A Tennessee state law banning gender-affirming care for trans youth has been upheld by the Supreme Court in a devastating loss for trans rights in the US.
Supreme Court justices voted to allow the southern state to continue banning trans healthcare for under-18s in a 6-3 decision handed down on Wednesday (18 June).
The decision will likely serve as a legal precedent for future cases surrounding gender-affirming care bans in the US.
The case, US v Skrmetti, was brought to the court in 2024 after a group of families with trans children and a gender-affirming care provider sued Tennessee over its bill restricing trans youth care.
Chief justice John Roberts, writing for the majority, argued the ban did not violate the Equal Protection Clause of the 14th Amendment, which aims to stop authorities from passing discriminatory laws.
“[The bill] prohibits healthcare providers from administering puberty blockers or hormones to minors to treat gender dysphoria, gender identity disorder, or gender incongruence, regardless of the minor’s sex,” Roberts wrote. “The Equal protection Clause does not resolve these disagreements.”
Majority justices further claimed that the bill, which specifically targets trans youth, did not discriminate against trans and non-binary people.
Dissenting, justrice Sonia Sotomayor wrote: “This case is about whether Tennessee can forbid doctors from providing necessary medical care to transgender teenagers. The answer should be a resounding no.”
“These laws intrude into the heart of the doctor-patient relationship,” she wrote. “Transgender people deserve equal dignity in the eyes of the law. The Constitution demands nothing less.”
Sotomayor was joined in dissenting the ruling opinion by justice Kentanji brown Jackson and justice Elena Kagan.
Data collected by the American Civil Liberties (ACLU) suggests that at least 530 anti-LGBTQ+ bills have been proposed in 2025 alone, with 112 of those restricting healthcare in some form.
Representing the plaintiffs, ACLU attorney Chase Strangio argued in December that the law was inconsistent because non-trans patients were still able to take puberty blockers.
“The law restricts medical care only when provided to induce physical effects inconsistent with birth sex,” Strangio said. “Someone assigned female at birth can’t receive medication to live as a male, but someone assigned male can.
“If you change the individual sex, it changes the result. That’s a facial sex classification, full stop, and a law like that can’t stand on bare rationality.”
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