A group of 164 members of Congress filed an amicus brief on Tuesday urging the U.S. Supreme Court to defend transgender Americans’ access to medically necessary healthcare as the justices prepare to hear oral arguments this fall in U.S. v. Skrmetti.

Lawmakers who issued the 27-page brief include House Democratic Leader Hakeem Jeffries (N.Y.) House Democratic Whip Katherine Clark (Mass.), House Democratic Caucus Chairman Pete Aguilar (Calif.), U.S. Sens. Ed Markey (D-Mass.) and Jeff Merkley (D-Ore.), and Congressional Equality Caucus Chair U.S. Rep. Mark Pocan (D-Wis.), along with the caucus’s 8 co-chairs and 25 vice-chairs. Ranking members of the powerful House Judiciary and House Ways and Means Committees, U.S. Reps. Jerry Nadler (D-N.Y.) and Frank Pallone Jr. (D-N.J.), were also among the signatories.

The case, among the most closely watched this term, will determine whether Tennessee’s ban on gender-affirming care for minors, along with a similar law passed in Kentucky, violate the Equal Protection Clause of the 14th Amendment.

In their brief, the lawmakers urge the Supreme Court to treat with skepticism “legislation banning safe and effective therapies that comport with the standard of care” and to examine the role of “animosity towards transgender people” in states’ gender affirming care bans.

“Decisions about healthcare belong to patients, their doctors, and their families—not politicians,” Pocan said. “The law at issue in this case is motivated by an animus towards the trans community and is part of a cruel, coordinated attack on trans rights by anti-equality extremists. We strongly urge the Supreme Court to uphold the constitution’s promise of equal protection under the law and strike down Tennessee’s harmful ban.”

“For years, far-right Republicans have been leading constant, relentless, and escalating attacks on transgender Americans. Their age-old, discriminatory playbook now threatens access to lifesaving, gender-affirming care for more than 100,000 transgender and nonbinary children living in states with these bans if the Supreme Court uphold laws like Tennessee’s at the heart of Skrmetti fueled by ignorance and hate,” Markey said.

“Transgender people deserve the same access to healthcare as everyone else,” said Nadler. “There is no constitutionally sound justification to strip from families with transgender children, and their doctors, the decision to seek medical care and give it to politicians sitting in the state capitol. I trust parents, not politicians, to decide what is best for their transgender children.”

Pallone warned that if Tennessee’s ban, S.B. 1, is “allowed to stand, it will establish a dangerous precedent that will open the floodgates to further discrimination against transgender Americans.”

“Unending attacks from MAGA extremists across the nation are putting trans youth at risk with hateful laws to ban gender-affirming care,” said Merkley author of the Equality Act. “Let’s get politicians—who have no expertise in making decisions for patients—out of the exam room. The Court must reject these divisive policies, and Congress must pass the Equality Act to fully realize a more equal and just union for all.”

Also filing an amicus brief on Tuesday was the Gender Research Advisory Council + Education (GRACE), a transgender-led nonprofit that wrote, in a press release, “Skrmetti  is critically important to the transgender community because approximately 40% of trans youth live in the 25 states that have enacted such bans.”

The group argued laws like Tennessee’s S.B. 1 are cruel, discriminatory, and contradict “the position of every major medical association that such treatments are safe, effective and medically necessary for adolescents suffering from gender dysphoria.”

GRACE’s brief includes 28 families “who hope to share with the Court that they are responsible, committed parents from a variety of backgrounds who have successfully navigated their adolescent’s transition.”

“These parents sought medical expertise for their children with diligence regarding the best care available and input from experienced physicians and mental health professionals and they have seen firsthand the profound benefits of providing medically appropriate care to their transgender children,” said GRACE Board Member and brief co-author Sean Madden.