The U.S. Supreme Court has upheld the state of Tennessee’s ban on gender-affirming care for children under 18.
Three transgender teenagers, their families, and a doctor sued the state after it implemented the ban in 2023.
They argued the law discriminated on the basis of gender, violating the U.S. Constitution.
The Supreme Court found the ban was lawful. Its decision can’t be appealed and could have consequences for other U.S. states.
Background
In 2023, the state of Tennessee passed a law banning gender-affirming medical care for anyone under 18.
It bars children’s access to surgery and treatment for gender dysphoria, a clinical condition marked by distress when someone’s gender differs from their sex characteristics.
It also forbids hormone therapy and puberty blockers, which pause the body’s production of testosterone or oestrogen. This can prevent changes like menstruation, breast development, voice changes, and facial hair. The medication’s effects are reversible.
Case
Three families and a doctor brought the case against the state of Tennessee.
They argued the ban discriminates on the basis of sex and transgender status, partly because it allows teen hormone therapies and puberty blockers to be used for reasons other than gender-affirming care.
They argued the law therefore breached the 14th Amendment in the U.S. Constitution, known as the “equal protection” clause, which bars states from depriving any citizen from equal legal protection to another citizen.
The case went through a series of appeals.
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Under former President Joe Biden, the U.S. Justice Department also challenged the Tennessee law, arguing it was discriminatory.
The matter was escalated to the U.S’ top court, the Supreme Court, whose decisions are binding and can’t be appealed.
Supreme Court justices are appointed through a political process. Six of the nine justices were nominated by Republican Presidents, and three by Democrats.
Judgement
In a majority opinion penned by Chief Justice John Roberts, the six justices appointed by Republicans noted the “sincere concerns” raised on both sides.
The justices said they could not judge the quality or fairness of the law, only whether it breached the Constitution.
“We leave questions regarding its policy to the people, their elected representatives, and the democratic process,” they concluded.
Justice Sonia Sotomayor, who dissented, wrote the ruling authorised “untold harm to transgender children and the parents and families who love them.”
Response
Tennessee Attorney General Jonathan Skrmetti called it a “landmark” decision.
The American Civil Liberties Union, a civil rights organisation that formed part of the legal team opposing the Tennessee law, called the ruling “heartbreaking”.
25 states have pushed ahead with bans on gender-affirming medical care, which the ACLU estimates impacts 100,000 transgender people under 18.
