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Notes -
To steelman, let's start with a different hypothetical law: African-Americans are prohibited from using metformin, and whites from using topiramate, for the treatment of weight loss, and for the sake of the hypothetical, assume that both formulations are off-label. In one sense, these are neutral laws, where both are prohibited from using a drug for a given diagnosis. In another sense, they aren't: one race is prohibited from using one drug, and another from another entirely different one. Recognizing them as 'similar enough' risks a bunch of absurd arguments, like banning one from doing something very common and the other from doing something that's facially similar but never actually desired. Similarly, it'd be nonsensical for it to be perfectly okay to do these laws as one unit, but consider them discriminatory if the state enacted them piecemeal.
That doesn't necessarily make them good or bad policy. Hence some of the specificity in my hypothetical: there actually are some reasons you might want gender- or race-specific restrictions on those two specific weight loss drugs. But because the aftermath of Caroline Products is such a clusterfuck, almost everything passes rational basis scrutiny, and the exceptions are so unusual that they're usually treated as some special not-really-just-rational-basis example. Heightened scrutiny is necessary before courts even consider whether a law's motivations are more than pretextual.
((This distinction is kinda what nara_burns is complaining about as a distinction between Kagan and the other left-leaners on the bench: Kagan recognizes that this is still an early preliminary injunction hearing and SCOTUS has had relatively little briefing on the facts, so it's should still be plausible for the state to present support for the bans that would survive intermediate (or even strict!) scrutiny.))
There's a lot of flaws to this steelman: the Caroline Products footnotes are completely unmoored in actual constitutional text, what types of discrimination and categorization gets protected is a result of arbitrary coincidence or political demand more than real analysis, courts routinely put their thumbs on whether a particular law is analyzed under one framework or another, so on.
((It doesn't help that the majority in this opinion is muddled, even by the low standards of a Roberts opinion. Whether a particular patient can be diagnoses with "male-pattern hair growth" is absolutely tied to biological reality, but that biological reality is a result of sex. And that's the example Roberts picked!))
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