Amicus Curiae Brief — United States, Petitioner v. Jonathan Skrmetti, Attorney General and Reporter for Tennessee, et al.
Supreme Court briefOct 15, 2024
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No. 23-477
In the Supreme Court of the United States
UNITED STATES OF AMERICA, Petitioner,
v.
JONATHAN SKRMETTI, ATTORNEY GENERAL AND
REPORTER FOR TENNESSEE, ET AL., Respondents.
On Writ of Certiorari to the United States
Court of Appeals for the Sixth Circuit
BRIEF OF KENTUCKY, ARKANSAS, INDIANA,
ALASKA, FLORIDA, GEORGIA, IDAHO, IOWA,
KANSAS, LOUISIANA, MISSISSIPPI, MONTANA, NEBRASKA, NORTH DAKOTA, OHIO,
OKLAHOMA, SOUTH CAROLINA, SOUTH DAKOTA, UTAH, VIRGINIA, WEST VIRGINIA,
AND WYOMING AS AMICI CURIAE SUPPORTING
RESPONDENTS
RUSSELL COLEMAN
Attorney General
MATTHEW F. KUHN
Solicitor General
Counsel of Record
JOHN H. HEYBURN
Principal Deputy Solicitor
General
DANIEL J. GRABOWSKI
Assistant Solicitor General
Office of the Kentucky
Attorney General
700 Capital Avenue, Suite 118
Frankfort, KY 40601
(502) 696-5300
Matt.Kuhn@ky.gov
TIM GRIFFIN
Attorney General
NICHOLAS J. BRONNI
Solicitor General
DYLAN L. JACOBS
Deputy Solicitor General
DREW BYDALEK
Solicitor General Fellow
Office of the Arkansas
Attorney General
323 Center Street, Suite 200
Little Rock, AR 72201
(501) 682-6302
(For Continuation of Counsel,
See Inside Cover)
THEODORE E. ROKITA
Attorney General
JAMES A. BARTA
Solicitor General
JOHN M. VASTAG
Deputy Attorney General
Office of the Indiana
Attorney General
IGCS – 5th Floor
302 W. Washington St.
Indianapolis, IN 46204
(317) 232-0709
i
TABLE OF CONTENTS
TABLE OF AUTHORITIES ........................................ii
INTERESTS OF AMICI CURIAE .............................. 1
SUMMARY OF THE ARGUMENT ............................ 2
ARGUMENT ................................................................ 3
I.
Tennessee’s law falls within the States’
traditional authority to regulate medicine. ......... 5
II. Even under intermediate scrutiny, the equalprotection challenge fails. ................................... 17
A. Intermediate scrutiny in sex-discrimination
cases ferrets out illegitimate legislative
objectives and means. .................................... 19
B. Intermediate scrutiny does not allow courts
to override legislative policy judgments,
especially in resolving ongoing disputes
about medical interventions.......................... 23
CONCLUSION .......................................................... 27
ADDITIONAL COUNSEL ........................................ 29
ii
TABLE OF AUTHORITIES
Cases
Abigail All. for Better Access to Developmental
Drugs v. von Eschenbach,
495 F.3d 695 (D.C. Cir. 2007) ............................ 7, 15
Alexander v. S.C. State Conf. of the NAACP,
602 U.S. 1 (2024) .................................................... 12
Ariz. State Legislature v. Ariz. Indep. Redistricting
Comm’n, 576 U.S. 787 (2015) ................................ 14
B.P.J. v. W.V. State Bd. of Educ.,
98 F.4th 542 (4th Cir. 2024) .................................. 14
Barbier v. Connolly,
113 U.S. 27 (1884) .................................................. 13
Barsky v. Bd. of Regents of Univ.,
347 U.S. 442 (1954) .............................................. 5, 6
Bowsher v. Synar,
478 U.S. 714 (1986) ................................................ 25
Brandt v. Rutledge,
677 F. Supp. 3d 877 (E.D. Ark. 2023) ................... 19
Caban v. Mohammed,
441 U.S. 380 (1979) ................................................ 21
Califano v. Goldfarb,
430 U.S. 199 (1977) .......................................... 20, 22
iii
Califano v. Westcott,
443 U.S. 76 (1979) .................................................. 22
City of Cleburne v. Cleburne Living Ctr.,
473 U.S. 432 (1985) ................................................ 20
City of Grants Pass v. Johnson,
144 S. Ct. 2202 (2024) ...................................... 17, 25
Collins v. Texas,
223 U.S. 288 (1912) .................................................. 5
Craig v. Boren,
429 U.S. 190 (1976) .......................................... 21, 22
Crane v. Johnson,
242 U.S. 339 (1917) ................................................ 10
Dandridge v. Williams,
397 U.S. 471 (1970) ................................................ 22
Dent v. West Virginia,
129 U.S. 114 (1889) .................................................. 5
Dobbs v. Jackson Women’s Health Org.,
597 U.S. 215 (2022) .......................... 2, 11–13, 16, 24
Doe v. Ladapo,
No. 4:23cv114-RH-MAF, 2024 WL 2947123
(N.D. Fla. June 11, 2024)....................................... 18
Florida v. Dep’t of Health & Hum. Servs.,
No. 24-cv-1080, 2024 WL 3537510
(M.D. Fla. July 3, 2024) ......................................... 26
iv
Frontiero v. Richardson,
411 U.S. 677 (1973) .......................................... 20, 22
Geduldig v. Aiello,
417 U.S. 484 (1974) ............................................ 2, 12
Gonzales v. Carhart,
550 U.S. 124 (2007) ................................ 8, 13, 23–25
Graves v. Minnesota,
272 U.S. 425 (1926) .................................................. 6
Greenlaw v. United States,
554 U.S. 237 (2008) ................................................ 25
Grimm v. Gloucester Cnty. Sch. Bd.,
972 F.3d 586 (4th Cir. 2020) .................................. 14
Hawker v. People of N.Y.,
170 U.S. 189 (1898) .............................................. 5, 6
J.E.B. v. Alabama ex rel. T.B.,
511 U.S. 127 (1994) ................................................ 21
Jacobson v. Massachusetts,
197 U.S. 11 (1905) .................................................... 8
K.C. v. Individual Members of Med.
