Supreme Court Upholds Tennessee’s Ban on ‘Gender-Affirming Care’ for Minors

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The Biden administration had suggested the law constituted a form of sex-based discrimination.

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.

Writing for the majority, Roberts said that the law didn’t classify individuals on the basis of sex and therefore didn’t force courts to apply greater scrutiny. Instead, the majority said, the law classified individuals according to age.

Sotomayor, who penned the primary dissent, disagreed. “Tennessee’s law expressly classifies on the basis of sex and transgender status, so the Constitution and settled precedent require the Court to subject it to intermediate scrutiny,” she said.

“The majority contorts logic and precedent to say otherwise, inexplicably declaring it must uphold Tennessee’s categorical ban on lifesaving medical treatment.”

The case was perhaps the most hotly anticipated for the term. Besides touching on a hot-button issue, it prompted the justices to reconsider its 2020 decision in Bostock v. Clayton County, wherein the court held that employers violate the Civil Rights Act by firing an individual “merely for being gay or transgender.” More specifically, Justice Neil Gorsuch said that type of firing was effectively based on an individual’s sex.

The Biden administration attempted to apply that reasoning to say that Tennessee’s law discriminated on the basis of sex. Roberts disagreed in his majority opinion and said that the Bostock case didn’t apply to the decision before them.

Tennessee’s law, known as Senate Bill 1, prohibits health care providers from administering puberty blockers or hormones for the purpose of “enabling a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex” or “treating purported discomfort or distress from a discordance between the minor’s sex and asserted identity.”

By Sam Dorman

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