STM Daily News
Supreme Court rules against trans girls participating in single‑sex sports, but leaves open larger questions of trans rights
The U.S. Supreme Court ruled on June 30, 2026, that West Virginia and Idaho did not violate the Constitution by preventing transgender students from joining female sports teams, and that states can restrict who participates on women’s and girls sports teams based on a student’s sex assigned at birth.
Marie-Amelie George, Wake Forest University
The U.S. Supreme Court ruled on June 30, 2026, that West Virginia and Idaho did not violate the Constitution by preventing transgender students from joining female sports teams, and that states can restrict who participates on women’s and girls sports teams based on a student’s sex assigned at birth.
This ruling, focused squarely on transgender students participating on single-sex sports teams, does not resolve other major questions that are important to trans rights. These issues include what bathrooms transgender or nonbinary students can use at school, as well as whether transgender individuals can update their names and gender markers on identity documents.
The court folded two related cases that address sports team participation at the middle, high school and college levels – Little v. Hecox and West Virginia v. B.P.J. – into one single decision that resolved both. The justices ruled 6-3 on the cases.
This ruling backs 25 other states that, over the past few years, have passed new laws restricting transgender students from participating on female sports teams.
Twenty-one states also have some sort of restriction on transgender and nonbinary students using school bathrooms designated by sex.
As a legal scholar and expert on LGBTQ+ rights, I believe that based on the court’s reasoning, it is likely that the conservative majority on the court would uphold states’ right to restrict school bathroom use based on sex assigned at birth. However, this ruling leaves bigger questions regarding transgender students’ broader rights in school, at work and elsewhere unanswered.
A political flash point
There were estimated to be fewer than 10 transgender athletes who participated in collegiate athletics in 2024.
But the issue of transgender students participating on sports teams is a hot-button issue for the Trump administration and Republicans, who argue that transgender female students have a biological advantage in competitive sports over athletes assigned female at birth.
The issue is nuanced and depends on factors including the athletes’ age and whether they have undergone gender-affirming hormonal therapy.
Some recent research shows that transgender female athletes who have undergone gender affirming hormone therapy have a comparable level of strength to cisgender female athletes.
What the rulings covered
At issue in these two Supreme Court cases were what protections Title IX – which bars sex-based discrimination in education programs and activities that receive federal funding – as well as the equal protection clause of the 14th Amendment gave transgender students.
Little v. Hecox challenged Idaho’s 2020 law that allows only students whose sex was designated female at birth to participate on girls and women’s school sports team.
Lindsay Hecox, a transgender female student at Boise State University, alongside a cisgender student, filed a lawsuit against the state in 2020. Hecox, now 24, could not try out for the school’s track and cross country team because of the law. She instead ran at the club level.
In West Virginia v. B.P.J., a transgender middle school student athlete named Becky Pepper-Jackson similarly sued the state so she could continue participating in track and field. Pepper-Jackson won a state title in girls shot put in May 2026.
The state’s 2021 Save Women’s Sports Act requires public middle schools, high schools and colleges to designate all school athletic teams by biological sex.
Understanding Title IX and how it applies
The Supreme Court determined that states are permitted to restrict sports team participation under Title IX and its regulations, which explicitly permit schools to have separate male and female sports teams.
The opinion started by emphasizing there are “enduring” physical differences between males and females, and that if there were unified sports teams, females could be at a disadvantage.
“Separate sports teams for biological males and biological females are reasonable: Given the inherent physical differences between the sexes, allowing only biological females to play on women’s and girls’ teams can reduce the risk of physical injury and ensure fair competition,” the court ruled in its opinion on West Virginia v. B.P.J., authored by Justice Brett Kavanaugh. Chief Justice John Roberts and Justices Samuel Alito, Clarence Thomas, Neil Gorsuch and Amy Coney Barrett joined the ruling.
Pepper-Jackson argued that this part of Title IX did not have relevance to her case because she had taken puberty blockers and never gone through male puberty.
As a result, she argued, she did not have heightened levels of testosterone or other physical differences that could raise the concern of a competitive advantage over cis female students in sports. She also posed no physical safety concerns for her teammates.
The court’s majority rejected this argument, saying that the Title IX regulations did not speak to this issue. The court recognized that although the laws might produce unfair results for someone like Pepper-Jackson, this did not make the restrictions improper.
