AAMFT Statement on United States v. Skrmetti and 988 Lifeline Changes

The American Association for Marriage and Family Therapy (AAMFT) reaffirms its commitment to ethical, evidence-based gender-affirming care for transgender youth and opposes the recent Supreme Court ruling in United States v. Skrmetti.

On June 18, 2025, in United States v. Skrmetti, the U.S. Supreme Court issued a 6–3 ruling to uphold Tennessee’s restrictions on medically recognized gender-affirming care for minors, including puberty blockers and hormone replacement therapies. This ruling also entrenches the ban across nearly two dozen states that have laws similar to Tennessee’s restrictions.

AAMFT’s Gender-Affirming Care Position Statement articulates our conviction that gender-affirming care is clinically appropriate, ethical, and essential for many transgender adolescents. Care decisions—such as the timing and type of intervention—must be made collaboratively by qualified clinicians, the youth, and their families, consistent with best practices and the AAMFT Gender-Affirming Care: Guidelines for Working Systemically with Transgender, Nonbinary, and Gender Expansive Clients.

Research consistently shows that delaying or denying such care increases risks of suicide, depression, anxiety, and family distress. The Supreme Court’s ruling, by dismissing established clinical consensus in favor of speculation, threatens to worsen outcomes for transgender youth nationwide. We urge lawmakers to protect the patient–clinician relationship and protect access to personalized, best-practice care.

In parallel, the Trump administration has announced that as of July 17, 2025, the 988 Lifeline will discontinue its specialized messaging and phone services for LGBTQ+ youth—the “Press 3” option—despite its vital role in crisis intervention.

Since its launch in September 2022, that specialized service has supported over 1.3 million LGBTQ+ youth. Removing this tailored support at a time when LGBTQ+ adolescents continue to face disproportionate rates of depression, anxiety, and suicide risk, is both irresponsible and inconsistent with our core values. More information on working with LGBTQIA+ can be located at AAMFT Clinical Guidelines for LGBTQIA-Affirming Marriage and Family Therapy.

Chris Michaels, CEO of AAMFT, offered the following reflection on the Supreme Court decision and the rollback of LGBTQ+ services in the 988 Lifeline:

“What we are witnessing is not an isolated decision—it is part of an escalating, coordinated effort to roll back the rights and wellbeing of trans, nonbinary, gender expansive individuals and the broader LGBTQIA+ community. The Supreme Court’s ruling and the rollback of LGBTQ+ services on the 988 Lifeline are deeply concerning and dangerous, particularly for youth”

“At AAMFT, we believe in a world where every person has access to ethical, evidence-based care that supports their mental health, safety, and dignity. These attacks are not just political; they are personal to the families we serve and the therapists we support.”

What AAMFT members can do now!