Licensing Bd. of Ind.,
677 F. Supp. 3d 802 (S.D. Ind. 2023) .................... 26
Kadel v. Folwell,
100 F.4th 122 (4th Cir. 2024) .......................... 14–16
v
Kansas v. Hendricks,
521 U.S. 346 (1997) .................................................. 8
Kirchberg v. Feenstra,
450 U.S. 455 (1981) ................................................ 21
L.W. ex rel. Williams v. Skrmetti,
83 F.4th 460 (6th Cir. 2023) ...................... 13, 15, 25
Lambert v. Yellowley,
272 U.S. 581 (1926) .............................................. 5, 8
Lassiter v. Dep’t of Soc. Servs. of Durham Cnty.,
452 U.S. 18 (1981) .................................................... 8
Marshall v. United States,
414 U.S. 417 (1974) ................................................ 24
Mass. Bd. of Ret. v. Murgia,
427 U.S. 307 (1976) ................................................ 22
Matthews v. Murphy,
63 S.W. 785 (Ky. 1901)............................................. 6
McNaughton v. Johnson,
242 U.S. 344 (1917) ............................................ 6, 10
Michael M. v. Superior Ct. of Sonoma Cnty.,
450 U.S. 464 (1981) .......................................... 23, 24
Minnesota ex rel. Whipple v. Martinson,
256 U.S. 41 (1921) .................................................... 6
Miss. Univ. for Women v. Hogan,
458 U.S. 718 (1982) .......................................... 18, 21
vi
New State Ice Co. v. Liebmann,
285 U.S. 262 (1932) ................................................ 14
Orr v. Orr,
440 U.S. 268 (1979) .......................................... 20, 22
Prince v. Massachusetts,
321 U.S. 158 (1944) .................................................. 8
Richardson v. State,
2 S.W. 187 (Ark. 1886) ............................................. 6
Robinson v. California,
370 U.S. 660 (1962) .................................................. 6
Rutherford v. United States,
616 F.2d 455 (10th Cir. 1980) .................................. 7
Schall v. Martin,
467 U.S. 253 (1984) .................................................. 8
Sessions v. Morales-Santana,
582 U.S. 47 (2017) ............................................ 20–22
Stanley v. Illinois,
405 U.S. 645 (1972) ................................................ 20
Stanton v. Stanton,
421 U.S. 7 (1975) .................................................... 20
Terrace v. Thompson,
263 U.S. 197 (1923) ................................................ 13
Tuan Anh Nguyen v. I.N.S.,
533 U.S. 53 (2001) ............................................ 18, 23
vii
Turner Broad. Sys. v. FCC,
512 U.S. 622 (1994) .......................................... 23, 25
United States v. Virginia,
518 U.S. 515 (1996) ........................ 12, 18, 20, 22, 23
Watson v. Maryland,
218 U.S. 173 (1910) .............................................. 6, 9
Weinberger v. Wiesenfeld,
420 U.S. 636 (1975) ................................................ 22
Wengler v. Druggists Mut. Ins.,
446 U.S. 142 (1980) ................................................ 22
Whalen v. Roe,
429 U.S. 589 (1997) ...................................... 6, 14, 15
Statutes
Tenn. Code Ann. § 33-8-301 ........................................ 8
Tenn. Code Ann. § 33-8-315 ........................................ 8
Tenn. Code Ann. § 68-33-102 ...................................... 4
Tenn. Code Ann. § 68-33-103 ................................ 3, 10
Other Authorities
Jo Taylor et al., Interventions to suppress puberty in
adolescents experiencing gender dysphoria or
incongruence: a systematic review, Arch Dis Child
(2024) ...................................................................... 26
viii
Jo Taylor et al., Masculinising and feminising
hormone interventions for adolescents experiencing
gender dysphoria or incongruence: a systematic
review, Arch Dis Child (2024)................................ 26
The Federalist No. 78 (Alexander Hamilton) ........... 25
1
INTERESTS OF AMICI CURIAE
This case, like so many others, comes down to who
decides. Who decides how best to protect health and
welfare? Who decides what to do when faced with scientific and medical uncertainty? And who decides
what medical interventions can be used on children?
In a word, the States do. They get to decide those
questions as a matter of state law. Medical interest
groups do not make those calls. Nor do the courts—
not even this one. In our federalist system, the States
determine how to ensure that medical procedures performed within their borders are safe and beneficial,
especially when there is medical uncertainty and especially when it comes to our children.
And that’s a good thing. In this case, it means that
the States can, and do, take different policy approaches to doctors giving hormones and puberty
blockers to children with gender dysphoria while a scientific and policy debate over those interventions continues. On one side, over 20 States have enacted laws
like Tennessee’s that prohibit such interventions. On
the other, at least 14 States have enacted laws protecting those interventions. That diverse approach is
the result of our federalist system. It shows the system
working. The people, through their elected state representatives, are hashing out what procedures are
safe and beneficial for children suffering from gender
dysphoria.
The amici States are actively involved in that discussion. And their sovereign prerogative to continue
participating is very much at stake here. Indeed,
many are defending their laws regulating the use of
2
puberty blockers and hormones for children with gender dysphoria. Those laws may rise or fall with Tennessee’s. Kentucky, Arkansas, Indiana, and the other
amici States therefore submit this brief so that they
are not judicially ousted from the ongoing debate
about what interventions are safe and beneficial for
children.
SUMMARY OF THE ARGUMENT
Since the founding, the States have enacted
health-and-welfare laws. Doing so falls within the
heart of their police power. That’s why, time and
again, this Court has recognized the deference due.
Only rational-basis review applies when States regulate medical professions or procedures. All the more so
when a law involves areas of medical uncertainty or
endeavors to protect children.
Our nation’s history of the States ensuring that
medicine is safe and beneficial drives the constitutional analysis here. It provides the historical backdrop for the equal-protection challenge to Tennessee’s
law. It shows just how jarring it would be to our federalist system to require States to permit puberty
blockers and hormones for children with gender dysphoria. And it explains the Court’s recognition in
Dobbs and Geduldig that the “regulation of a medical
procedure that only one sex can undergo does not trigger heightened constitutional scrutiny,” unless just a
pretext. Dobbs v. Jackson Women’s Health Org., 597
U.S. 215, 236 (2022); see Geduldig v. Aiello, 417 U.S.
484, 496 n.20 (1974).
If the Court sweeps away all the history supporting the States’ broad power to protect health and
3
safety, especially when it comes to medical uncertainty and children, then the consequences are clear.
Perhaps most worrying, the Court would constitutionalize an issue of intense public and scientific debate
best left to the political branches. The Court would remove from the people and their representatives the
chance to weigh the scientific claims, decide how best
to address the competing interests, and make the difficult policy decisions.
