The US Supreme Court ruled 6–3 on June 18, 2025, that Tennessee’s law regarding gender-affirming care for minors, banning puberty blockers and hormones for transgender youth does not violate the Equal Protection Clause of the 14th Amendment.
The majority opinion, led by Chief Justice John Roberts, held that the law regulates medical treatment by age, not sex, and is subject to the more lenient “rational basis” review.
Majority vs. Dissent
- Majority view: Roberts emphasized the court’s role is not to assess the wisdom of the law but to ensure it’s constitutionally sound. He noted lawmakers, not judges, should handle policy decisions.
- Dissenting opinion: Justice Sonia Sotomayor, joined by Justices Jackson and Kagan, described the rule as gender-based discrimination hidden behind legal reasoning. She warned it abandons trans youth to politically driven harm.
Implications for Trans Youth
- The decision upholds similar bans in 26 states, affecting over 100,000 transgender minors.
- Major medical groups, including the American Medical Association, American Psychological Association, and World Professional Association for Transgender Health, support gender-affirming care as safe and beneficial.
- The ACLU, Lambda Legal, and other civil-rights advocates condemned the ruling as “outrageous and alarming,” arguing it denies critical, life-saving treatment to trans youth.
Beyond Tennessee
- The court’s decision under United States v. Skrmetti could embolden other states to enforce or enact similar restrictions.
- Although federal executive restrictions (like former Executive Order 14187) have faced legal challenges, federal and state legal battles are likely to continue.
Why This Matters
- The ruling shifts key health-care decisions to legislatures, not courts.
- It sets a precedent for legal review of youth gender-care policies under rational basis, not stricter judicial scrutiny.
- Mental-health professionals warn the decision could exacerbate suicide rates, anxiety, and depression among transgender youth.
The Supreme Court’s decision to uphold Tennessee’s ban on gender-affirming care for minors has effectively shifted the legal battleground to the states, leaving families, doctors, and advocates in a holding pattern. While the ruling refrains from addressing the medical merit of such treatments, it reinforces the authority of legislatures to shape policy in this space. For now, the future of trans healthcare for adolescents will depend not on a federal mandate, but on the state lines they happen to live within and the elected officials who govern them.
Leo Cruz brings sharp insights into the world of politics, offering balanced reporting and analysis on the latest policies, elections, and global political events. With years of experience covering campaigns and interviewing world leaders, Leo ensures readers are always informed and engaged.