The court added that Pepper-Jackson and other students in her position need to take up their concerns with state legislatures.
The court’s liberal wing – Justices Sonia Sotomayor, Elena Kagan and Ketanji Brown Jackson – agreed with the conservative majority that the laws did not violate Title IX.
The role of the equal protection clause
The court also addressed the equal protection clause of the U.S. Constitution, which says that the government must apply its laws fairly and cannot treat people differently without a valid reason.
The court’s conservative majority ruled that the laws distinguished based on sex, and as a result they scrutinized the laws more carefully. However, the court concluded that the athletic restrictions nevertheless passed constitutional muster.
Here, too, the court’s majority cited the interests of safety and competitive fairness as important justifications for the laws.
The liberal justices disagreed with their colleagues’ analysis. In their view, the laws were too broad to satisfy the Constitution, because they banned transgender girls who had never experienced male puberty from female sports teams.
A side step
The decision is a narrow one. The court went to great lengths to emphasize that it was focused on sports, and that the court was not being asked about transgender people’s rights more broadly.
In the court’s telling, sports are unique because competition depends on the physiology and physical differences between those assigned male and female at birth. That is important, because there are few circumstances in which the physical differences between males and females continue to be relevant.
In the past, many occupations and schools were sex-segregated. Today, bathrooms, school sports teams, changing facilities, some college residence halls, juvenile detention centers and prisons are among the last places that remain segregated by sex.
Moreover, the court avoided ruling on the constitutional standard that should apply when transgender people are discriminated against. Under constitutional doctrine, courts will more closely scrutinize laws that discriminate against historically powerless minority groups, such as people of color and women.
One of the open questions in transgender rights litigation is whether transgender people qualify for that more searching review.
This case did not resolve that issue.
The court’s narrow ruling on transgender athletes ultimately did not resolve other key issues for transgender rights, which the court will likely be asked to address at a later date.
Marie-Amelie George, Associate Professor of Law, Wake Forest University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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health and wellness
Zepbound Linked to Lower Healthcare Costs in Adults 55+ With Obesity, Real-World Study Suggests
A new real-world study of adults over age 55 with overweight or obesity found that sustained use of Zepbound (tirzepatide) for weight management was associated with lower healthcare costs over time compared with similar adults who were not treated. Eli Lilly and Company said the findings were driven in part by lower rates of hospital admissions and emergency department visits, and were published in Diabetes, Obesity and Metabolism.
What the study found
According to Lilly, researchers estimated healthcare cost differences over time (excluding the cost of Zepbound itself) using two established analytic methods. Across both approaches, monthly healthcare costs were lower, on average, among older adults who stayed on Zepbound.
Key estimates reported in the release include:
- At six months: costs were up to 15% lower (up to $181 per patient, per month).
- At 12 months: the estimated difference widened to as much as $607 per patient, per month, reflecting up to 38% lower costs than those not treated (estimates varied by model).
In the primary analysis, adults over 55 treated with Zepbound had lower rates of hospital admissions and emergency department visits across every follow-up period, along with numerically higher rates of routine outpatient and office visitsa pattern the company said was consistent with greater engagement in routine care.
Why Medicare is part of the conversation
Lilly said the cost findings may be relevant for older adults, including those in Medicares GLP-1 Bridge program. The company noted that beginning at six months, estimated healthcare savings nearly covered the programs monthly treatment cost of $195 per patient, per month, and by 12 months the estimated savings exceeded the reported monthly treatment cost.
Its important to note the release also emphasizes a limitation: claims data do not capture Zepbounds net price, and the study excluded the cost of Zepbound from total treatment costs. That means the reported differences reflect potential savings elsewhere in care that could offset treatment costs, not the full net cost impact.
Who was included in the analysis
The retrospective observational cohort study used Komodos Healthcare Map, a database of de-identified claims data from more than 330 million individuals enrolled in U.S. healthcare plans. The analysis included 15,843 adults over age 55 (mean age 64.5) with obesity or overweight plus at least one obesity-related complication who initiated Zepbound between November 2023 and September 2025. Each Zepbound user was matched 1:1 with a control participant who met the same eligibility criteria but did not initiate GLP-1 or GIP/GLP-1 receptor agonist medication.
