The court’s 6–3 ruling means other states that have passed or considered laws similar to Tennessee’s will likely survive legal challenges.
The Supreme Court has issued a major decision upholding Tennessee’s ban on so-called gender-affirming care, such as puberty blockers and cross-sex hormones, for minors. Its decision on June 18 will likely influence how states craft legislation and how other gender-related cases unfold in the legal system.
In the case United States v. Skrmetti, a majority of the justices disagreed with the Biden administration’s argument that Tennessee’s law should undergo more rigorous scrutiny in the courts. Instead, Chief Justice John Roberts said in his majority opinion that courts should apply a less rigorous standard known as rational basis, under which states have to show that their law is rationally related to a state interest.
The Tennessee law forbids all medical treatments intended to allow “a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex” or to treat “purported discomfort or distress from a [disagreement] between the minor’s sex and asserted identity.”
Roberts wrote that about 1.6 million Americans older than 13 “identify as transgender, meaning that their gender identity does not align with their biological sex.”
Here are some key takeaways from the decision and what to expect from future cases.
1. Laws Like Tennessee’s Are Constitutional
States across the country have passed or considered laws similar to Tennessee’s. With the Supreme Court’s new ruling, it seems more likely that such bans will survive future legal challenges.
Roberts said courts shouldn’t view the issue through the lens of sex-based discrimination, which would invite challenges to state laws under the equal protection clause of the 14th Amendment. The state law here forbids puberty blockers and hormone treatments based on the age of the patient, as opposed to the patient’s sex, he said.
The court’s language about Tennessee’s reasons for adopting the law also indicates that states could assert legitimate interests in shielding minors from risky procedures.
“Tennessee determined that administering puberty blockers or hormones to minors to treat gender dysphoria, gender identity disorder, or gender incongruence carries risks, including irreversible sterility, increased risk of disease and illness, and adverse psychological consequences,” the court said.
“The legislature found that minors lack the maturity to fully understand these consequences, that many individuals have expressed regret for undergoing such treatments as minors, and that the full effects of such treatments may not yet be known.”
By Sam Dorman and Matthew Vadum
