The U. S. Supreme Court has ruled today that Tennessee’s ban on gender-affirming care for transgender minors can remain in effect. In a 6-3 decision, the court upheld the law in U.S. v. Skrmetti, dealing a major blow to legal efforts challenging anti-trans legislation nationwide.
Chief Justice John Roberts wrote the majority opinion, stating the law does not violate the Equal Protection Clause of the Constitution, reasoning that it differentiates among minors based on age and medical purpose, rather than targeting transgender youth specifically. He emphasized that the Supreme Court’s role is not to weigh in on medical opinions or assert the wisdom of such laws, but to ensure that a “rational basis” exists.
In a strong dissent, Justice Sonia Sotomayor wrote:
“Tennessee’s law expressly classifies on the basis of sex and transgender status, so the Constitution and settled precedent require the Court to subject it to intermediate scrutiny. The majority contorts logic and precedent to say otherwise, inexplicably declaring it must uphold Tennessee’s categorical ban on lifesaving medical treatment so long as ‘any reasonably conceivable state of facts’ might justify it. Ante, at 21. Thus, the majority subjects a law that plainly discriminates on the basis of sex to mere rational-basis review. 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.”
She was joined by Justices Elena Kagan and Ketanji Brown Jackson.
Chase Strangio, the first openly transgender lawyer to argue a case before the Supreme Court, and co-director of the ACLU’s LGBTQ & HIV Project, issued a statement.
“Today’s ruling is a devastating loss for transgender people, our families, and everyone who cares about the Constitution,” said Strangio. “Though this is a painful setback, it does not mean that transgender people and our allies are left with no options to defend our freedom, our health care, or our lives. The Court left undisturbed Supreme Court and lower court precedent that other examples of discrimination against transgender people are unlawful. We are as determined as ever to fight for the dignity and equality of every transgender person and we will continue to do so with defiant strength, a restless resolve, and a lasting commitment to our families, our communities, and the freedom we all deserve.”
Sasha Buchert, counsel and director of the Nonbinary and Transgender Rights Project at Lambda Legal, also spoke out about the ruling.
“This is a heartbreaking ruling, making it more difficult for transgender youth to escape the danger and trauma of being denied their ability to live and thrive,” said Buchert. “But we will continue to fight fiercely to protect them. Make no mistake, gender-affirming care is often life-saving care, and all major medical associations have determined it to be safe, appropriate, and effective. This is a sad day, and the implications will reverberate for years and across the country, but it does not shake our resolve to continue fighting.”
The National Coalition for LGBTQ Health released a statement via email responding to the ruling.
“As public health leaders committed to advancing the health and well-being of LGBTQ+ communities, the National Coalition for LGBTQ Health and HealthHIV condemn this decision and the chilling precedent it sets. Gender-affirming care is not only medically necessary — it is a central component of effective, person-centered healthcare. National medical organizations and provider coalitions have affirmed this time and again. The Court’s retreat from its role in safeguarding civil rights opens the door to further restrictions in dozens of states, threatening an already vulnerable population and eroding trust in our health systems.
This is a developing story and we will bring you updates as they become available.