This Court’s equal-protection doctrine confirms
what history teaches—States get to decide whether
children can receive puberty blockers and hormones
for gender dysphoria. And that’s true even if intermediate scrutiny applies. Intermediate scrutiny is designed to ferret out illegitimate government objectives
or means. It does not strip States of the space needed
to resolve competing scientific claims nor weigh
States’ policy decisions regulating medicine. That
means, in applying intermediate scrutiny, the judicial
role is to determine that there is substantial evidence
behind a policy choice. The Constitution does not
make the judiciary the final arbiter of ongoing scientific debates. And whatever else one might say, there
is no doubt that a scientific debate continues over
whether puberty blockers and hormones are safe and
effective for children. That’s reason enough to uphold
Tennessee’s law.
ARGUMENT
Tennessee’s law prohibits medical interventions
before age 18 that enable boys and girls to identify or
attempt to live as members of the opposite sex. Tenn.
Code Ann. § 68-33-103(a)(1)(A). The prohibited proce-
4
dures include both performing surgery and administering puberty blockers or hormones. Id. § 68-33102(5).
To be sure, in today’s political environment, Tennessee’s law is controversial in some quarters. But
that does not change its status as a health-and-welfare measure designed to protect children in an area
of scientific and medical uncertainty. That situation is
exactly when a State’s authority to regulate is at its
highest and a court’s authority to scrutinize is at its
lowest.
Yet the United States and private plaintiffs brush
aside the sovereign stakes of this case. As the United
States puts it: “No one doubts that States have a compelling interest in protecting minors and ample authority to regulate the practice of medicine. So long as
a State does not legislate based on sex or transgender
status, its regulations receive only deferential rational-basis review.” U.S. Br. 19.
That passing statement is all the United States
has to say about the States’ sovereign authority to regulate medicine and protect children (and the private
plaintiffs say just as little). But that dismissive approach neglects the role that the States have always
played in regulating medicine, especially when faced
with medical uncertainty and especially when protecting children. It ignores that heightened scrutiny does
not apply to regulations of medical procedures that
only one sex can undergo. And it discounts the conse-
5
quences if the Court overlooks the States’ role. Besides, even if intermediate scrutiny applies, the States
still get to act in areas of medical uncertainty.
I. Tennessee’s law falls within the States’ traditional authority to regulate medicine.
1. Over and over, the Court has made clear that
States may regulate medicine to ensure it is safe and
effective. Doing so falls squarely within their police
power. And that is not up for debate.
Early on, the Court explained: “The power of the
state to provide for the general welfare of its people
authorizes it to prescribe all such regulations as in its
judgment will secure or tend to secure them against
the consequences of ignorance and incapacity, as well
as of deception and fraud.” Dent v. West Virginia, 129
U.S. 114, 122 (1889). And that power necessarily includes regulating medicine. “Care for the public
health is something confessedly belonging to the domain of that power.” Hawker v. People of N.Y., 170
U.S. 189, 193–94 (1898). Indeed, the Court has described regulating the practice of medicine as “a vital
part of a state’s police power.” Barsky v. Bd. of Regents
of Univ., 347 U.S. 442, 449 (1954). And the flipside is
that “there is no right to practice medicine which is
not subordinate to the police power of the states.”
Lambert v. Yellowley, 272 U.S. 581, 596 (1926).
Consider two examples. First, take the States’ ability to regulate who can practice medicine. A State can,
“for the protection of society,” exclude individuals
from practicing medicine if they lack a license or are
otherwise unqualified. Dent, 129 U.S. at 123; see also
Collins v. Texas, 223 U.S. 288, 296 (1912). And it can
do so for “all professions concerned with health.”
6
Barsky, 347 U.S. at 449; see also McNaughton v. Johnson, 242 U.S. 344, 346 (1917) (optometry); Graves v.
Minnesota, 272 U.S. 425, 427 (1926) (dentistry).
In that vein, a State can ensure not only that a
physician “possess[es] a knowledge of diseases and
their remedies” but also that he “may safely be trusted
to apply those remedies.” Hawker, 170 U.S. at 194
(emphasis added). Ensuring safety in medicine is
therefore the key. The States’ police power extends to
regulating the medical profession precisely because it
helps ensure “the lives and health of the people.” Watson v. Maryland, 218 U.S. 173, 176 (1910); see also
Richardson v. State, 2 S.W. 187, 188 (Ark. 1886); Matthews v. Murphy, 63 S.W. 785, 786 (Ky. 1901).
Second, turn to the States’ authority to regulate
drugs. Direct regulation of potentially dangerous
medical treatments like providing drugs is another
critical way that the States ensure safety in medicine.
As the Court has explained, it “is, of course, well settled that the State has broad police powers in regulating the administration of drugs by the health professions.” Whalen v. Roe, 429 U.S. 589, 603 n.30 (1977).
Or put differently: ‘There can be no question of the authority of the state in the exercise of its police power
to regulate the administration, sale, prescription and
use of dangerous and habit[-]forming drugs.” Robinson v. California, 370 U.S. 660, 664 (1962) (quoting
Minnesota ex rel. Whipple v. Martinson, 256 U.S. 41,
45 (1921)). That power—needed to protect “the public
health and welfare”—is “too firmly established to be
successfully called in question.” Id. (quoting Whipple,
256 U.S. at 45).
7
That’s why the Tenth Circuit has held that there
is no individual right to elect a drug or treatment that
the government has prohibited. A patient’s “selection
of a particular treatment, or at least a medication, is
within the area of governmental interest in protecting
public health.” Rutherford v. United States, 616 F.2d
455, 457 (10th Cir. 1980). So the government may
“limit the patient’s choice of medication.” Id.
And it’s why the en banc D.C. Circuit has held
much the same. There is no “affirmative right of access to particular medical treatments reasonably prohibited by the Government.” Abigail All. for Better Access to Developmental Drugs v. von Eschenbach, 495
F.3d 695, 710 (D.C. Cir. 2007) (en banc). In so holding,
the D.C. Circuit examined our nation’s history and
tradition, concluding that the government has long
regulated drugs based on “the risks associated with
both drug safety and efficacy.” Id. at 703. For example,
one colony’s 1736 law “addressed the dispensing of
more drugs than was ‘necessary or useful’ because
that practice had become ‘dangerous and intolerable.’”
