Last week, the Supreme Court heard oral arguments in the case United States v. Skrmetti, which asks whether the state of Tennessee should be allowed to enforce its ban on gender-affirming care for youth.

Throughout arguments, several themes appeared in the questions coming from the Court’s conservative justices. One of these was the supposed risk of gender-affirming care.

“If the treatment’s barred, some kids will suffer because they can’t access the treatment. If the treatment is allowed … some kids will suffer who get the treatment and later wish they hadn’t and want to detransition,” Justice Brett Kavanaugh said. “And so there are risks both ways in here … it’s a difficult judgment call as a matter of policy.”

American Civil Liberties Union attorney Chase Strangio—who happens to be the first openly trans person to argue a case before the Supreme Court—appeared on behalf of the case’s original plaintiffs, several families and one physician. He pointed out that many of the figures about regret and detransition cited to justify bans on gender-affirming care are old, and often come from studies of very young children. At issue in Skrmetti are treatments like puberty blockers and hormones, which don’t apply to children who haven’t reached puberty.

“The evidence shows that once an adolescent reaches the onset of puberty, their likelihood to ultimately desist and identify with their birth sex is very low,” Strangio told the Court. In fact, according to more recent, better-designed studies, that rate is about one percent—or less.

But Kavanaugh was not the only justice who seemed to think that trans adolescents need to be saved from themselves. On several occasions, Justice Samuel Alito referenced recent guidelines from the Swedish government, as well as the United Kingdom’s Cass Review. In both cases, health authorities determined that benefits of gender-affirming care had not been demonstrated to outweigh its potential risks in all cases, and instituted new limits on access.

However, as U.S. Solicitor General Elizabeth Prelogar argued on behalf of the United States, neither Sweden nor the U.K. have banned gender-affirming care outright. Health officials in both countries recognize that gender-affirming care is necessary in at least some cases.

The Cass Review has also been widely criticized for its selective use of data and the bias at its very foundation. Notably, Dr. Hilary Cass was selected to lead the review because of her lack of experience providing trans health care. And the original “terms of reference” handed down by the U.K. government intentionally excluded “subject matter experts or people with lived experience of gender services” from the Assurance Group that guided the review process.

But even if risks and rates of regret were higher, would banning gender-affirming care really be good policy? According to many bioethicists, the answer is no.

This is thanks to a concept called the dignity of risk, which arose from the disability rights movement in the 1970s.

“Overprotection,” wrote disability rights advocate Robert Perske in a 1972 paper, undermines a person’s “individuality and growth potential,” smothers them emotionally, and prevents them from “experiencing the normal taking risks in life which is necessary for normal human growth and development.”

“There can be such a thing as human dignity in risk, and there can be a dehumanizing indignity in safety,” Perske wrote.

Since the 1970s, researchers and ethicists have applied this framework to many other areas of medicine. In 2014, bioethicist Katie Watson wrote a commentary in the Journal of the American Medical Association applying the framework to abortion.

Abortion and gender-affirming care are not the same thing—though abortion can be gender-affirming care. What they have in common is that they are hated by the same people, because both allow individuals to cast aside rigid, traditional gender roles and take control of their own sexuality and reproduction.

And let’s be extremely clear about one thing: It is very, very difficult to access gender-affirming care in the U.S. It requires tremendous determination and forethought. To suggest that young people who manage to overcome these barriers are doing so flippantly, or that providers and parents are acting recklessly in helping them, is insulting.

In another striking moment from yesterday’s arguments, Justice Amy Coney Barrett said she wasn’t aware of examples of “de jure” discrimination against trans people—in other words, government discrimination against trans people, as a group, enacted in the form of laws, which is the type of discrimination at issue in this case.

Strangio pointed out, among other things, the U.S.’s history of bans on cross-dressing. These bans date back to the mid-19th century, the same time that states also began to restrict abortion. Struggles for trans rights and reproductive rights in the U.S. are, and always have been, linked.

And ever since its 19th century origins, the American anti-abortion movement has been a sophisticated engine of disinformation. We now see the same people using the same playbook against trans people, and most despicably, against trans youth.

We see it in violence and threats of violence against care providers, a tactic long used by the anti-abortion movement to make its “abortion is dangerous” myth true—just not for the reasons the movement claims. We see it in the misleading and selective use of scientific evidence or outright pseudoscience. We see it in the cruel and disparaging claims made about trans people. We see it in the assertion that bans like Tennessee’s are simply about protecting people, especially children.

Countering misinformation requires spreading corrective information far and wide. It also requires critical thinking. So, let’s think critically about regret.

Another commonality between abortion and gender-affirming care is their low rates of regret. For example, the Turnaway Study found that after five years, 95 percent of participants still felt abortion was the right choice for them.

And, as Turnaway Study team member Corinne Rocca told me on my podcast, ACCESS, in 2021, of that five percent who report feeling regret, 90 percent still feel abortion was the right decision for them.

“I think it’s really important to distinguish decision rightness or decisional regret from having negative emotions or even the emotion of regret,” Rocca told me.

And even when people do make choices they regret, isn’t that part of what makes us human?

Failure, Watson, the bioethicist, told me, is “part of being an autonomous adult. That’s how you learn. That’s how you develop resilience.”

In a 2022 paper, psychologists Wendy Heller and Haley Skymba argued that the concept of dignity of risk can be applied to adolescent development as well. Not only is a certain amount of risk age-appropriate for young people, it helps them develop good decision-making skills. Rather than trying to save adolescents from themselves, they argue, parents and guardians should help them make their own decisions and learn from them—including when they make mistakes.

Rates of regret for elective plastic surgery not related to gender-affirming care range as high as 47 percent. Nearly 20 percent of people regret bariatric surgery. And around 10 percent of patients regret having knee replacements. Yet, we aren’t restricting these life-altering medical procedures based on their high levels of regret and dissatisfaction—including for young people. Why would we legislate based on fears of risk and regret around gender-affirming care, where these risks are objectively lower?

It comes down to whether or not you see trans people as, well, people—human beings who deserve dignity, the right to bodily autonomy, and the freedom to risk failure.