Supreme Court seems likely to uphold ban on gender-affirming care

Driving the news: The court heard oral arguments Wednesday over a Tennessee law that bans gender-affirming care for minors. Roughly half the states have similar laws on the books.

• The central question before the court is whether Tennessee is simply regulating the practice of medicine or discriminating on the basis of sex. If it's the latter, the state would have to clear a much higher legal bar to defend its law.

Three key conservative votes — Chief Justice John Roberts and Justices Amy Coney Barrett and Brett Kavanaugh — all seemed to come down on Tennessee's side.

• Kavanaugh cited medical disagreements and tight regulations in Europe, arguing that the science of gender-affirming care is unsettled and that the court should not "constitutional-ize" the issue.
• "For us to come in and choose one side of that, knowing that either way people are going to be harmed — there's no perfect way out," he said.
• Two other conservative justices, Clarence Thomas and Samuel Alito, are very unlikely to oppose the bans.

The intrigue: Just four years ago, the court ruled that firing trans workers because they are trans is a form of illegal sex discrimination. Advocates argued that the same logic should apply to health care.

• Justice Neil Gorsuch, a Trump appointee, wrote the majority opinion in that case, joined by Roberts and the court's liberals.
• Gorsuch did not ask any questions Wednesday, so there's no way to know whether he thinks the two cases are aligned.
• Even if he is inclined to side with the families challenging Tennessee's law, he would need to bring along at least one other conservative justice to achieve a majority.

Yes, but: Oral arguments are an indication of how the justices are thinking about a case, not a surefire prediction of how they'll ultimately rule.