What Zepbound is
Zepbound (tirzepatide) is a dual GIP and GLP-1 receptor agonist indicated for adults with obesity, or some adults with overweight who also have at least one weight-related medical problem, to lose weight and keep it off. Lilly also noted Zepbound is FDA-approved to treat adults with moderate-to-severe obstructive sleep apnea and obesity, and should be used alongside a reduced-calorie diet and increased physical activity.
Safety summary (high level)
The release includes an indications and safety summary with warnings. Among other risks, Lilly notes Zepbound carries a warning about thyroid tumors, including thyroid cancer, and may cause serious side effects such as severe stomach problems, dehydration leading to kidney problems, gallbladder problems, pancreatitis, serious allergic reactions, and low blood sugar (especially when used with certain diabetes medicines). Patients should talk with a healthcare provider about risks and whether the medication is appropriate for them.
Related Links
- Zepbound (official product site): https://zepbound.lilly.com/
- Lilly newsroom: https://www.lilly.com/news
- Journal page (publisher hub): https://dom-pubs.onlinelibrary.wiley.com/journal/14631326
- Medicare (official): https://www.medicare.gov/
- FDA MedWatch (side effect reporting): https://www.fda.gov/medwatch
Source
- PRNewswire / Eli Lilly and Company press release (Aug. 26, 2026): Zepbound linked to lower healthcare costs in adults over age 55 with obesity according to a real-world study
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Lifestyle
California and Minnesota Face $1B Medicaid Funding Hold
The Trump administration is withholding more than $1 billion in Medicaid funding from California and Minnesota over disputed medical claims. A social-policy historian examines how concerns about fraud have historically been used to justify funding cuts and undermine public confidence in Medicaid.
Ben Zdencanovic, University of Cambridge
California and Minnesota Face $1B Medicaid Funding Hold
The Trump administration announced on July 21, 2026, that it’s withholding US$867 million in federal healthcare funding for California and $200 million for Minnesota – a total of more than $1 billion.
Federal officials said the two states had failed to provide sufficient evidence that a number of disputed medical claims were legitimate. These include bills for in-home care and other services covered by the two states’ Medicaid programs for low-income residents.
Medicaid administrators say the funds can be recovered if the states supply the requested documentation. But the action is highly unusual: Typically, Medicaid officials partner with states to conduct an audit when they suspect fraud, a careful process that often takes years.
It’s the second time in 2026 that the Trump administration has withheld or deferred federal Medicaid funds for several states, including California and Minnesota, because of alleged fraud and abuse. The Democratic governors of those states have called the decision a politically motivated attack on their constituents.
I’m a historian of social policy who led the first comprehensive historical overview of Medi-Cal, California’s statewide Medicaid system. I’ve found that U.S. leaders have long used the language of fraud and abuse to blur the line between correcting very real failures within Medicaid and – as I believe the Trump administration is currently doing – discrediting and defunding the program itself.
Slashing the safety net
The Medicaid restrictions are part of the Trump administration’s overall efforts to slash federal funding for the safety net.
The large tax-and-spending bill that Trump signed into law in July 2025 as the cornerstone of his second-term agenda pared eligibility for Medicaid by introducing work requirements for some adults. It is cutting close to $1 trillion in federal spending on the program over the next decade.
Researchers estimate that almost 12 million people, on top of the estimated 28 million without health insurance in 2025, could become uninsured by 2034 due to these changes. By mid-2026, more than 3 million people had already lost their insurance coverage due to Republican changes to the Affordable Care Act.
‘Padlocking’ the ‘cookie jar’
In February 2026, Vice President JD Vance, Health Secretary Robert F. Kennedy Jr. and Dr. Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services, or CMS, announced a new anti-fraud initiative called Comprehensive Regulations to Uncover Suspicious Healthcare.
Also known by its rather unsubtle acronym, CRUSH, this initiative is taking unprecedented steps to withhold and defer funds in response to suspected fraud. “CMS is done trying to catch fraudsters with their hands in the cookie jar,” Oz said in announcing CRUSH’s formation. “Instead, we’re padlocking the jar and letting them starve.”
To be sure, Medicaid fraud, waste and abuse – such as providers billing Medicaid for services that are unnecessary or never rendered – are very real problems that cost taxpayers billions of dollars annually. They do divert funds from the low-income and disabled Americans enrolled in the program.
