The U.S. Supreme Court on Wednesday released an opinion that allows Tennessee to keep in place a ban on gender-affirming care for minors.

While seen as a setback for trans youth, a legal challenge in North Dakota is still active. The North Dakota case, which seeks to overturn a 2023 ban adopted by the Legislature, is moving through the state-level courts.

Brittany Stewart, senior staff attorney with the legal nonprofit Gender Justice, said proceedings in the bench trial are winding down. She said parents of transgender youth in this region might think the Supreme Court outcome permanently cuts off similar cases, but stresses they shouldn't jump to conclusions.

"I would like to tell people, especially folks who are parents of kids who might be suffering from gender dysphoria, not to give up hope," she stressed. "This is just one case, on one specific issue."

The Tennessee case focused solely on the U.S. Constitution's equal protection clause, and Stewart said the North Dakota case has other legal aspects to it. Republicans behind such bans argue they're trying to protect children, noting young people aren't mature enough for these decisions. But ban opponents say parents and doctors are deeply involved in discussing the lengthy process, and that gender-affirming surgery is rare for minors.

Stewart said the second main argument in her plaintiff's case is whether North Dakota's ban violates the right to personal autonomy. She added it's important to remember that the questions posed in this lawsuit have to do with the state constitution.

"The North Dakota Supreme Court has also said that the North Dakota Constitution isn't necessarily interpreted exactly the same as the U.S. Constitution," she continued.

She said if the judge rules in their favor, it's likely the state would appeal to the North Dakota Supreme Court. But there are questions about whether it would reach the U.S. Supreme Court because of the legal differences.

Analysts say the federal decision is still a big win for ban supporters in the nearly two dozen states that have them. But Stewart said the high court left an opening for future consideration if opponents can effectively prove such laws cause harm.


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Rural LGBTQ+ youth in Indiana face greater mental health challenges, but have found ways to build community online, according to a new report. 48% of the state's LGBTQ-plus youth live in a small city or town, according to the 2024 Survey on the Mental Health of LGBTQ+ Young People in Indiana study. The next largest region is the suburbs.

Michael Parent, principal researcher with HopeLab, said the demographic has difficulty finding support in their communities, compared to their urban peers, but noted that there are some positive trends too.

"They had a lot of sense of internal pride in their identity," he said. "So despite being in some more challenging circumstances, they also had really positive internal feelings about themselves."

Parent added that, while young LGBTQ+ people in rural areas struggle to connect in person, they often find friends online. Those communities can be based around a shared LGBTQ+ identity but can also involve a shared passion for gaming or art. 53% of this demographic in Indiana are aged 18-to-24, while 47% are between 13 and 17.

Data from the survey found that family and community are seen as places of affirmation - an environment of validation through a sense of belonging, safety, and respect. Parent agrees community plays an important role, but pointed to a lack of in-person support for rural LGBTQ+ youth.

"Rural LGBTQ+ young people are having a lot of challenges in their circumstances and environments," he added. "But finding that they had a lot of internal sense of pride in their identity is really positive and was surprising, because we didn't really think that would show up."

Other ways to show support for the community include not supporting politicians that advocate for anti-LGBTQ+ legislation, accepting their partner, and doing research about gender identities.


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Advocacy groups are speaking out about how they believe congressional cuts to Medicaid will disproportionately affect caregiver LGBTQ+ communities in Illinois.

Jaimie Worker, senior director of policy and research for the advocacy group Caring Across Generations, said Medicaid can be a lifeline for LGBTQ+ people who are aging or living with disabilities, especially those without traditional family support. She explained for many, care is provided by "chosen family" or friends, with support from Medicaid largely making that possible.

"LGBTQ+ communities are impacted in a unique way when it comes to self-directed care: being able to choose who your care provider is as an older adult or person with a disability," Worker pointed out. "Many of these programs are heavily supported by Medicaid."

She noted as people already face barriers to receiving the care they need, Medicaid cuts would unnecessarily force some into institutional settings like nursing homes, where they would never have chosen to receive care.

An estimated 700,000 people nationwide are on waiting lists to receive home- and community-based care through Medicaid. Last year, more than 15,000 were in Illinois. No matter how dire their need, Worker stressed people can wait years to access these services and LGBTQ+ individuals face additional barriers.

"Those are the folks who already know about the services; not everyone is aware about the services that are available. LGBTQ folks are also more likely to experience discrimination while trying to access care needs."

Currently, people who make less than $22,000 a year in Illinois could qualify for Medicaid. Worker predicts new federal qualifications will make it more difficult for people to qualify, even with extremely limited resources.

"And make it harder for people to live and age with dignity, and largely in their own homes and communities where most people would prefer to live and age," Worker underscored.

She reported starting July 24, Caring Across Generations will host a 60-hour vigil for Medicaid in Washington, D.C., to amplify the stories of caregivers, people with disabilities, older adults and families from across the country.

June is Pride Month, and people who fight for LGBTQ+ health care are speaking out against huge proposed cuts to Medicaid, known as Medi-Cal in the Golden State.

The U.S. Senate is about to vote on the reconciliation bill, known as the "One Big Beautiful Bill Act." Republican backers say they want to add more work requirements and make people reapply every six months.

Juan Carlos Guerrero, western regional organizing manager for the nonprofit Caring Across Generations, said that will kick eligible people off the program.

"This is part of a misinformation that we're trying to really address and make clear that these are cuts to Medicaid services that are going to be felt in the community around us," he said, "through people who use it for in-hospital services, people who use it for in-home supportive services."

The bill's supporters have said they want to use the Medicaid savings to fund an extension of President Donald Trump's 2017 tax cuts.

LGBTQ+ people are three to four times less likely to have children and twice as likely to be single and living alone as adults, so they often depend on Medicaid. Caring Across Generations is organizing a 60-hour vigil for Medicaid on the U.S. Capitol grounds July 24-26. By that time, Guerrero said, the Senate and House will have each passed their own version of the bill and will need to hash out a compromise.

"There will have to be a larger discussion between them to reach a strong consensus on what the cuts should include," he said, "but with both their packages being different enough where it will lead to larger-scale conversations."

The mobilization protests in July will also highlight some important anniversaries coming up. July 28 is the anniversary of the Americans with Disabilities Act, July 30 marks Medicaid's 60th birthday, and in mid-August, the Social Security Act will turn 80 years old.