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A highly significant Supreme Court decision is approaching, and the lives of trans teens and their families hang in the balance. United States vs Skrmetti will decide, once and for all, whether state bans on gender-affirming treatments are constitutional. If the court sides with Tennessee, its ban and other similar laws will remain in place. Nationally, access to gender affirming care has also been threatened by a presidential executive order and the Republican-dominated congress, but these efforts thus far have fallen short of a full ban.

At stake in Skrmetti, advocates say, is safety and stability for trans youth and their families. If the conservative-leaning court upholds state care bans, loving families fear the prospect that their children could be removed by state child protective services. (Due to the seriousness of these potential legal threats, this piece uses pseudonyms for trans youth and their families in states with bans.)

Why have some families decided to risk everything for these treatments? The answer, families say, is as simple as love. Those Teen Vogue spoke to describe how decisions to seek gender-affirming treatments sprang from the trust trans youth placed in their parents, and parents’ drive to do what’s best for the health of their children.