West Virginia et al. v. B.P.J.

In 2021, West Virginia’s “Save Women’s Sports Act” was signed into law, recognizing the reality of biological sex and restricting transgender women and girls from participating on women’s and girls’ sports team in public secondary schools and colleges.

However, the Fourth Circuit ultimately enjoined West Virginia from enforcing the law, and the state sought further review by the United States Supreme Court. Thereafter, a biological male, who identifies as female, sued the state, alleging violations of Title IX and the Equal Protection Clause of the Fourteenth Amendment. The Fourth Circuit ultimately enjoined West Virginia from enforcing the law, and the state sought further review by the United States Supreme Court.

In 2024 and 2025, Do No Harm filed amicus briefs at the Supreme Court in support of the State of West Virginia.

The briefs first explain (1) that sex is binary, rooted in biology, and distinct from gender identity, which is a psychological state; (2) that intersex conditions are rare disorders of sexual development and should not be conflated with transgender identity; and (3) that biology-denying interventions such as puberty blockers and cross-sex hormones are dangerous, lack compelling evidence, and carry unknown risks in addition to known physical harms.

The briefs go on to point out that the Fourth Circuit’s decision contains numerous glaring scientific and legal errors. For example, the appeals court (1) wrongly assumed that biology denying interventions are inevitably necessary and appropriate; (2) ignored or misunderstood the nature of sex as distinct from gender identity and the consequent fact that gender identity does not alter a person’s sex; and (3) mischaracterized the prevalence and relevance of intersex conditions to the dispute at issue.

On June 30, 2026, the United States Supreme Court held in favor of West Virginia, reversing the Fourth Circuit and concluding that the state may maintain separate women’s and men’s sports teams defined by biological sex and did not violate either the Constitution or Title IX in doing so.