The Supreme Court has upheld Tennessee’s ban on providing such interventions as cross-sex hormones and puberty blockers for minors experiencing gender dysphoria.
In a 6-3 decision released on June 18, the court disagreed with the Biden administration’s argument that the law should face higher legal scrutiny than had been applied by an appeals court.
The U.S. Court of Appeals for the Sixth Circuit had upheld Tennessee’s law, stating that it passed something known as “rational basis” review, which is a relatively low level of scrutiny to determine whether the law is constitutional.
Chief Justice John Roberts wrote the majority opinion. Three of the justices—Justices Sonia Sotomayor, Elena Kagan, and Ketanji Brown Jackson—dissented from the decision.
“This case carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field. The voices in these debates raise sincere concerns; the implications for all are profound,” Roberts wrote. “The Equal Protection Clause does not resolve these disagreements. Nor does it afford us license to decide them as we see best.”
In a dissent joined by her liberal colleagues, Justice Sotomayor wrote that the majority “abandons transgender children and their families to political whims.”
The decision comes amid a range of other federal and state efforts to regulate the lives of transgender people, including which sports competitions they can join and which bathrooms they can use. In April, President Donald Trump’s administration sued Maine for not complying with the government’s push to ban transgender athletes in girls sports.
The Republican president also has sought to block federal spending on gender-affirming medical care for those under age 19 — instead promoting talk therapy only to treat young transgender people. In addition, the Supreme Court has allowed him to kick transgender service members out of the military, even as court battles continue. The president also signed another order to define the sexes as only male and female.
Trump's administration has also called for using only therapy, not broader health measures, to treat transgender youths.
The justices acted a month after the United Kingdom’s top court delivered a setback to transgender rights, ruling unanimously that the U.K. Equality Act means trans women can be excluded from some groups and single-sex spaces, such as changing rooms, homeless shelters, swimming areas and medical or counseling services provided only to women.
Five years ago, the Supreme Court ruled that transgender people, as well as gay and lesbian people, are protected by a landmark federal civil rights law that prohibits sex discrimination in the workplace. That decision is not affected by Wednesday’s ruling.
But the justices on Wednesday declined to apply the same sort of analysis the court used in 2020 when it found that “sex plays an unmistakable role” in employers’ decisions to punish transgender people for traits and behavior they otherwise tolerate. Roberts joined that opinion written by Justice Neil Gorsuch, who also was part of Wednesday's majority.
Tennessee Attorney General Jonathan Skrmetti on social media called the ruling a “Landmark VICTORY for Tennessee at SCOTUS in defense of America’s children!”