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Gay, Lesbian, Bisexual, Transsexual Rights

Fields v. Smith, 653 F.3d 550 (7th Cir. 2011)

Also under Civil Rights

Outcome:    Very favorable

Issue

The issue in this case was whether a Wisconsin law that prohibited prison doctors from using hormonal therapy or sex reassignment surgery to treat inmates with gender identity disorder (GID) caused the inmates to suffer cruel and unusual punishment under the Eighth Amendment or deprived them of equal protection of the laws under the Fourteenth Amendment.

AMA Interest

The AMA supports the provision of competent medical care for all patients, and it opposes limiting medical treatment options because of moral idiosyncrasies or social stigmas.

Case Summary

Persons suffering from GID feel that their physical sexual characteristics are the opposite of their internal sexual identity.  Thus, a GID sufferer is a man trapped in a woman’s body or vice versa. In addition to feeling depressed and frustrated, a sufferer may attempt self-mutilation or suicide.

A Wisconsin law prohibited prison doctors from using hormonal therapy or sex reassignment surgery to treat inmates with GID, regardless of the medical necessity of such therapies and regardless of the resultant disruption or financial cost to the prison system from withholding the therapy.  Several inmates in Wisconsin prisons sued to have the law declared facially unconstitutional.  Following an evidentiary hearing, the trial court judge found that the law violated the Eighth and Fourteenth Amendments.

The State of Wisconsin appealed to the Seventh Circuit.  The Seventh Circuit affirmed, holding that it would be cruel and unusual punishment, in violation of the Eighth Amendment, to withhold hormone therapy or sex reassignment surgery from prisoners with acute GID.

AMA Involvement

The AMA filed an amicus brief in the Seventh Circuit to support the prisoners.

Seventh Circuit Brief 

Gill v. Office of Personnel Management, 133 S.Ct. 2884 (2013)

682 F.3d 1 (1st Cir. 2012)

Outcome:    Very favorable

Issue

The issue in this case was whether the Federal Defense of Marriage Act (“DOMA”), 1 USC § 7, was constitutional.

AMA interest

The AMA opposes the stigmatization that arises from non-recognition of same-sex marriages.

Case summary

DOMA defined “marriage”  as “a legal union between one man and one woman as husband and wife,” to the exclusion of same sex marriages.

Three widowers and six married same-sex couples, who would otherwise have been otherwise have qualified for but were denied various federal benefits (i.e., Social Security survivor benefits, joint filing of taxes, tax exemption on spousal health insurance, federal employee health insurance) because of DOMA challenged the constitutionality of DOMA on equal protection grounds.  They claimed there was no rational basis for the federal government to deny married same-sex couples the same legal benefits and protections available to other married couples. 

While this case was proceeding, the Commonwealth of Massachusetts brought a similar suit.  Massachusetts claimed that, as a state, it alone had the power to make marital status determinations and the federal government could not simply override state determinations of which it disapproved.  Massachusetts also claimed that it was forced to discriminate against its own married citizens with respect to joint state-federal programs, such as Medicaid coverage for nursing home care. 

In both cases, the United States District Court found DOMA unconstitutional and entered judgment for the plaintiffs.  The United States appealed both decisions, and the cases were then consolidated.  Before the appellate briefing was completed the Department of Justice announced that it would no longer prosecute the appeal, as it itself considered DOMA to be unconstitutional.  The U.S. House of Representatives therefore intervened to defend DOMA’s constitutionality on appeal.

The First Circuit found DOMA unconstitutional.  The House of Representative then appealed to the Supreme Court.

By virtue of the holding in United States v. Windsor, 133 S.Ct. 2675 (2013), the Supreme Court affirmed and the Office of Personnel Management was ordered to provide equal federal benefits to a same-sex spouse of a federal employee.

AMA involvement

The AMA, along with several other health care organizations, filed an amicus brief in the First Circuit.  The brief, which opposes DOMA, presents scientific information on the nature of sexual orientation, the comparability of committed same-sex and different-sex adult relationships, and the factors affecting child welfare.  It concludes that there is no scientific basis for finding heterosexual relationships to be meaningfully superior to homosexual relationships.

United States Court of Appeals for the First Circuit brief

Golinski v. United States Office of Personnel Management, 133 S.Ct. 2887 (2013)

Outcome:    Very favorable

Issue

The issue in this case was whether the Federal Defense of Marriage Act, (“DOMA”), 1 USC § 7, was constitutional.

