The long history of delimiting citizenship through the body

Beginning with the nation’s founding contradictions, Goodwin recalls how the Constitution’s compromises over slavery embedded the ownership and control of bodies into the architecture of American law. Laws designating the children of enslaved women as enslaved “tied slavery to forced pregnancy” and “fastened capitalism to rape” (Goodwin Reference Goodwin2026, 11). Goodwin’s historical lens reveals how the reproductive subjugation of Black women becomes the template for later denials of bodily autonomy: marital-rape exemptions under coverture, the coerced sterilizations dubbed “Mississippi appendectomies,” and, today, state-mandated childbirth in the wake of Dobbs.

Goodwin’s central claim is that the contours of citizenship in the United States have always been ambiguous and fluid. While the law’s definitions of who counts as a citizen have shifted over time, they remain tethered to hierarchies of race, sex, sexuality, ability, and economic status. From the Fugitive Slave Laws of the early republic to contemporary debates over embryonic personhood, Goodwin illustrates how the state has continually redrawn the boundaries of inclusion through the regulation of bodies. By linking the sexual violence endured by enslaved women to modern-day abortion bans and surveillance of pregnant people, she insists that the legal control of reproduction is not a discrete phenomenon but part of a centuries-long campaign to define the body politic through bodily conformity. Her invocation of Dr. King’s moral integration invites socio-legal scholars to connect reproductive injustice to other denials of bodily autonomy – including those directed at transgender and gender-nonconforming communities (Goodwin Reference Goodwin2026, 2).

Understanding Skrmetti through this lens transforms it from a dispute over medical policy into a constitutional moment in the ongoing politics of the body. Just as Goodwin situates post-Dobbs reproductive control within a history of racialized and gendered exclusion, the Skrmetti decision illustrates how the law continues to construct hierarchies of citizenship by determining whose bodies possess the privileges attached to full inclusion within the body politic.

Skrmetti and state regulation of gendered bodies

United States v. Skrmetti makes clear that sex remains a defining fault line in the American body politic – precisely the throughline Goodwin traces – revealing how contemporary constitutional doctrine echoes long-standing patterns of exclusion and control (Goodwin Reference Goodwin2026, 9). At issue in Skrmetti was the constitutionality of Tennessee’s ban on gender affirming medical care for minors – a statute that, like similar laws in more than twenty states, bars health care providers from providing puberty blockers, hormone therapy or surgical interventions to individuals under eighteen, but only if the treatment serves to align the individual with a gender identity different from their sex assigned at birth. Cis-gendered youth can continue to receive gender affirming care (Konnoth Reference Konnoth2025). A majority of the Supreme Court concluded that Tennessee’s ban regulates only the use of certain medical treatments for a particular purpose and restricts care based on age – classifications subject merely to rational basis review. In other words, according to the majority, bans on gender affirming care classify based on age and medical treatment rather than based on sex. Furthermore, the majority reasoned that such bans do not discriminate based on transgender status, relying heavily on the long discredited reasoning in Geduldig v. Aiello (1974). The Court declined to address whether transgender people constitute a quasi-suspect class, and thus whether discrimination against transgender individuals warrants heightened scrutiny similar to sex-based discrimination. Instead, applying rational basis scrutiny, the Court held that gender-affirming care bans reflect “sincere concerns” regarding “the safety, efficacy, and propriety of [these] medical treatments.” (Skrmetti 2025, 1836–37).

Justice Barrett concurred with the majority, but wrote separately to argue that transgender people do not constitute a quasi-suspect or suspect class deserving of heightened judicial scrutiny. Among other issues, Justice Barrett asserted that there was insufficient evidence of de jure discrimination against transgender people. Similarly, Justice Alito wrote in his separate concurrence that there was no “history of widespread and conspicuous discrimination [against transgender people] that is similar to that experienced by racial minorities or women” (Skrmetti 2025, 1866).

In contrast, Justice Sotomayor’s dissenting opinion argued that the ban should be subject to intermediate scrutiny because its provisions on their face constitute sex-based discrimination. Sotomayor’s dissent explained that the statute facially discriminates on the basis of sex because only children identified as male at birth are able to access male puberty hormones, and likewise only children assigned female at birth may access female puberty hormones (Skrmetti 2025, 1873). Criticizing the majority’s reliance on Geduldig v. Aiello despite its widespread disfavor, Justice Sotomayor further emphasized that Geduldig was nevertheless inapplicable because “the class of minors potentially affected by [Tennessee’s ban] and transgender minors are one and the same” (Skrmetti 2025, 1881). Justice Sotomayor also disputed the concurrences’ historical claims, detailing that transgender people in the United States “have been subject to a lengthy history of de jure discrimination” including “cross-dressing bans, police brutality, and anti-sodomy laws” as well as “discrimination in healthcare, employment, and housing” (Skrmetti 2025, 1881).