Id. at 704 (citation omitted). And by 1870, “at least
twenty-five states or territories had statutes regulating adulteration (impure drugs), and a few others had
laws addressing poisons.” Id. (citation omitted). In
other words, history shows the States responding to
risks in medical treatments as they became known.
Id. And critically, it shows this Court giving the States
the latitude to do so.
Such deference is even more warranted when it
comes to situations of medical uncertainty and to protecting children. A few words on both. First, the Court
has repeatedly noted the high level of deference due
when States regulate in areas in which the effects of
8
medicine are unknown. It “has given state and federal
legislatures wide discretion to pass legislation in areas where there is medical and scientific uncertainty.”
Gonzales v. Carhart, 550 U.S. 124, 163 (2007) (collecting cases). Disagreement by health professionals does
not “tie [a] State’s hands.” Kansas v. Hendricks, 521
U.S. 346, 360 n.3 (1997). Rather, “it is precisely where
such disagreement exists that legislatures have been
afforded the widest latitude.” Id. That is the “traditional rule.” Gonzales, 550 U.S. at 163; see also Lambert, 272 U.S. at 597 (explaining how it would “be
strange” if Congress could not act when medical authorities conflict).
Second, the Court has made clear the States’ role
in “preserving and promoting the welfare of the child.”
Schall v. Martin, 467 U.S. 253, 265 (1984) (citation
omitted). Indeed, States have “an urgent interest” in
children’s welfare. Lassiter v. Dep’t of Soc. Servs. of
Durham Cnty., 452 U.S. 18, 27 (1981). And their “authority over children’s activities is broader than over
like actions of adults.” Prince v. Massachusetts, 321
U.S. 158, 168 (1944). No doubt, that’s because children are different than adults—their bodies and
minds are not yet fully developed.
That difference matters in the medical context.
The States can and do prohibit medical interventions
for children but not adults or regulate them differently. E.g., Tenn. Code Ann. §§ 33-8-301 (electroconvulsive therapy), 33-8-315 (child lobotomies). In fact,
the Court has even held that States can do the opposite. In some cases, a State can require a medical procedure on adults but exempt children. Jacobson v.
Massachusetts, 197 U.S. 11, 30 (1905) (“[T]here are obviously reasons why regulations may be appropriate
9
for adults which could not be safely applied to persons
of tender years.”). If a State has deference in exempting children from an otherwise required intervention,
it likewise has deference in prohibiting a medical intervention for children otherwise allowed for adults.
2. Now compare Tennessee’s law to all those circumstances in which deference is due. It is a law regulating medicine within the heartland of the States’
police power. It fits within the long tradition of States
ensuring that medicine is safe and beneficial. It concerns an area in which there is scientific and medical
disagreement. And it regulates a medical intervention
for children. Adding all those circumstances up, there
should be layer after layer of deference due.
But the United States and private plaintiffs disagree. As they see it, no deference should be given
simply because of their equal-protection challenge.
E.g., U.S. Br. 19. That could not be more wrong.
For starters, the Court has long applied deferential
review to equal-protection challenges of regulations
involving medicine. Consider Watson for example.
There, the Court upheld a state law exempting some
physicians from a registration requirement. Watson,
218 U.S. at 176. The Court explained that the “regulations of a particular trade or business essential to
the public health and safety [are] within the legislative capacity of the state in the exercise of its police
power” and that classifications need only a “reasonable basis.” Id. at 178. Put differently, “the details of
such legislation rest primarily within the discretion of
the state legislature.” Id. at 177. And the Court has
reasoned similarly for other equal-protection challenges to regulations of the medical profession. See
10
Crane v. Johnson, 242 U.S. 339, 344 (1917) (“We cannot say that the state’s estimate of the practices and
of their differences is arbitrary, and therefore beyond
the power of government.”); McNaughton, 242 U.S. at
349.
The challengers’ main response to that caselaw is
that the traditional deference given to state regulations of medicine disappears altogether whenever a
law classifies based on sex. But Tennessee’s law does
not classify based on sex.
In the United States’ view, because a girl cannot
get puberty blockers or testosterone to enable her to
identify or live as a boy, but a boy can, then Tennessee’s law discriminates based on sex. U.S. Br. 21–22.
And the same argument in the United States’ view
goes for a boy: he cannot get puberty blockers or estrogen to enable him to identify or live as a girl, but a girl
can. On the surface, that framing implicates a child’s
sex. But on closer look, the framing is wrong. All Tennessee’s law does is regulate medical interventions for
a particular purpose in an evenhanded way based on
biological differences.
Under Tennessee’s law, there are two relevant prohibited procedures. First, a boy cannot use puberty
blockers and estrogen to identify or live as “a purported identity inconsistent with” his sex. Tenn. Code
Ann. § 68-33-103(a)(1)(A). But only one sex can undergo that medical procedure: males. Biology dictates
as much. Second, a girl cannot use puberty blockers
and testosterone to identify or live as “a purported
identity inconsistent with” her sex. Id. But again, only
one sex can undergo that procedure: females. Biology
also dictates as much.
11
That means the United States’ argument runs directly into the deference owed to the States’ regulation
of medicine. Not only have the States long regulated
medicine, but they have long done so for procedures,
like those here, that only one sex can undergo. Abortion is the prime example. No doubt, that’s a medical
procedure that only women can undergo. And the
Court in Dobbs thoroughly examined the history of
state regulations of that procedure. Dobbs, 597 U.S. at
241. For example, when the Fourteenth Amendment
was ratified, “three-quarters of the States had made
abortion a crime at any stage of pregnancy, and the
remaining States would soon follow.” Id. And the
Court did more than just recount the history. It definitively foreclosed any equal-protection claim that
might try to take the place of Roe.
Based on its precedent, the Court held that “abortion is not a sex-based classification and is thus not
subject to the ‘heightened scrutiny’ that applies to
such classifications.” Id. at 236 (citation omitted).
That is because the “regulation of a medical procedure
that only one sex can undergo does not trigger heightened constitutional scrutiny unless the regulation is a
‘mere pretex[t] designed to effect an invidious discrimination against members of one sex or the other.’”1 Id.
1 The United States does not argue pretext, but the private plain-
tiffs do. L.W. Br. 33–34. There are a host of problems with that
argument. Not only was it not pressed below, but the argument
also runs headlong into the presumption of legislative good faith.
That presumption requires courts to “draw the inference that
cuts in the legislature’s favor when confronted with evidence that
could plausibly support multiple conclusions.” Alexander v. S.C.
