SCOTUS solidifies states' ability to ban trans care

• "The Court is greenlighting red state laws that will deeply affect the lives of marginalized and victimized people seeking health care, social acceptance, and dignity," Lawrence Gostin, co-faculty director at Georgetown's O'Neill Institute for National and Global Health Law, said in a statement.
• The decision does not affect the legality of gender-affirming care for kids in states without bans.

State of play: Justices ruled 6-3 on Wednesday that Tennessee's law does not discriminate based on sex, and regulates the practice of medicine. That means the state policy isn't subject to a higher level of legal scrutiny, Chief Justice John Roberts wrote for the majority.

• Tennessee's law takes aim at puberty blockers and hormone replacement therapies in connection to youths diagnosed with gender dysphoria specifically, the majority said. Therefore, the treatments could still be available for other diagnoses.

Between the lines: The ruling leaves open a legal pathway to overturn gender-affirming care restrictions if they can be shown to be harming transgender adolescents, Jennifer Levi, senior director of transgender and queer rights at GLAD Law, told Axios.

• She expects other state laws to be challenged on these grounds in the future.
• About 40% of transgender kids live in the 27 states that already limit access to gender affirming care for minors, per KFF. Of those states, 17 currently face legal challenges to their policies.
• Wednesday's decision also does not change the fact that it is illegal for employers to discriminate against someone because they are transgender.

Major medical associations endorse gender affirming care to treating gender dysphoria in minors. The overwhelming majority of youth who receive gender-affirming care report high levels of satisfaction and low levels of regret, research shows.

• The court's majority opinion acknowledged that if untreated, "gender dysphoria may result in severe physical and psychological harm."

• "The ruling also sets a dangerous precedent for legislative interference in the practice of medicine and the patient-physician relationship that is at the core of our health system," American Academy of Pediatrics President Susan Kressly said in a statement.

The other side: U.S. Attorney General Pam Bondi applauded the decision in a post on X.

• "This Department of Justice will continue its fight to protect America's children and parental rights. I encourage other states to follow Tennessee's lead and enact similar legislation to protect our kids," she wrote.
• The Trump administration, which sided with Tennessee during oral arguments in the case, is seeking to restrict gender-affirming medical care for kids nationwide.
• President Trump signed an executive order in January seeking to cut off federal funding for hospitals and institutions that provide gender-affirming medical services to minors. A federal judge halted the order, but the administration is appealing.
• The budget reconciliation bill moving through Congress currently would also prohibit federal Medicaid funds from being used for "gender transition procedures" for kids or adults.