United States v. Skrmetti is not distinct from these fights over reproductive rights — it’s their next phase. Before 2020, there was not a single law that banned access to gender-affirming care for trans people. Since then, nearly 36 states have attempted to restrict trans rights. This is not a coincidence. Recognizing the conservative turn of the courts, the Alliance Defending Freedom has drafted and promoted bills that restrict access to gender-affirming care. These model bills have been introduced in various state legislatures, contributing to a coordinated and successful strategy to limit transgender healthcare. These laws “are the result of an openly political effort to wage war on a marginalized group and our most fundamental freedoms,” writes Chase Strangio, Co-Director of the ACLU's LGBT & HIV Project.