Washington, D.C. — June 18, 2025
In a 6-3 ruling that could reshape civil rights litigation for decades, the U.S. Supreme Court has upheld Tennessee’s law banning gender-affirming medical care for minors. The decision, delivered in United States v. Skrmetti, declared that such treatment does not fall under protected class status—effectively greenlighting other states to follow Tennessee’s path.

The court’s conservative majority found that the law does not discriminate on the basis of sex, even as it prohibits treatments—like puberty blockers and hormone therapy—that are almost exclusively sought by transgender youth. “SB1 prohibits healthcare providers from administering puberty blockers or hormones to minors for certain medical uses, regardless of a minor’s sex,” the opinion stated.

But the liberal justices, in a searing dissent, accused the court of “abandoning” transgender children to “political whims,” pointing to the targeted nature of the legislation and its emotional, medical, and social consequences.

The case had become a legal and political lightning rod. Backed initially by the Biden administration and later abandoned under President Donald Trump, the plaintiffs—three transgender teens, their families, and a Memphis doctor—argued that the Tennessee law violated their constitutional rights. Civil rights groups like the ACLU and Lambda Legal joined the fight, calling the law cruel and unconstitutional.

However, the Court of Appeals reversed a lower court’s injunction, and the Supreme Court has now affirmed that decision—handing a major victory to Tennessee Republicans and their allies nationwide.

“This is a proud day for the Volunteer State and all who believe in protecting the innocence and well-being of America’s children,” said Tennessee’s House Republican Caucus in a statement. “The sterilization and disfigurement of children will no longer be normalized.”

Senate Majority Leader Jack Johnson, the bill’s sponsor, was blunt: “The simple message the Supreme Court has sent the world is ‘enough is enough.’”

But LGBTQ advocates see it differently.

“We are profoundly disappointed,” said the Tennessee Equality Project. “The Supreme Court has sided with anti-trans ideology and eroded the rights of transgender children and their families. This decision flies in the face of medical consensus and human dignity.”

Indeed, major medical organizations—the American Academy of Pediatrics, the American Medical Association, and others—support gender-affirming care as life-saving treatment. Many have cited data showing reductions in depression, anxiety, and suicide risk among trans youth who receive it.

Wednesday’s ruling rejects that argument. Instead, Chief Justice John Roberts, writing for the majority, sidestepped the medical and moral questions altogether: “Our role is not to judge the wisdom, fairness, or logic of the law before us,” he wrote, “but only to ensure that it does not violate the equal protection guarantee of the Fourteenth Amendment.”

The court found no “invidious discriminatory purpose,” despite the political fervor surrounding the bill and its national implications. According to Roberts, questions about transgender care belong not in courtrooms, but in legislatures.

But critics argue that the court’s logic fails to account for the lived experience of transgender people and the uniquely vulnerable position of trans youth in a country increasingly hostile to their existence.

In Tennessee, that hostility was palpable long before the court’s decision. Attorney General Jonathan Skrmetti, who brought the case to the high court, framed the ruling as a rebuke of “judicial activism.” “Common sense has won,” he said, thanking the legislature and Governor Bill Lee for “standing strong” against what he called “withering opposition from LGBT special interest groups, social justice activists, and even Hollywood.”

The ruling lands like a thunderclap amid a flurry of similar bills across red states. According to the Human Rights Campaign, more than 30 states are considering or have passed restrictions on gender-affirming care since 2023.

Now, with the highest court in the land legitimizing Tennessee’s restrictions, the legal path for challenging those laws has narrowed.

Still, many in the LGBTQ community and their allies are vowing to fight on.

“This is not the end,” said one of the plaintiff families in a brief statement outside the courthouse. “Our children deserve dignity, safety, and the freedom to be who they are. We won’t stop until they have it.”