![\""Trans](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/06\/trans-rights-rally.jpg\")
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Hundreds of trans people, activists and supporters rally outside of the Supreme Court of the United States in Washington, D.C., on December 4, 2024, as the Supreme Court hears the U.S. v. Skrmetti case.<\/p>\n
Marvin Joseph\/The Washington Post via Getty Images<\/p>\n
The U.S. Supreme Court has upheld a Tennessee law banning gender-affirming care for minors in the case U.S. v. Skrmetti<\/a>. In a 6\u20133 decision by the conservative supermajority, the court ruled that the state law, called Senate Bill 1 (SB1), does not violate the Equal Protection Clause of the Constitution by discriminating on the basis of sex\u2014despite the fact that the law forbids certain medical treatments<\/a> for young people based on their assigned sex at birth.<\/p>\n Why This Matters<\/b><\/p>\n The ruling is a major blow to transgender Americans\u2019 rights and protections, which have been under attack at the state and federal level<\/a>. The challenge to Tennessee\u2019s SB1 had been brought by three transgender adolescents, their families and a doctor. \u201cThis might seem like a small issue to others but it affects my whole world,\u201d wrote one of the plaintiffs, a then 12-year-old transgender boy, in a declaration submitted to the district court. \u201cI\u2019ve gone through a lot to finally get to the happy, healthy place where I am and I desperately hope that doesn\u2019t all get taken away from me.\u201d<\/p>\n On supporting science journalism<\/p>\n If you’re enjoying this article, consider supporting our award-winning journalism by subscribing<\/a>. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.<\/p>\n For anyone under the age of 18, SB1 banned medical treatments that aim to alleviate the symptoms of gender dysphoria\u2014a feeling of misalignment between someone\u2019s perceived gender and their assigned sex at birth. The law bans gender-affirming medical treatments, including puberty-blocking drugs and hormone therapies. There\u2019s no evidence of serious negative effects of these medications, though long-term use of puberty blockers may limit the buildup of bone mineral density.<\/p>\n Such medications have also long been used by nontransgender adolescents and children to treat a variety of conditions. Their use for gender dysphoria is currently supported by the American Medical Association, the American Association of Pediatrics, the American Psychological Association and other important medical institutions.<\/p>\n Research has shown that young people who experience gender dysphoria are at a high risk of depression and suicide. Those who receive care have better mental health outcomes, including decreased suicidal ideation, multiple<\/a> studies<\/a> have found<\/a>. In contrast, between 2018 and 2022, when states enacted antitransgender laws, suicide attempts among transgender young people increased by as much as 72 percent<\/a>. In the U.K., a ban on puberty blockers for transgender youth led to a sharp decline in mental health among this group, including increased depression, social isolation, and suicidal ideation, a recent study found<\/a>.<\/p>\n The Decision<\/b><\/p>\n In the Supreme Court\u2019s majority decision<\/a>, Chief Justice John Roberts pointed to \u201cfierce scientific and policy debates about the safety, efficacy, and propriety\u201d of the treatments. Many of those debates have largely been political, not scientific<\/a>, however.<\/p>\n The Court was tasked with deciding whether the law constituted sex discrimination under the Equal Protection Clause and should thus be subject to a higher level of judicial scrutiny. Plaintiffs argued that SB1 prohibits established medical treatments for some people and allows them for others based on individuals\u2019 assigned sex at birth. For example, in Tennessee, a teenager who had been assigned female at birth could not receive testosterone therapy, but a teenager who had been assigned male at birth could.<\/p>\n \u201cThe Equal Protection Clause does not resolve these disagreements,\u201d Roberts wrote in the majority opinion. \u201cNor does it afford us license to decide them as we see best. Our role is not \u2018to judge the wisdom, fairness, or logic\u2019 of the law before us … but only to ensure that it does not violate the equal protection guarantee of the Fourteenth Amendment. Having concluded it does not, we leave questions regarding its policy to the people, their elected representatives, and the democratic process.\u201d<\/p>\n In dissent, Justice Sonia Sotomayor wrote, \u201cTennessee\u2019s law expressly classifies on the basis of sex and transgender status…. The majority contorts logic and precedent to say otherwise, inexplicably declaring it must uphold Tennessee\u2019s categorical ban on lifesaving medical treatment…. By retreating from meaningful judicial review exactly where it matters most, the Court abandons transgender children and their families to political whims. In sadness, I dissent.\u201d<\/p>\n What the Experts Say<\/b><\/p>\n The Court\u2019s decision means that Tennessee\u2019s SB1 and any similar state laws do not merit heightened scrutiny from the judicial system to ensure they are appropriate. \u201cThis is unfortunate because the evidence base regarding gender-affirming care is overwhelming supportive of access to the care,\u201d says Elana Redfield, a LGBTQ+ policy expert at the Williams Institute at the University of California, Los Angeles. \u201cHowever, the legislature disregarded this evidence and relied instead on misinformation and conjecture when it passed the law\u2014and, one can argue, bias against transgender people.\u201d<\/p>\n Redfield notes that the case\u2019s outcome doesn\u2019t prevent states from passing laws to protect access to gender-affirming care\u2014as 14 states and Washington, D. C.<\/a>, have chosen to do. She adds that the ruling also does not prevent future challenges to antitransgender laws from being brought before the Court on different grounds.<\/p>\n Lawrence Gostin, co-faculty director of the O\u2019Neill Institute for National and Global Health Law at Georgetown University Law Center, has decried the Court\u2019s decision. \u201cIt\u2019s jaw-dropping to see a majority of Supreme Court justices turn a blind eye while transgender minors are flatly denied access to health services in consultation with their doctors,\u201d Gostin said in a recent press release<\/a>. \u201cThe Court is greenlighting red state laws that will deeply affect the lives of marginalized and victimized people seeking healthcare, social acceptance, and dignity. This decision paves the way for additional restrictions on other essential but politically fraught services, notably within sexual and reproductive health.\u201d<\/p>\n Read More about the Case and Transgender-Affirming Care<\/b><\/p>\n IF YOU NEED HELP<\/b><\/p>\n