But the Trump administration’s latest moves are part of a much broader history of weaponizing Medicaid fraud and abuse – both real and imagined. I see them as a politicized attempt to prove that Medicaid itself is wasteful, that state governments cannot be trusted to administer federal money, and that public benefits inevitably invite dishonesty.
Providing little oversight at the start
Medicaid was established, along with Medicare for older adults, in 1965 as part of President Lyndon B. Johnson’s “Great Society” reforms. Despite providing millions of Americans with health insurance coverage for the first time, these programs had few centralized mechanisms for the kind of federal oversight that could prevent and catch fraud and abuse.
And the sheer scale and complexity of the Medicaid system – joint federal-state funding, varying eligibility requirements, millions of enrollees and thousands of providers – created opportunities for questionable billing practices among providers.
The 1970s saw a number of highly publicized Medicaid scandals involving nursing homes, laboratories, pharmacies and so-called “Medicaid mills” – healthcare providers that sought to bill the government for large numbers of Medicaid patients for shoddy and often fraudulent care.
A series of high-profile congressional investigations spurred demand for stronger Medicaid oversight and enforcement. That led to the Medicare-Medicaid Anti-Fraud and Abuse Amendments of 1977, which established the national Medicaid Fraud Control Units program.
The state-run Medicaid Fraud Control Units received generous federal matching funds to investigate and prosecute fraud.
The most serious Medicaid fraud was generally committed by healthcare providers and contractors, not patients. Medicaid Fraud Control Units were principally responsible for investigating providers, while also prosecuting the abuse and neglect of patients whose care was billed to Medicaid.
At the same time, however, Medicaid was becoming entangled in a broader political debate over social spending, whether many Americans were becoming too dependent on government benefits, and the alleged use of benefits by people who should not have received them. In the 1980s and 1990s, widely circulated stories about Medicaid exposed fraud and malfeasance by providers.
But disproportionately, they also highlighted the comparatively few instances of fraud by people enrolled in the program, such as cases where they submitted false receipts for covered medically related travel or sold drugs they obtained through Medicaid for free or at low cost.
Using Medicare fraud to justify spending cuts
The distinction between Medicaid and cash assistance programs, such as the Aid to Families with Dependent Children “welfare” program, frequently disappeared in political rhetoric. False or exaggerated stories that portrayed African American single mothers living extravagantly while fraudulently claiming welfare benefits became potent symbols of supposed government failure.
While campaigning as a presidential candidate, Ronald Reagan seized on this trope of the “welfare queen” in his attacks on social spending.
By the mid-1990s, opposition to welfare programs had become increasingly bipartisan. Politicians in both parties often used tales of Medicaid fraud on the part of providers and recipients to justify tighter eligibility rules and spending cuts.
Federal oversight expanded further with the Deficit Reduction Act of 2005, which created the Medicaid Integrity Program and strengthened federal oversight of state programs. The Affordable Care Act, the landmark healthcare legislation Congress passed in 2010, added new measures to screen providers and verify billing.
Concerns about Medicaid’s “integrity” became highly politicized in the debates surrounding the ACA. Critics of Medicaid expansion argued that increasing the number of people who could get health insurance through the program would increase fraud and improper enrollment. Supporters of expanding Medicaid to help more Americans gain health insurance maintained that anti-fraud rhetoric often disguised ideological opposition to the program’s expansion.
Blurring distinctions then and now
For the six decades that this program has helped millions of low-income Americans get healthcare, politicians have blurred the distinction between protecting Medicaid from abuse and using abuse to discredit Medicaid itself.
In my view, the Trump administration’s campaigns against California and Minnesota continue that pattern. It is using real weaknesses within Medicaid to advance much broader political arguments: that Democratic states cannot be trusted, that public benefits naturally invite abuse, and that withholding funds is itself a form of reform.
The result will no doubt be that fewer low-income Americans will be able to get the healthcare they need.
Ben Zdencanovic, Assistant Professor of U.S. History, University of Cambridge
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Community
9/11 Day Awards $3 Million in Grants to Expand Volunteer Opportunities Nationwide Ahead of 25th Anniversary
9/11 Day announced $3 million in grants to nearly 200 groups across 40 states, expanding service projects for the 25th anniversary observance.
