Advocating for the LGBTQ+ Community in a Post-Skrmetti and Post-Mahmoud World

The 2024-2025 Supreme Court term wrapped up with two damaging cases for LGBTQ+ rights and equity: U.S. v. Skrmetti and Mahmoud v. Taylor.

In Skrmetti, SCOTUS upheld a Tennessee law that banned gender affirming care for minors. The court held that the ban on transgender care was not discriminating based on gender or transgender status, but rather distinguishing those with gender dysphoria, a class with less constitutional protection and requiring only rational basis review. The Court found the ban on care, thus, did not violate the Equal Protection Clause of the U.S. Constitution and allowed it to go forward. The Court did not address the issue of what level of scrutiny would apply to discrimination on the basis of transgender status. The case upheld this specific Tennessee law, but it did not preclude other challenges to similar bans in the future.

This holding cuts off access to care for trans youth in Tennessee and green-lights other states to institute similar discriminatory restrictions. As Justice Sotomayor’s dissent notes, the majority “invites legislatures to engage in discrimination by hiding blatant sex classifications in plain sight.” See AFJ’s full statement on the case here.

In Mahmoud, the Supreme Court ruled that parents of children in public schools can opt their children out of reading books with LGBTQ+ characters and themes if they conflict with their religious beliefs. The majority opinion does not acknowledge the harm this may bring to the LGBTQ+ community and distorts the content of the books in question. Justice Sotomayor’s dissent emphasizes that there will be a chilling effect as a result of this case, which will reverse progress towards inclusive curricula.

AFJ President, Rachel Rossi, notes “[w]e can’t ignore that this ruling will harm LGBTQ+ students and those with LGBTQ+ family members who will see their peers ‘opt out’ of recognizing their existence.” See AFJ’s full statement here. 

It is clear that a majority of this Supreme Court will not stand up to protect trans youth and the LGBTQ+ community at large. But there is plenty that nonprofit advocates can still do in spite of these rulings:

• Advocate for funding trans healthcare research: The majority in Skrmetti cites a lack of scientific research into the impacts of gender affirming care for young people and yet the current administration, led by Health and Human Services Secretary RFK Jr., has cut funding into LGBTQ+ related health concerns. On top of that, rather than focus on alleviating disparities in LGBTQ+ health and improving care, the Trump Administration has directed the National Institute of Health to conduct research supporting its anti-LGBTQ+ political agenda. Nonprofits can make sure quality, scientifically accurate research continues by calling for renewed and increased funding.

Encouraging the executive branch to fund research is not considered lobbying under the IRS definition. This means executive branch advocacy does not count towards a 501(c)(3)’s public charity’s lobbying limits. If you are advocating at the state or local level, make sure to check any state and local lobbying regulations that may have different lobbying definitions.

• Advocate for inclusive school curricula: Meet with school boards and local leaders to encourage inclusive, safe school environments for members of the LGBTQ+ community and their families. School boards do not count as legislatures under the IRS lobbying definitions, so 501(c)(3) public charities’ advocacy at the school board level will generally not count towards their IRSlobbying limits.
• Lobby your Legislators
• Call for increased state Medicaid funding at the state level: Trump’s budget bill that recently was signed into law cut funding to Medicaid and restricted access to healthcare for millions. This includes crucial access to gender affirming care, PrEP (pre-exposure prophylaxis), and more. State legislatures can help fill that gap and ensure everyone has healthcare coverage.
• Protect the LGBTQ+ community from further harmful legislation: Representative Marjorie Taylor Greene is calling for even more restrictions to trans healthcare through H.R. 3492, which attempts to criminalize medical providers who provide transition-related health care for youth. Nonprofits can lobby against federal bills like this, and states can counter these harmful measures with more protective legislation of their own.
• Lobby for good judicial nominees and against those that threaten our rights: Judges make decisions that affect all of us and can be the first line of defense against both the Trump administration’s policies down to local school board decisions like in Mahmoud–or with bad judges seated, they may help enact an anti-LGBTQ agenda. Trump’s very first judicial nominee ofhis second term was, in fact, a lawyer who argued Skrmetti, defending Tennessee’s gender affirming care ban for trans youth. Keep up to date with AFJ’s judicial nomination tracker and follow along with our courts team to learn more.
• Create state level protections that go beyond federal protections: In Skrmetti, the Court found that the Tennessee ban was constitutional, but it did not stop other states from continuing care for trans youth or creating new protections for trans youth to expand care. States can work to enshrine equal protection for the trans community in their state laws and constitutions. Proactively build a grassroots campaign to get LGBTQ+ protective ballot measure(s) on your state’s ballot if allowed in your state. We can learn from the abortion context where, post-Dobbs, many advocates turned to the ballot box to score important wins to protect access to abortion and reproductive care.
• While SCOTUS has cleared the way for more states to enact bans on trans youth care, those states still must pass laws through their legislatures, and nonprofits can stand in the way. Don’t let thes
  e bans become law in more states. To learn more about lobbying rules and regulations, take a look at our guide, Being a Player, and our state by state lobbying resources

Following Skrmetti, we can expect to see a result very similar to what we have seen in the abortion context—a patchwork of laws that differ in each state with some states serving as safe havens. States that allow care for trans youth may have more demand, need more providers, and need protections for their providers. To prepare for this, states like Delaware have taken affirmative steps with the Governor signing an executive order to make Delaware a shield state for providers of gender-affirming care. As we have seen in the abortion context, this protects providers against out of state legal actions.

• Community care: work to create mutual aid networks, like seen in the abortion context, to help youth get access to care. Support the LGBTQ+ community, act as an ally by sharing stories of LGBTQ+ families, and work towards equity when other barriers persist.