Among the many battles between parents and governments, from public education to public health, none may be as consequential as when the state withholds children from their parents for not affirming the minors' gender confusion, for religious or other reasons.

Yet parents of potential and actual runaways from the Pacific to the Rockies may never get to press their First and Fourteenth amendment rights in court, under an appeals court ruling that found they aren't harmed by a 2023 Washington law deemed "state-sponsored kidnapping" and thus have no legal standing to sue before their children run away.

Five sets of parents and two nonprofits that help parents with children struggling with gender confusion, one of which has two dozen parent-members in the Evergreen State, filed their opening brief last week with the Supreme Court, which granted their petition in June.

Unlike parents challenging their children's exposure to LGBTQ themes or treatment as the opposite sex in public schools, endangerment from unwitting athletic competition against males or mandatory vaccination as a condition of even virtual public education, the Washington parents may lose their children entirely or even the knowledge of where they are located.

They received massive support in friend-of-the-court briefs before SCOTUS intervened, including from the California transgender child psychologist Erica Anderson, a critic of the pediatric gender transition field's lax standards.

Senate Bill 5599, signed into law by then-Democrat Gov. Jay Inslee and pushed through by the Democrat-led Legislature as "life-saving care" for transgender youth, not only allows youth shelters to hide gender-confused runaways from their parents but also refers them for puberty blockers, cross-sex hormones and surgery without parental notice or consent.

It works in conjunction with Inslee-signed House Bill 1406, which lets minors stay in a licensed shelter for up to 90 days without parental permission as long as they withhold their parents' contact information, and a 1985 law that allows minors 13 and older to receive outpatient treatment without parental consent. 

The lawsuit targets all three as unconstitutional.

The state holds all the cards for when and under which conditions to return such children to their parents as well, with "no effective deadline for contacting parents or returning the child," the brief says.

"Parents should not have to wait until their children are irreparably harmed to seek protection from courts," said senior counsel Ryan Gardner of First Liberty Institute. The nonprofit, Christian conservative legal group recently took over as co-counsel from America First Legal, which unsuccessfully sued to block the law from taking effect in 2023.

"The goal of the state should be reunification of families, not the separation of children from their parents," said Gene Schaerr, managing partner at the firm Schaerr Jaffe, which has represented the plaintiffs from the start as co-counsel.

Doctors face threats from gender-affirming Colorado, British Columbia

Democrat-led states are fighting the opposite battle with the Trump administration, suing to block a Department of Health and Human Services regulation issued last month that cuts off federal Medicaid and Children's Health Insurance Program funding for so-called gender-affirming care for minors but not for other conditions with the same treatment.

A week later, Christian doctors sued one of them, Colorado, to block a state law that forces them to participate in gender-affirming care for patients, including minors, against their "conscience and medical judgment," also on the basis that they offer hormones and procedures for conditions other than gender dysphoria.

Canadian provinces are also at odds with each other over medicalized gender transitions.

Echoing Washington state Democratic lawmakers, the Saddle Lake Cree Nation asserted its treaty rights to restore "life-saving healthcare" for younger teenagers in response to Alberta's prohibition on blockers and hormones for trans youth under 16, creating a sanctuary state for potentially irreversible treatment and recruiting medical professionals to provide it.

British Columbia's Human Rights Tribunal fined a Christian family doctor, Nigerian immigrant Henry Ajaero, roughly $28,000 last week for refusing to give the drug Lupron to a gender-confused minor, claiming his asserted religious beliefs didn't prohibit the treatment.

Officially indicated for the chemical castration of sex offenders but widely prescribed off-label as a puberty blocker, Lupron has a reputation for severe side effects.

Freedom of Information Act litigation by America First Legal revealed the Food and Drug Administration has known for nearly a decade that Lupron increases "suicidality," not just "intracranial pressure," and detransitioner Kayla Lovdahl's lawsuit against her gender-affirming care providers alleges Lupron gave her endocrine disorders.

Scalia: Legal standing not 'controversial' when majorities target minority rights 

Gender-affirming conditions on adoption and foster care have faced difficulty in courts on opposite sides of the country, including Washington's southern neighbor, but the 9th U.S. Circuit Court of Appeals, which has jurisdiction from Hawaii and Alaska to Montana and Arizona, refused to even consider the merits of Washington's runaway laws.

The parents allege they only altered their "parenting styles" to avoid "the looming 'threat'" of the laws, according to the three-judge panel, which notably included nominees of GOP presidents Trump and George W. Bush. Such injuries are self-inflicted because they are the result of "voluntary' actions" by the parents, not required by the laws.

The individual plaintiffs are parents of minor and adult children of both sexes who have "struggled" or "suffered from" gender confusion, including a "fragile" autistic male adolescent, an "older son [...] encouraged to run away" because his parents weren't affirming, and a girl who experienced rapid onset gender dysphoria at 12 and ran away briefly at 13. Two couples are identified as religious: Roman Catholics and nondenominational Christians.

The associational plaintiffs are International Partners for Ethical Care, whose members include Washington parents at risk from the laws, and Virginia-based Advocates Protecting Children, which particularly challenges the scientific credibility of gender affirming care.

The opening brief paraphrases the late Justice Antonin Scalia's 1983 law review article, which argued standing "should not be controversial" when a majority uses "a law or regulation to target a minority in a way that infringes their legal right."

Like the recent Supreme Court parental rights precedents Mirabelli and Mahmoud, newly invoked to support challenges to vaccine mandates and gender ideology in athletics, this "classic" case involves a deep-blue state trying to "curtail the exercise of legal rights by a political minority – parents whose beliefs about gender differ from those of the majority."

Washington laws "deliberately lure children to run away when they disagree with their parents on gender identity" and hang a "state-created Sword of Damocles" in plaintiffs' homes, which "forces them to avoid discussing gender-related issues with their children, using their children’s given names and biologically accurate pronouns, and implementing ordinary discipline."

Relying on the same SCOTUS precedent recently used by pro-life Louisiana to argue against mail-order prescribing conditions for an abortion pill – finding that California targeted fuel producers by requiring automakers to reduce production of gas-powered vehicles – the Washington parents argue they are "the object of the law" for standing purposes.

Yet the 9th Circuit ignored the Diamond precedent by requiring parents to show the laws "directly regulate" their speech and "immediate injury," regardless of how "drastic" the feared injury is – losing their children indefinitely, the brief says.