As the United States approaches the 25th anniversary of September 11, 2001, the nonprofit 9/11 Day is putting major resources behind a familiar idea with renewed urgency: remembrance through service. The organization—founded by 9/11 families and leaders and co-led by co-founders David Paine and Jay Winuk—announced $3 million in grants to roughly 200 nonprofits, schools, and community groups across 40 states to expand local volunteer projects tied to this year’s September 11 National Day of Service and Remembrance.
The funding is designed to dramatically increase the number of ways Americans can participate close to home, from food insecurity initiatives to neighborhood cleanups and support programs for veterans and first responders. Together, grant recipients are expected to engage more than 70,000 volunteers nationwide.
A major push toward youth-led service
More than 70% of the grant funding is going to youth organizations and educational institutions, including K–12 schools, universities, and other learning programs. The emphasis reflects a generational reality: millions of students today know 9/11 primarily through textbooks, family stories, and classroom lessons.
“For many students participating in the observance this year, 9/11 is something they’ve only encountered in textbooks or through stories from parents and grandparents,” said Jay Winuk, co-founder and executive vice president of 9/11 Day and a 9/11 family member. “By connecting history with hands-on service, we’re helping young people understand that the legacy of 9/11 isn’t defined only by tragedy. It’s also defined by compassion, resilience and the responsibility we all share to care for one another.”
Youth-focused projects supported by the grants include school-wide days of service, hunger-relief efforts, donation drives, community improvement work, and service-learning initiatives that connect the history of September 11 with practical ways to help others.
UNIITE for Good: turning an anniversary into a nationwide “doing good” moment
The grant program is a cornerstone of 9/11 Day’s nationwide UNIITE for Good campaign, scheduled to officially launch August 24. The campaign aims to transform the 25th anniversary into what organizers describe as America’s largest day of doing good—channeling remembrance into tangible community impact.
The program is administered in collaboration with AmeriCorps, with principal funding provided by AmeriCorps and the Popeyes Foundation. A special emphasis this year is addressing hunger—an issue described in the release as an “ever-growing hunger crisis across the nation.”
Meeting community needs where people live
Grant-funded projects span urban, suburban, and rural communities. Activities include assembling meals for individuals and families facing food insecurity, packing care kits for veterans and first responders, restoring community spaces, and strengthening schools and neighborhoods.
Beyond the service itself, the grants are also intended to help local groups recruit volunteers, purchase supplies, coordinate logistics, and expand the number of service opportunities available in their areas.
“As we mark the 25th anniversary of 9/11, we have a responsibility to preserve not only the memory of that day and those lost and injured, but also the extraordinary way Americans came together in the aftermath of the attacks,” said David Paine, president and co-founder of 9/11 Day. “These community-led projects are helping rekindle that spirit of unity, compassion and service by bringing neighbors together to help solve local challenges.”
AmeriCorps echoed that message, framing service as a way to honor those who responded in the immediate aftermath of the attacks.
“This year, we invite Americans to carry forward that enduring spirit of unity and service by becoming a hero for someone in need,” said Emily Stock, project manager for Volunteer Initiatives at AmeriCorps, noting that AmeriCorps-funded projects will include food drives, home repairs, neighborhood cleanups, and disaster preparedness activities.
The Popeyes Foundation also highlighted its community-focused mission and its role in supporting local projects.
Why this anniversary matters now
Organizers say the 25th anniversary arrives at a pivotal moment: more than 100 million Americans are now too young to have personal memories of September 11. That makes this milestone one of the last major opportunities to connect those who lived through the day with younger generations learning about it as history.
Examples of grant-supported efforts include:
- Marshall University, which plans to build on its existing 9/11 Days of Service tradition, including a Memorial Stair Challenge and volunteer projects supporting veterans, first responders, and families in need.
- Middlebury Elementary School, which will expand hands-on service activities that teach younger students about 9/11 through compassion and community action.
- University of South Dakota, where students will work alongside community partners to address local needs while learning how service can bridge backgrounds and perspectives.
How to get involved
A full list of 2026 9/11 Day Grant Program recipients is available through 9/11 Day. To learn more about the September 11 National Day of Service and Remembrance—and to find ways to participate—visit 911day.org.
STM Daily News will continue tracking community service initiatives and local observances tied to the 25th anniversary as September approaches
