The Supreme Court issued a decisive ruling on Wednesday backing Tennessee’s law that prohibits medical treatments intended to alter the biological sex of minors.
By a 6-3 margin, the justices upheld Tennessee’s statute, finding no violation of the Fourteenth Amendment’s Equal Protection Clause.
Chief Justice John Roberts, writing for the majority, recognized the intense and ongoing debates around the safety and appropriateness of such medical treatments.
“The voices in these debates raise sincere concerns; the implications for all are profound,” Roberts wrote.
He clarified that the Equal Protection Clause is not designed to settle such disputes, and these questions are better left to elected lawmakers and the democratic process.
The ruling analyzed Tennessee’s law, known as SB1, which includes two classifications: one based on age and the other on medical use.
The court rejected arguments from plaintiffs who claimed the law relied on impermissible sex-based classifications warranting heightened judicial scrutiny.
Instead, the court found that the law applies uniformly without regard to a minor’s sex.
“The application of SB1, moreover, does not turn on sex. The law does not prohibit certain medical treatments for minors of one sex while allowing those same treatments for minors of the opposite sex,” the opinion stated, according to The Post Millennial.
The court further dismissed claims that the law enforces government preferences about conformity to sex-based expectations, concluding any allegations of sex stereotyping were misplaced.
The justices found no evidence that the classifications were motivated by discriminatory intent, noting that the statutory findings underlying SB1 do not indicate sex-based stereotyping.
Tennessee passed SB1 in 2023 to prevent minors from receiving medical interventions that assist them in living as a gender “inconsistent” with their biological sex.
The Biden administration challenged the law, arguing it violated the Equal Protection Clause, The Daily Caller reports.
Justice Sonia Sotomayor, joined by Justices Ketanji Brown Jackson and Elena Kagan, dissented.
Sotomayor warned the ruling “authorizes, without second thought, untold harm to transgender children and the parents and families who love them.”
She referenced Trump administration policies targeting trans-identifying individuals, including the expulsion of trans-identifying servicemembers from the military and threats to withhold funding from schools and nonprofits that support “trans” rights.
The Trump administration’s Department of Justice shifted its stance on the case in February but urged the Supreme Court to proceed with a ruling.
Earlier in January, President Donald Trump signed an executive order cutting federal funding for gender transition procedures involving minors.
He criticized the World Professional Association of Transgender Health (WPATH) guidelines as “junk science” and barred federal agencies from citing WPATH’s recommendations.
The Biden administration, however, referenced WPATH standards in its legal briefs.
The ruling highlights a clear division on the court over how “trans” issues intersect with constitutional protections and state regulatory authority.
The majority held that such medical policy decisions fall within the domain of state legislatures and the democratic process, rather than judicial intervention.
Sotomayor’s dissent emphasized the real-world consequences for trans-identifying youth and their families, according to TDC.
She expressed concern over the potential for increased hardship due to restricted access to “gender-affirming care,” which supporters argue is critical for the well-being of trans-identifying minors.
The decision comes amid an escalating national conversation over “gender-affirming” healthcare and the rights of trans-identifying individuals, especially minors.
Several states have passed similar laws regulating or banning gender transition treatments for children, prompting legal challenges and sparking intense public debate.
