Law & Principles, Culture & the Family

U.S. opposed Oklahoma ban on child gender ‘transitions’

July 9, 2025

Ray Carter

In 2023, Oklahoma policymakers enacted Senate Bill 613, which states, “A health care provider shall not knowingly provide gender transition procedures to any child.”

When a lawsuit was filed seeking to have the law overturned, Oklahoma officials found themselves faced against not only run-of-the-mill liberal activists, but also against the United States government.

On June 9, 2023, Clinton J. Johnson, U.S. Attorney for the Northern District of Oklahoma, along with lawyers from the Civil Rights Division of the U.S. Department of Justice, submitted a “Statement of Interest of the United States” urging the court to strike down Oklahoma’s law that prohibits providing puberty blockers, cross-sex hormones, or sex-change surgeries to youth younger than 18, calling those acts “medically necessary health care.”

“Senate Bill 613 (‘SB 613’) conditions the medical care a minor may receive on the sex that person was assigned at birth, prohibiting health care providers from administering medically necessary care for transgender minors with a diagnosis of gender dysphoria, while leaving non-transgender minors free to receive the same procedures and treatments,” the statement declared. “The United States respectfully submits this Statement of Interest under 28 U.S.C. § 5171 to advise the Court of the United States’ view that, by denying transgender minors—and only transgender minors—access to medically necessary and appropriate care, SB 613 violates the Equal Protection Clause of the Fourteenth Amendment.”

The arguments put forth in the statement were comparable to those raised in a challenge to a similar Tennessee law. When the Tennessee case reached the U.S. Supreme Court, the Court rejected those types of arguments.

Oklahoma’s law defines “gender transition procedures” to include surgical procedures that alter or remove physical or anatomical characteristics or features that are typical for the individual’s biological sex, or the provision of puberty-blocking drugs and cross-sex hormones. The restrictions apply to patients younger than 18, with exceptions for youth being treated for conditions such as precocious puberty or delayed puberty.

The American Civil Liberties Union and likeminded groups sued, seeking to have SB 613 overturned.

The plaintiffs in Peter Poe v. Gentner Drummond included five youth who claim to be transgender, their parents/guardians, and one doctor.

The Oklahoma Council of Public Affairs (OCPA) joined with Do No Harm, a group of medical professionals, to defend SB 613 in an amici curiae brief filed in the case.

Activist Rhetoric and Legislative Intent

But in the statement of interest, the attorneys for the United States sided with the plaintiffs, utilizing rhetoric throughout the document associated with transgender activism, such as declaring the removal of healthy body parts to be “gender-affirming care.”

The statement described the provision of cross-sex hormones or sex-change surgeries as beneficial, and insisted it is medically harmful for some children to undergo puberty or develop naturally.

“The inability of transgender youth to live consistent with their gender identity due to the irreversible physical changes that accompany puberty can have significant negative impacts on their overall health and well-being,” the statement declared.

The document further argued that Oklahoma lawmakers “demonstrated anti-transgender animus” in passing SB 613, because one legislator said that the embrace of a transgender identity involved “desolation, destruction, degeneracy, and delusion, ending in delusional play acting,” and another lawmaker declared that “gender-affirming care” is built on a foundation of “misinformation” and is “a lie.” The statement also objected that one lawmaker said those who embraced a transgender identity are “pretending.”  

The statement of interest also indicated that anti-transgender animus was demonstrated when state Sen. Julie Daniels, a Bartlesville Republican who authored the law, referred on Feb. 15, 2023, to the provision of puberty blockers, cross-sex hormones, and sex-change surgeries to children as “experimental” and “very dangerous” with the potential to cause “unpredictable, unsettled, and irreversible physical conditions” in children.

The statement of interest claimed that Oklahoma lawmakers’ “stated objective of protecting youth from dangerous treatments does not appear to be fully ‘genuine’” and “appears instead to be a ‘largely pretextual’ justification” that is “lacking accurate scientific or medical basis.”

The statement of interest declared that Oklahoma’s law “discriminates on the basis of sex” and “discriminates against transgender individuals, who constitute a quasi-suspect class.” The document urged the court to “conclude that SB 613 discriminates on the basis of sex because the medical treatments available to a minor depend on the sex the minor was assigned at birth.”

