SCOTUS Upholds Tennessee Ban on Gender Affirming Care

In December the Supreme Court heard oral arguments in a challenge to Tennessee’s ban on Gender Affirming Care for minors. The media consensus at the time was that the liberals were in lockstep but the conservatives seemed unlikely to overrule the state’s ban.

Today, the Supreme Court released a 6-3 decision in the case written by Chief Justice Roberts. The majority sided with Tennessee allowing the ban to remain in place. More importantly, similar bans in about half the states will also remain in place.

The Supreme Court on Wednesday upheld Tennessee’s ban on gender-affirming care for trans minors in a blockbuster ruling that will bolster efforts by conservative state lawmakers to pass and preserve other divisive laws targeting transgender Americans.

The 6-3 decision by a conservative majority is a major blow to the transgender community and its advocates at a critical time. Since 2020, Republican-led states around the country have passed a wave of laws regulating the lives of trans Americans, with a particular focus on minors. And President Donald Trump, who ran for reelection in part on ending the “transgender lunacy,” has taken several steps intended to roll back gains made by that community.

Roughly half of the nation’s states have bans similar to Tennessee’s. Federal courts have disagreed on the constitutionality of those laws, and the Tennessee case, filed by the Biden administration, was the first to reach the high court.

The central argument in the case was a bit difficult to follow. ACLU lawyer Chase Strangio described it this way:

Strangio explains it like this: A birth-sex male who hits puberty too early can receive puberty blockers in order to later develop like other boys. A birth-sex female may also want to to receive puberty blockers in order to undergo puberty as a typical boy. So it is the same purpose, Strangio says, and what makes the treatment prohibited for the latter person is sex.

Of course in this example one person is delaying the puberty they would go through anyway to a slightly later date and the other person is blocking the puberty they would normally experience in order to undergo an alternative puberty regulated by the addition of cross-sex hormones. It’s not the same thing at all but it was the best argument the ACLU had to offer for why elected officials should have no role in determining state policy on this issue.

That is really what the case was about. Do the people and their representatives get a say in this or would the court take it out of the sphere of politics and render it untouchable the way abortion rights used to be untouchable before the Dobbs decision. Fortunately, this court left the decision in the hands of the states and the people.

The court in an opinion authored by Chief Justice John Roberts concluded that the Tennessee law does not constitute a form of sex discrimination that would violate the Constitution’s 14th Amendment.

“This case carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field,” Roberts wrote. “The voices in these debates raise sincere concerns; the implications for all are profound.”

“The Equal Protection Clause does not resolve these disagreements,” he added.

The court’s three liberals disagreed and Justice Sotomayor made a show of reading her dissent from the bench.

Liberal Justice Sonia Sotomayor wrote in a dissenting opinion that contrary the the majority’s conclusion, the law does discriminate based on both sex and transgender status and should therefore be analyzed closely.

“By retreating from meaningful judicial review exactly where it matters most, the court abandons transgender children and their families to political whims,” she wrote. “In sadness, I dissent.”

Reactions to the decision are still coming in.

Landmark VICTORY for Tennessee at SCOTUS in defense of America’s children! #Skrmetti pic.twitter.com/jqBao5MBNx

— TN Attorney General (@AGTennessee) June 18, 2025

I applaud today’s Supreme Court decision that allows states to protect vulnerable children from genital mutilation and other so-called “gender-affirming care” that leaves children permanently disfigured and scarred.

This Department of Justice will continue its fight to protect…

— Attorney General Pamela Bondi (@AGPamBondi) June 18, 2025