State Conf. of the NAACP, 602 U.S. 1, 10 (2024). So even if there
12
(alteration in original) (quoting Geduldig, 417 U.S. at
496 n.20).
The result is that the challengers’ frontline equalprotection argument falls under Dobbs and Geduldig’s
holdings. And neither the United States nor the private plaintiffs urge the Court to overturn those holdings—for good reason.2 Giving the States the same degree of deference when they regulate procedures only
one sex can undergo as they usually get for medical
regulations maps onto the history discussed. Nothing
in passing the Fourteenth Amendment remotely suggests that the Equal Protection Clause was meant to
override the States’ traditional role in regulating medicine—not when the medical regulation is based on
the “enduring” biological “differences between men
and women.” United States v. Virginia (VMI), 518 U.S.
515, 533 (1996).
As the Court explained long ago, “neither the
amendment—broad and comprehensive as it is—nor
any other amendment, was designed to interfere with
the power of the state, sometimes termed its police
power, to prescribe regulations to promote the health,
were some evidence that suggests pretext (there’s not), at a minimum that evidence also supports Tennessee doing its level best
to protect children.
2 Instead, they argue that Dobbs and Geduldig do not apply be-
cause both sexes can receive the medical interventions in question. E.g., U.S. Br. 26. But that conflates the medical interventions, which only one sex can undergo, with the drugs used in the
interventions. And we know that the former is what matters. The
Court in Dobbs looked to the “medical procedure” being regulated—not the drugs used in it. 597 U.S. at 241. And that makes
sense. It is the procedure (that is, the specific intervention being
done) that must factor in biological difference and whether only
one sex can undergo it.
13
peace, morals, education, and good order of the people.” Barbier v. Connolly, 113 U.S. 27, 31 (1884); see
also Terrace v. Thompson, 263 U.S. 197, 216–17
(1923). To be sure, “discriminating against some and
favoring others, is prohibited.” Barbier, 113 U.S. at 32.
But “legislation which, in carrying out a public purpose, is limited in its application, if within the sphere
of its operation it affects alike all persons similarly situated, is not within the amendment.” Id.
That historical understanding largely underlies
why regulations of medical procedures that only one
sex can undergo are not subject to heightened scrutiny—as it should. As Chief Judge Sutton noted below,
the challengers have not argued “that the original
fixed meaning” of the Equal Protection Clause “covers” their claim. L.W. ex rel. Williams v. Skrmetti, 83
F.4th 460, 471 (6th Cir. 2023). And as the history recounted in Dobbs shows, the States have regulated
medical procedures that only one sex can undergo
since before the Fourteenth Amendment was ratified.
That longstanding practice is no different from the
tradition of States regulating medical professions and
procedures or in areas of medical uncertainty and concerning children. And so the “traditional rule” applies
to Tennessee’s law. Gonzales, 550 U.S. at 163. Deference is due several times over.
3. If the Court overlooks that, if it waves away the
history of deference owed to States ensuring medical
interventions are safe and beneficial, then the consequences are clear.
For one thing, it would mean heightened scrutiny
would logically apply to other laws regulating medical
14
procedures that only one sex can undergo. From pregnancy, to abortion, to even the prohibition in Tennessee’s law on sex-transition surgeries for boys and girls,
heightened scrutiny would logically apply. And for another, it would mean the Court inserting itself right in
the middle of the public debate on transgender issues.
Of course, that includes a host of topics—from bathrooms, Grimm v. Gloucester Cnty. Sch. Bd., 972 F.3d
586, 613 (4th Cir. 2020), to healthcare-plan coverage,
Kadel v. Folwell, 100 F.4th 122, 133 (4th Cir. 2024)
(en banc), to sports, B.P.J. v. W.V. State Bd. of Educ.,
98 F.4th 542, 556 (4th Cir. 2024), to all manner of
things in between. But step back and look at the big
picture.
The Court would remove the debate over such issues from the democratic process. It would sideline
the States in an area where their power to legislate
should be at its peak. And it would impose a judicial
straitjacket across the nation, largely cutting off the
chance for diverse approaches. That is the opposite of
how our system is supposed to work. The States are
meant to serve “as laboratories for devising solutions
to difficult legal problems.” Ariz. State Legislature v.
Ariz. Indep. Redistricting Comm’n, 576 U.S. 787, 817
(2015) (citation omitted). Them doing so is one of the
“happy incidents of the federal system.” Whalen, 429
U.S. at 597 n.20 (quoting New State Ice Co. v. Liebmann, 285 U.S. 262, 311 (1932) (Brandeis, J., dissenting)). It lets the people try different approaches without affecting the whole nation in the hope of finding
lasting solutions. And that experimentation is not
something the Court should lightly cut off. “To stay
experimentation in things social and economic is a
grave responsibility.” Id. (citation omitted).
15
Chief Judge Sutton said it well below. “Given the
high stakes of these nascent policy deliberations—the
long-term health of children facing gender dysphoria—sound government usually benefits from more
rather than less debate, more rather than less input,
more rather than less consideration of fair-minded
policy approaches.” L.W., 83 F.4th at 472. The ability
of the States to engage in that debate and take those
different policy approaches is a “key premise” of our
federalist system. Id. That way, the “people’s electoral
representatives [can] identify the strengths and weaknesses of any policy,” leaving “the antidote for mistakes [to] the passage of time and the good sense and
self-interest of election-tenured public officials to fix
them.” Id.
Or take the D.C. Circuit’s description in Abigail Alliance. “The Alliance’s arguments about morality,
quality of life, and acceptable levels of medical risk are
certainly ones that can be aired in the democratic
branches, without injecting the courts into unknown
questions of science and medicine.” Abigail Alliance,
495 F.3d at 713. No doubt, that is because “the democratic branches are better suited to decide the proper
balance between the uncertain risks and benefits of
medical technology, and are entitled to deference in
doing so.” Id.
Or finally, consider how Judge Wilkinson put it in
Kadel. “Plaintiffs envision an Equal Protection Clause
that is dogmatic and inflexible, one that leaves little
room for a national dialogue about relatively novel
treatments with substantial medical and moral implications.” Kadel, 100 F.4th at 193 (Wilkinson, J., dissenting). If the Court adopts such an approach, that
would “encroach on a State’s prerogative under its
16
basic police power to safeguard the health and welfare
of its citizens.” Id. Indeed, the arguments over “puberty blocking drugs, cross-sex hormones, and gender
reassignment surgery” involve “matters of significant
scientific debate and uncertainty.” Id. And that means
arguments to a court “are advanced in the wrong forum. The right forum is a legislative hearing.” Id.