Where Dobbs reduced pregnant women to hosts for embryos and fetuses, Skrmetti reconstitutes transgender youth as potential victims of their own agency (Ben-Asher and Pollans Reference Ben-Asher and Pollans2024). In each instance, bodily autonomy is recast as a danger for the state to manage rather than a right to be respected. Understanding Skrmetti through Goodwin’s historical frame illustrates the broad stakes of the decision. The decision is not merely a contest over medical policy but a reaffirmation of law’s historical role in constructing the borders of civic belonging. By transforming bodily self-determination into a privilege contingent on conformity, the Court furthers the vision of citizenship wrought by Dobbs wherein only certain bodies – those legible within dominant norms of sex, gender and reproduction – can claim the full protections of the law (Katri and Sudai Reference Katri and Sudai2025).

Parallels between the regulation of reproductive and gender nonconforming bodies

The parallels between the regulation of abortion and the regulation of gender-affirming care are unmistakable. Both regimes – reproductive control and gender-identity control – construct bodily self-determination that contradicts gender norms as a social risk requiring containment. Both Dobbs and Skrmetti rely on Geduldig v. Aiello to recast sex-based discrimination as neutral regulation, allowing the Court to sidestep heightened judicial scrutiny (Eyer Reference Eyer2023). These decisions reduce bodily autonomy to a contingent privilege that can be denied when the state asserts a moral or paternalistic interest. In both sets of laws, the state invokes the protection of life or health to justify criminal prohibitions on health care: “protecting unborn life” in abortion bans, “protecting minors” in gender-affirming care bans. The effect, however, is the same – the erasure of self-determination for those whose bodies or identities threaten a traditional, binary gendered social order. Just as the pregnant person’s body becomes a vessel for state interests, the trans or nonbinary body becomes a site of moral panic (Woods Reference Woods2025).

The juxtaposition of Dobbs and Skrmetti reveals how the Court’s jurisprudence of bodily control over subordinated populations has evolved without ever abandoning the foundational logic that Goodwin traces back to the institution of slavery. In Dobbs, the Court selectively resurrected nineteenth-century norms to reimagine constitutional liberty as dependent on an imagined historical consensus, all while erasing the history animating the Reconstruction Amendments (Goodwin Reference Goodwin2022; Siegel Reference Siegel2023). In Skrmetti, the Court repackaged similar reasoning in the idiom of medical uncertainty, which notably was also an idiom used to justify abortion bans in Gonzales v. Carhart (2007) (Wuest Reference Wuest2025; Ahmed Reference Ahmed2015). Justice Barrett’s and Justice Alito’s concurrences stretch historical erasure even further, outright denying the existence of a history of discrimination against transgender individuals (Currah Reference Currah2024; Purvis Reference Purvis2024; Velte Reference Velte2025). And both reaffirm a vision of citizenship in which certain bodies – pregnant, queer, trans – serve as testing grounds for the state’s authority to define the limits of liberty as it pertains to the body.

The Skrmetti decision does not arise in isolation; it extends a long genealogy of state interventions that police the bodily autonomy of marginalized groups and, in turn, circumscribe their citizenship stature in the body politic. Goodwin’s address makes this genealogy visible. Her account of reproductive control – from the legal codification of slavery to the coerced sterilizations of the twentieth century – maps how the state has repeatedly claimed dominion over particular bodies in the name of social order, morality or paternalistic protection. That same logic underwrites contemporary bans on gender-affirming care.

Goodwin’s work invites scholars to see these domains not as parallel crises but as interconnected theaters of the same struggle. Skrmetti extends the apparatus of gender surveillance – such as criminal penalties for health care providers and patients as well as interstate conflicts over medical travel – into new terrain (Cohen et al. Reference Cohen, Donley and Rebouché2022; Goodwin Reference Goodwin2021). Both forms of regulation transform the Reconstruction Amendments’ promise of full and equal citizenship for all into a fluctuating status that can be withdrawn when the citizen’s embodied identity disrupts the state’s legally sanctioned visions of gendered bodies in the body politic.

These intertwined legal regimes of reproductive and gender-identity control also expose the intersectional character of bodily exclusion from full citizenship. Low-income people, racial minorities, women, and LGBTQ + individuals disproportionately bear the burdens of restricted autonomy (Manian Reference Manian2024; Walter-McCabe Reference Walter-McCabe2021; Walter-McCabe and Chen Reference Walter-McCabe and Chen2022). The same social determinants of health that limit access to reproductive health care – poverty, racism, geographic isolation – now restrict access to gender-affirming care. In both contexts, the state’s selective recognition of individual sovereignty over the body fragments citizenship along lines of identity, denying the full panoply of citizenship rights to those who challenge gendered and raced hierarchies.