“For example, under SB 613, a minor assigned female at birth cannot receive testosterone to treat gender dysphoria, but a non-transgender minor assigned male at birth can receive testosterone to treat low hormone production because the treatment is consistent with the sex the minor was assigned at birth,” the statement declared.

The document also argued that SB 613 “discriminates on the basis of sex because it conditions the availability of particular medical procedures on compliance with sex stereotypes. First, it conditions medical care on the assumption that an individual’s gender identity should match their sex assigned at birth.”

Medical Consensus or Ongoing Debate?

The statement of interest repeatedly claimed there is a broad consensus among medical experts endorsing the provision of cross-sex hormones and sex-change surgeries to children and indicated there is no real medical debate on the issue.

But this year, when the U.S. Supreme Court upheld a similar law in Tennessee (Senate Bill 1) in United States v. Skrmetti, justices in the 6-3 majority rejected arguments similar to those made in the statement of interest. 

The majority opinion, authored by Chief Justice John Roberts, held that the Tennessee law “is not subject to heightened scrutiny under the Equal Protection Clause of the Fourteenth Amendment and satisfies rational basis review.”

“Tennessee determined that administering puberty blockers or hormones to minors to treat gender dysphoria, gender identity disorder, or gender incongruence carries risks, including irreversible sterility, increased risk of disease and illness, and adverse psychological consequences,” the majority opinion syllabus stated. “The legislature found that minors lack the maturity to fully understand these consequences, that many individuals have expressed regret for undergoing such treatments as minors, and that the full effects of such treatments may not yet be known. At the same time, the State noted evidence that discordance between sex and gender can be resolved through less invasive approaches. SB 1’s age- and diagnosis-based classifications are rationally related to these findings and the State’s objective of protecting minors’ health and welfare.”

The plaintiffs in the Tennessee case—three transgender-identifying minors, their parents, and a doctor—argued that the law discriminated based on sex and transgender status, and that transgender-identifying individuals are a protected class.

But the U.S. Supreme Court majority held that the Tennessee law is based on only two classifications—one based on age and the other based on medical use.

“Neither of the above classifications turns on sex,” Roberts wrote. “Rather, SB 1 prohibits healthcare providers from administering puberty blockers and hormones to minors for certain medical uses, regardless of a minor’s sex” [emphasis in original].

The majority opinion noted that the same drug may be used for different treatments. For example, Roberts noted that a girl (who identifies as a boy) and receives puberty blockers to address gender incongruence “receives a different medical treatment than a boy whose biological sex is male who takes puberty blockers to treat his precocious puberty.”

The court rejected claims, put forth in the statement of interest filed by the attorneys in the Oklahoma case and other entities in the Tennessee case, claiming the ban on puberty blockers, etc., for youth experiencing gender dysphoria involves discrimination based on sex.

Roberts’ opinion noted that the “law does not prohibit conduct for one sex that it permits for the other.”

“Under SB 1, no minor may be administered puberty blockers or hormones to treat gender dysphoria, gender identity disorder, or gender incongruence; minors of any sex may be administered puberty blockers or hormones for other purposes,” Roberts wrote [emphasis in original].

The majority also found that the Tennessee law “does not exclude any individual from medical treatments on the basis of transgender status but rather removes one set of diagnoses—gender dysphoria, gender identity disorder, and gender incongruence—from the range of treatable conditions.”

In a concurring opinion, Justice Clarence Thomas wrote that evidence showed that no medical consensus existed, and he also noted that “there are particularly good reasons to question the expert class here, as recent revelations suggest that leading voices in this area have relied on questionable evidence, and have allowed ideology to influence their medical guidance.”

Thomas also stressed that the voices of individuals who have undergone the procedures championed by the plaintiffs should not be ignored.

“The voices of ‘detransitioners’—individuals who have undergone sex-transition treatments but no longer view themselves as transgender—provide States with an additional reason to question whether children are providing informed consent to the medical interventions described above,” Thomas wrote.

Roberts raised a similar issue in the majority opinion.

“The plaintiffs and the dissent, however, contort the meaning of the term ‘medical treatment,’” Roberts wrote. “Notably absent from their framing is a key aspect of any medical treatment: the underlying medical concern the treatment is intended to address.”