If the Court holds otherwise and constitutionalizes
this issue, then it will commit the cardinal sin of Roe
all over again. Rather than expanding substantive
due process to intrude on the States’ authority, this
time it would expand equal protection. But the result
would be the same. The Court just got out of the middle of deciding one issue of intense public debate that
is had no business being in. Dobbs, 597 U.S. at 232. It
should not step into the middle of another one.
The Court could not have been clearer in Dobbs.
“The permissibility of abortion, and the limitations,
upon it, are to be resolved like most important questions in our democracy: by citizens trying to persuade
one another and then voting.” Id. (citation omitted).
Transgender issues are among those important questions. They are some of the “numerous other difficult
questions of American social and economic policy that
the Constitution does not address.” Id. at 338 (Kavanaugh, J., concurring). So they are rightly left to
“the people and their elected representatives to resolve through the democratic process.” Id. That is who
decides.
To hold otherwise would do exactly what the Court
admonished the Roe Court for doing. Or take an even
more recent example. Just last term, the Court reversed the Ninth Circuit for expanding the Eighth
17
Amendment to short-circuit the democratic process as
it relates to homelessness. City of Grants Pass v.
Johnson, 144 S. Ct. 2202, 2216 (2024). The Ninth Circuit’s decision did not encourage “‘productive dialogue’
and ‘experimentation’ through our democratic institutions.” Id. at 2224 (citation omitted). Instead, under
the decision, courts froze their own preferences and
rules in place by judicial “fiat.” Id. (citation omitted).
And those rules only “produced confusion,” given that
the issuing courts were “removed from realities on the
ground.” Id. Worse still, they “interfered with ‘essential considerations of federalism,’ taking from the people and their elected leaders difficult questions traditionally” reserved to them. Id. (citation omitted). The
Court ultimately recognized that people disagree over
the best policy responses to homelessness. Id. at 2226.
So they can experiment on different approaches and
change them if they “find later another set works better.” Id. The key is that, “in our democracy, that is
their right.” Id.
No less so than when regulating what medical procedures are safe and beneficial for children suffering
from gender dysphoria.
II. Even under intermediate scrutiny, the equalprotection challenge fails.
States’ traditional power to regulate medicine explains why rational-basis review applies. But even if
the Court were to apply intermediate scrutiny, it
should still uphold Tennessee’s law. Intermediate
scrutiny requires a court to determine whether a sexbased classification “serves important governmental
objectives” and is “substantially related to the
achievement of those objectives.” VMI, 518 U.S. at 533
18
(citation omitted). That involves consideration of the
legitimacy of the government’s objective and chosen
means, and the relational fit between the two. See
Miss. Univ. for Women v. Hogan, 458 U.S. 718, 725
(1982) (explaining that the government must show a
“direct, substantial relationship between” its “objective and means”); Tuan Anh Nguyen v. I.N.S., 533
U.S. 53, 68 (2001) (“Having concluded that facilitation
of a relationship between parent and child is an important governmental interest, the question remains
whether the means Congress chose to further its objective—the imposition of certain additional requirements upon an unwed father—substantially relate to
that end.”).
Under this Court’s caselaw, where a State’s use of
a sex-based classification is neither motivated by sexbased normative judgments or stereotypes nor carried
out using sex as an awkward proxy for the State’s true
regulatory target, the classification survives heightened scrutiny. The lower-court decisions siding with
plaintiffs challenging laws like Tennessee’s have instead used heightened scrutiny’s means-end-fit analysis to impermissibly convert the court’s policy disagreement with the State’s law into a constitutional
problem. See, e.g., Doe v. Ladapo, No. 4:23cv114-RHMAF, 2024 WL 2947123, at *4–5 (N.D. Fla. June 11,
2024) (describing legislators and others who do not
support puberty blockers and cross-sex hormone interventions as “transgender opponents” and commenting that “the arc of the moral universe is long,
but it bends toward justice”).
But this Court’s sex-discrimination precedent has
never given courts license to substitute their policy
judgment for that of legislative bodies, especially on
19
disputed medical and scientific issues. In testing for a
substantial relationship between a State’s objective
and chosen means of achieving it, this Court has always recognized that legislatures still get to resolve
medical and scientific disagreements without second
guessing by the courts. That principle makes all the
difference here.
A. Intermediate scrutiny in sex-discrimination cases ferrets out illegitimate legislative objectives and means.
The courts siding against States that have enacted
laws like Tennessee’s have centered the intermediatescrutiny analysis on testing the validity of States’ policy and scientific or medical predictive judgments.
See, e.g., Brandt v. Rutledge, 677 F. Supp. 3d 877, 921
(E.D. Ark. 2023) (“The State failed to meet [its] burden
to show that the risks of [medical interventions for
gender dysphoria] substantially outweigh the benefits.”). But under this Court’s caselaw, cases are won
and lost on the legitimacy of the government’s objective and means. When the government’s objective is
legitimate and its means are not mired with awkward
sex-based proxies, this Court has not required that
the government prove to statistical certainty that its
chosen path is the best one or that its sex classification will ultimately accomplish its intended goal. Instead, a review of the caselaw reveals only two classes
of cases where sex-based classifications are invalid.
1. The first category of sex-discrimination cases in
which the government loses is where its objective is
illegitimate. A sex-based classification must serve an
“important governmental objective[ ].” Sessions v. Morales-Santana, 582 U.S. 47, 59 (2017). But this Court’s
20
decisions do not weigh the relative level of an objective’s importance, so long as the objective is not entirely arbitrary. See, e.g., Califano v. Goldfarb, 430
U.S. 199, 211 n.9 (1977) (“[A]dministrative convenience and certainty of result have been found inadequate justifications for gender-based classifications.”).
Rather, they focus on ferreting out government objectives that are altogether illegitimate under the Equal
Protection Clause.
The government invariably loses when its objective is rooted in a sex-based normative judgment concerning how men and women should behave, be regarded, or be treated simply by virtue of their sex. The
caselaw has variously described these normative judgments as “outmoded notions of the relative capabilities of men and women,” City of Cleburne v. Cleburne
Living Ctr., 473 U.S. 432, 441 (1985), “gross, stereotyped distinctions between the sexes,” Frontiero v.