AMA interest

The AMA opposes the stigmatization that arises from non-recognition of same-sex marriages.

Case summary

A federal employee was married to another woman under the laws of California, her state of residence.  She claimed marital benefits from the federal government for her spouse, but the Office of Personnel Management denied her claims under DOMA.  The trial court held in favor of the employee, based on the right to equal protection implied under the Fifth Amendment Due Process Clause.

The United States Department of Justice declined to appeal, as it had itself determined that DOMA is unconstitutional.  Accordingly, a committee of the United States House of Representatives appealed the decision to the Ninth Circuit.  The Ninth Circuit held in favor of the employee.  The House of Representatives then appealed to the Supreme Court.

By virtue of the holding in United States v. Windsor, 133 S.Ct. 2675 (2013), the Supreme Court affirmed, and the Office of Personnel Management was ordered to provide equal federal benefits to a same-sex spouse of a federal employee.

AMA involvement

The AMA, along with several other health care organizations, filed an amicus brief in the Ninth Circuit.  The brief, which opposed DOMA, presented scientific information on the nature of sexual orientation, the comparability of committed same-sex and different-sex adult relationships, and the factors affecting child welfare.  It concluded that there was no scientific basis for finding heterosexual relationships to be meaningfully superior to homosexual relationships.

United States Court of Appeals for the Ninth Circuit brief

Hollingsworth v. Perry, 186 L.Ed.2d 768 (2013)

Outcome:    Favorable

Issue

The issue in this case was whether California’s “Proposition 8,” which amended the California Constitution to delegitimize same-sex marriages, violated the United States Constitution.            

AMA interest

The AMA believes that, from a medical viewpoint, same-sex marriages are as stable and as suitable for raising children as are opposite-sex marriages.

Case summary

As a result of a citizen initiative, the State of California amended its constitution to prohibit same-sex marriages.  The trial court and the United States Court of Appeals held that the amendment violated the Equal Protection Clause of the Fourteenth Amendment, as it discriminated against homosexual couples without a legitimate reason for doing so.

The case was appealed to the United States Supreme Court. Instead of ruling on the merits, the Supreme Court held, by a split decision, that neither it nor the Court of Appeals had jurisdiction to decide the substantive issue. In effect the Court upheld the trial court decision that had invalidated Proposition 8. The Court noted that the appeal had been brought by the proponents of Proposition 8, rather than an officer of the State of California. Because the Proposition 8 proponents were private citizens without a personal interest in the outcome, they lacked standing to bring the appeal.

AMA involvement

The AMA, along with the California Medical Association and several other health care organizations, filed an amicus brief to oppose Proposition 8.  The brief presented scientific information on the nature of sexual orientation, the comparability of committed same-sex and different-sex adult relationships, and the factors affecting child welfare.  It argued that there is no scientific basis for finding heterosexual relationships to be meaningfully superior to homosexual relationships.

United States Supreme Court brief

Windsor v. United States, 186 L.Ed.2d 808 (2013)

Outcome:    Very favorable

Issue

The issue in this case was whether the Defense of Marriage Act, 1 USC § 7 (“DOMA”), violated the right of equal protection guaranteed under the Fifth Amendment.

AMA interest

The AMA believes that, from a medical viewpoint, same-sex marriages are as stable and as suitable for raising children as are opposite-sex marriages.

Case summary

Section 3 of DOMA defined “marriage,” for purposes of federal law, as “a legal union between one man and one woman as husband and wife,” to the exclusion of same-sex marriages.   By virtue of that law, same-sex spouses of federal employees were denied government employment benefits available to spouses of heterosexual marriages. This case challenged the constitutionality of DOMA.

The case was appealed to the United States Supreme Court. The Court found that that Congress had intended to harm a politically unpopular group and had interfered with a function, the definition and regulation of marriage, within the realm of state law. By a split decision, it ruled that §3 of DOMA violated the due process and equal protection principles of the Fifth Amendment.

AMA involvement

The AMA, along with the California Medical Association and several other health care organizations, filed an amicus brief to oppose DOMA.  The brief presented scientific information on the nature of sexual orientation, the comparability of committed same-sex and different-sex adult relationships, and the factors affecting child welfare.  It argued that there is no scientific basis for finding heterosexual relationships to be meaningfully superior to homosexual relationships.

United States Supreme Court brief