WASHINGTON — The Supreme Court on Wednesday upheld Tennessee’s ban on transgender medical treatments for minors.
The justices’ 6-3 decision in a case from Tennessee effectively protects from legal challenges many efforts by President Donald Trump’s Republican administration and state governments to roll back protections for transgender people. Another 26 states have laws similar to Tennessee’s.
Chief Justice John Roberts wrote for a conservative majority that the law banning puberty blockers and hormone treatments for trans minors doesn’t violate the Constitution’s equal protection clause, which requires the government to treat similarly situated people the same.
“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 for the court’s three liberal justices that she summarized aloud in the courtroom, Justice Sonia Sotomayor wrote, “By retreating from meaningful judicial review exactly where it matters most, the court abandons transgender children and their families to political whims. In sadness, I dissent.”
The law also limits parents’ decision-making ability for their children’s health care, she wrote.
Alabama in 2022 prohibited sex-change procedures and hormone treatments for minors. Alabama Attorney General Steve Marshall celebrated Wednesday’s decision.
“Until a few years ago, the notion of providing sex-change procedures to children was practically unthinkable,” Marshall said in a written statement. “So was the idea that the judiciary is the best branch to sort through the evidence and decide that kids suffering from gender-related psychological distress must be allowed to take powerful hormones that risk permanently changing their bodies and leaving them sterilized.
“I applaud the Supreme Court for recognizing that state governments have the authority and responsibility to regulate medicine in the face of medical interest groups that have placed radical gender ideology over evidence-based medicine and patient welfare.”
Some providers have stopped treatment already
Several states where transgender treatment for minors remains in place have adopted laws or state executive orders seeking to protect it. But since Trump’s executive order, some providers have ceased some treatments. For instance, Penn Medicine in Philadelphia announced last month it wouldn’t provide surgeries for patients under 19.
The president of the American Academy of Pediatrics, Dr. Susan Kressly, said the organization is “unwavering” in its support of gender-affirming care and “stands with pediatricians and families making health care decisions together and free from political interference.”
Five years ago, the Supreme Court ruled LGBTQ people are protected by a landmark federal civil rights law that prohibits sex discrimination in the workplace. That decision is unaffected by Wednesday’s ruling.
But the justices declined to apply the same sort of analysis the court used in 2020 when it found “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 was part of Wednesday’s majority.
Justice Amy Coney Barrett also fully joined the majority but wrote separately to emphasize that laws classifying people based on transgender status should not receive any special review by courts. Barrett, also writing for justice Clarence Thomas, wrote that “courts must give legislatures flexibility to make policy in this area.”