Richardson, 411 U.S. 677, 685 (1973), and the “denigration of the members of either sex” by placing “artificial constraints on an individual’s opportunity,”
VMI, 518 U.S. at 533.
In case after case, this Court’s focus has been on
identifying and eliminating those sex-based normative judgments. See, e.g., Stanley v. Illinois, 405 U.S.
645, 648 (1972) (judgment that unmarried fathers,
but not mothers, are presumably unsuitable parents);
Stanton v. Stanton, 421 U.S. 7, 14 (1975) (reliance on
“old notions” that “it is the man’s primary responsibility to provide a home” and “girls tend to mature earlier than boys”); Orr v. Orr, 440 U.S. 268, 279 (1979)
(a State’s “preference for an allocation of family responsibilities under which the wife plays a dependent
role”); Caban v. Mohammed, 441 U.S. 380, 388 (1979)
21
(judgment that “a natural mother, absent special circumstances, bears a closer relationship with her child
than a father does” (cleaned up)); Kirchberg v.
Feenstra, 450 U.S. 455, 459 (1981) (judgment that
men, rather than women, should be designated as
managers of community property); Hogan, 458 U.S. at
730 (the “old view that women, not men, should become nurses”); J.E.B. v. Alabama ex rel. T.B., 511 U.S.
127, 137–38 (1994) (stereotyped view of how men approach jury service).
In each case, the government lost not because it
did a poor job of furthering the objective it set out to
achieve, but because its objective was constitutionally
illegitimate in the first place. When a State’s objective
seeks to impose or depends on these types of impermissible normative judgments and stereotypes, no
“close means-end fit” can rescue it. Sessions, 582 U.S.
at 68.
2. In the second category of sex-discrimination
cases the government invariably loses, it acts in furtherance of what may well be a legitimate objective.
But rather than drawing classifications to directly target the desired object of its regulation, the government instead uses sex as a clumsy proxy. See Craig v.
Boren, 429 U.S. 190, 198 (1976) (explaining that statutes will be held invalid when they use sex “as an inaccurate proxy for other, more germane bases of classification”); accord Hogan, 458 U.S. at 726.
In numerous cases, this Court has held invalid
well-meaning government action that used impermissible sex-based proxies. See, e.g., Frontiero, 411 U.S.
at 688 (using sex as a proxy for financial dependency);
Weinberger v. Wiesenfeld, 420 U.S. 636, 645 (1975)
22
(same); Califano, 430 U.S. at 214 (same); Wengler v.
Druggists Mut. Ins., 446 U.S. 142, 151 (1980) (same);
Craig, 429 U.S. at 201 (sex as a proxy for propensity
to drink and drive); Califano v. Westcott, 443 U.S. 76,
88 (1979) (sex as proxy for likelihood of familial desertion); VMI, 518 U.S. at 541 (sex as a proxy for suitableness for institution’s educational model); Sessions,
582 U.S. at 67 (sex as a proxy for propensity to accept
parental responsibility).
The rationale behind those cases is that the government has no legitimate reason to use sex as a proxy
when it can simply regulate the actual target of its objective. See Orr, 440 U.S. at 281 (concluding there was
“no reason . . . to use sex as a proxy for need” rather
than examining an individual’s circumstances); Wienberger, 420 U.S. at 653 (describing a sex-based distinction as “gratuitous” where “without it, the statutory
scheme would only provide benefits to those men who
are in fact similarly situated to the women the statute
aids”). That rationale separates heightened scrutiny
from rational-basis review, under which the State
may rely on non-protected traits or behaviors as a
proxy for the target of its objective. Mass. Bd. of Ret.
v. Murgia, 427 U.S. 307, 316 (1976) (“[W]here rationality is the test, a State ‘does not violate the Equal
Protection Clause merely because the classifications
made by its laws are imperfect.’” (quoting Dandridge
v. Williams, 397 U.S. 471, 485 (1970)).
23
B. Intermediate scrutiny does not allow
courts to override legislative policy judgments, especially in resolving ongoing disputes about medical interventions.
As explained above, this Court’s sex-discrimination caselaw has focused on eliminating sex-based
normative judgments and the use of sex-based proxies
in legislation. But the Court has recognized that
States may draw sex-based distinctions without running afoul of those two constitutional guardrails. See
VMI, 518 U.S. at 533 (recognizing that “[p]hysical differences between men and women . . . are enduring”
and the “two sexes are not fungible” (citation omitted)). Indeed, sometimes doing so is necessary. As the
Court has explained: “To fail to acknowledge even our
most basic biological differences . . . risks making the
guarantee of equal protection superficial, and so disserving it.” Tuan Anh Nguyen, 533 U.S. at 73.
1. Across various contexts, this Court’s precedents make clear that heightened scrutiny is not a license for courts to substitute their policy judgments
for those of a legislature. See, e.g., Gonzales, 550 U.S.
at 161–64; Turner Broad. Sys. v. FCC, 512 U.S. 622,
665 (1994). Indeed, so long as the government’s objective is not constitutionally illegitimate and the government avoids using clumsy sex-based proxies, a sexbased classification will be upheld regardless of
whether the Court thinks the policy is a good one.
Take Michael M. v. Superior Court of Sonoma
County, 450 U.S. 464 (1981), for example. There, the
Court upheld a California statute that criminalized
males engaging in sexual intercourse with an underage female, but not females for the reverse. Id. at 466
24
(plurality op.). As the lead opinion explained, the critical consideration was that the statute did not rest on
“invidious[ ] discriminat[ion]” or “sexual stereotypes.”
Id. at 475–76. Rather, it reflected the biological reality
that “young men and young women are not similarly
situated with respect to the problems and the risks of
sexual intercourse.” Id. at 471; see id. at 482
(Blackmun, J., concurring) (judging the statute a “sufficiently reasoned” response to pressing problems). So
assured that the legislature had a properly rooted rationale, the Court upheld the statute.
This approach holds even truer in the medical and
scientific context. As history bears out, the “normal
rule” is that courts must “defer to the judgments of
legislatures ‘in areas fraught with medical and scientific uncertainties.’” Dobbs, 597 U.S. at 274 (quoting
Marshall v. United States, 414 U.S. 417, 427 (1974)).
