do think it is clearly established in the science and in in the record. I think, as with all underlying questions of looking at evidence, there can be disagreement. I don't dispute that, but here and sort of going back to questions about the Cass Review, for example, the Cass Review only looked at studies up until 2022."

"I don't regard the Cass Review as necessarily as a Bible or as something that's true in every respect," Alito said, "But on page 195 of the Cass Report," Alito asked Strangio, "it says there is no evidence that gender affirmative treatments reduce suicide." 

"What I think that is referring to is there is no evidence in the studies," Strangio replied, "that this treatment reduces completed suicide, and the reason for that is completed suicide, thankfully, and admittedly, is rare, and we're talking about a very small population of individuals with studies that don't necessarily have completed suicides within them. However, there are multiple studies, long-term, longitudinal studies, that do show that there is a reduction in suicidality, which I think is a positive outcome to this treatment."

The report reads: "Tragically deaths by suicide in trans people of all ages continue to be above the national average, but there is no evidence that gender-affirmative treatments reduce this. Such evidence as is available suggests that these deaths are related to a range of other complex psychosocial factors and to mental illness."

"This raises the question of whether, for those who are in late adolescence and not on puberty blockers, managing any mental health problems, ensuring participation in education or work, supporting social transition and organising fertility preservation if required are more pressing issues than commencing masculinising/feminising hormones."

Leor Sapir has also investigated the rates of trans suicide, specifically with regard to findings published by the ACLU, for whom Strangio is an attorney. Sapir said in 2023 that "This politically potent 'affirm or suicide' narrative has been marshalled at nearly every opportunity in public debates over pediatric gender medicine. It enjoys the endorsement of top-ranking officials in the Biden administration. Last year, the Department of Health and Human Services called 'gender-affirming care' a 'potentially lifesaving' intervention." 

However, he went on to cite research showing that "suicide is a socially contagious behavior, especially in youth," crediting the CDC with having accumulated that data. "Transgender advocacy groups acknowledged the dangers of speaking irresponsibly about suicide and agreed with the CDC’s guidelines," Sapir said, "that is, until Republican-majority states started pushing back against medical associations and the Biden administration on the issue of pediatric gender medicine."