The United States treats heightened scrutiny as an
exception. See U.S. Br. 19. But this Court reaffirmed
its traditional approach once again in Gonzales, which
involved a challenge to Congress’s enactment of a ban
on partial-birth abortion. 550 U.S. at 132. At the time,
this Court applied heightened scrutiny to abortion
regulations. See id. at 146, 156. Yet once again it did
not attempt to resolve an ongoing “medical disagreement” about the “‘necessity or safety’” of partial-birth
abortions. Id. at 162, 164. Rather, the Court held that
the “medical uncertainty” itself “provide[d] a sufficient
basis” to uphold the challenged ban on a surgical intervention. Id. at 164. The Court thus deferred to Congress’s evaluation of competing risk-benefit considerations rather than impose its own preferred view of
the evidence.
25
2. This approach to heightened scrutiny makes
sense—and not only because of the States’ historic
power to enact health-and-safety regulations for medicine. Institutionally, legislatures are “far better
equipped than the judiciary” to set the rules for “complex and dynamic” issues. Turner Broad. Sys., 512
U.S. at 665–66; see Gonzales, 550 U.S. at 164.
Whereas courts are generally limited to considering
the evidence that the parties present under time and
resource constraints, see Greenlaw v. United States,
554 U.S. 237, 243 (2008), legislatures can conduct
hearings, commission investigations, and direct agencies to collect missing data. Legislatures, moreover,
need not wait for a new case or controversy to emerge
to update their judgments. They can react to new information as soon as it emerges—which is singularly
important in rapidly evolving areas of science.
Consider, too, the “risks of error.” L.W., 83 F.4th at
473. If the legislature errs, voters can select new representatives. If the judiciary gives a premature answer to a constitutional question, it risks shutting
down further investigation and continued debate. See
City of Grants Pass, 144 S. Ct. at 2224. This reality
also means that there are greater institutional risks
for the judicial than the legislative branch. In our representative system, legislatures derive their authority
and legitimacy directly from the people. See Bowsher
v. Synar, 478 U.S. 714, 722 (1986). The judiciary, however, exercises “neither force nor will, but merely judgment.” The Federalist No. 78, at 402 (Alexander Hamilton) (Gideon ed., 2001). So the courts assume a
greater risk should they declare something a scientific
“truth”—only to be proven wrong in a few years.
26
As this case illustrates, that risk is far from theoretical. The United States and the private plaintiffs
argue at length that Tennessee’s law cannot withstand heightened scrutiny because the district court
deemed Tennessee’s experts to have “exaggerated” the
risks of puberty blockers and hormones while understating their benefits. U.S. Br. 34–35, 41. But other
district courts, including ones otherwise amenable to
the United States and plaintiffs’ positions, have found
that the “safety and effectiveness of puberty blockers
and hormone therapy is uncertain and unsettled.”
K.C. v. Individual Members of Med. Licensing Bd. of
Ind., 677 F. Supp. 3d 802, 816 (S.D. Ind. 2023); see
Florida v. Dep’t of Health & Hum. Servs., No. 24-cv1080, 2024 WL 3537510, at *19 (M.D. Fla. July 3,
2024) (science is “reasonably disputed”).
And since the district court issued its decision below, new systematic reviews have found that the evidence for puberty blockers and hormones as an intervention for gender dysphoria is so weak that “[n]o conclusions can be drawn” about their safety and efficacy
for youth. Jo Taylor et al., Interventions to suppress
puberty in adolescents experiencing gender dysphoria
or incongruence: a systematic review, Arch Dis Child
at 13 (2024); see Jo Taylor et al., Masculinising and
feminising hormone interventions for adolescents experiencing gender dysphoria or incongruence: a systematic review, Arch Dis Child at 7 (2024). With so much
still unknown and debated it would be perilous to declare the issue settled—much less to do so based on
the record in a single case. The constitutionality of
more than 20 States’ laws should not turn on which
set of experts a single district judge happens to find
most persuasive.
27
*
*
*
In our federalist system, the States get to decide
within their borders what interventions are available
for boys and girls suffering from gender dysphoria.
Tennessee gets to decide that using puberty blockers
and hormones as an intervention is not sufficiently
safe or beneficial—that long-term it will do more harm
than good. No equal-protection challenge can change
that. Tennessee gets to choose caution and compassion based on its judgment just like other States can
choose differently based on theirs. Either way, the
States get to decide.
CONCLUSION
The Court should affirm.
28
Respectfully submitted,
RUSSELL COLEMAN
Attorney General
MATTHEW F. KUHN
Solicitor General
Counsel of Record
JOHN H. HEYBURN
Principal Deputy
Solicitor General
DANIEL J. GRABOWSKI
Assistant Solicitor
General
Office of the Kentucky
Attorney General
700 Capital Avenue,
Suite 118
Frankfort, KY 40601
(502) 696-5300
Matt.Kuhn@ky.gov
TIM GRIFFIN
Attorney General
NICHOLAS J. BRONNI
Solicitor General
DYLAN L. JACOBS
Deputy Solicitor General
DREW BYDALEK
Solicitor General Fellow
Office of the Arkansas
Attorney General
323 Center Street
Suite 200
Little Rock, AR 72201
(501) 682-6302
THEODORE E. ROKITA
Attorney General
JAMES A. BARTA
Solicitor General
JOHN M. VASTAG
Deputy Attorney General
Office of the Indiana
Attorney General
IGCS – 5th Floor
302 W. Washington St.
Indianapolis, IN 46204
(317) 232-0709
29
ADDITIONAL COUNSEL
TREG TAYLOR
Attorney General
of Alaska
AUSTIN KNUDSEN
Attorney General
of Montana
ASHLEY MOODY
Attorney General
of Florida
MICHAEL T. HILGERS
Attorney General
of Nebraska
CHRIS CARR
Attorney General
of Georgia
DREW WRIGLEY
Attorney General
of North Dakota
RAÚL LABRADOR
Attorney General
of Idaho
DAVE YOST
Attorney General
of Ohio
BRENNA BIRD
Attorney General
of Iowa
GENTNER DRUMMOND
Attorney General
of Oklahoma
KRIS KOBACH
Attorney General
of Kansas
ALAN WILSON
Attorney General
of South Carolina
LIZ MURRILL
Attorney General
of Louisiana
MARTY JACKLEY
Attorney General
of South Dakota
LYNN FITCH
Attorney General
of Mississippi
SEAN REYES
Attorney General
of Utah
30
JASON MIYARES
Attorney General
of Virginia
PATRICK MORRISEY
Attorney General
of West Virginia
BRIDGET HILL
Attorney General
of Wyoming
This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.