Supreme Court upholds Tennessee ban on gender-affirming care for transgender youth
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A transgender rights supporter takes part in a rally outside of the U.S. Supreme Court on December 04, 2024. Photo: Kevin Dietsch/Getty Images
The Supreme Court on Wednesday upheld a state law banning gender-affirming care for transgender youth.
Why it matters: Roughly half the states have similar laws on the books — and more can now freely follow suit if they want to.
Driving the news: In a 6-3 ruling, the court said Tennessee can continue to enforce a ban on hormone therapy and other treatments.
- The central question in the case was whether Tennessee is simply regulating the practice of medicine or discriminating on the basis of sex. If it were the latter, the state would have to clear a much higher legal bar to defend its law.
- But the state does not have to meet that higher standard, Chief Justice John Roberts wrote for the majority.
"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," he wrote. "Questions regarding the law's policy are … appropriately left to the people, their elected representatives, and the democratic process."
What they're saying: Minnesota state Rep. Leigh Finke, the first openly transgender member of the state legislature, called the decision an "attack" on trans rights and the Equal Protection Clause in a media statement.
- "The ruling is not unexpected, but it doesn't mean the grave consequences are any less heartbreaking," Finke said. "The decision strikes at the heart of trans identity and the ability to live our full autonomous lives."
National Center for LGBTQ Rights Legal Director Shannon Minter says health care decisions belong with families, rather than politicians.
- "The Court's ruling abandons transgender youth and their families to political attacks," he said in a statement. "It ignored clear discrimination and disregarded its own legal precedent by letting lawmakers target young people for being transgender."
- Chase Strangio, co-director of the ACLU's LGBTQ & HIV Project, condemned the ruling as a "devastating loss for transgender people, our families, and everyone who cares about the Constitution."
The other side: Tennessee Attorney General Jonathan Skrmetti said in a statement that in the "historic Supreme Court win, the common sense of Tennessee voters prevailed over judicial activism."
Context: The Tennessee ban targets hormone therapies such as hormone replacement therapy and puberty blockers.
- The law specifically bars procedures that "[e]nable a minor to identify with, or live as, a purported identity inconsistent with the minor's sex" or "[t]reat purported discomfort or distress from a discordance between the minor's sex and asserted identity."
- Major medical associations, including the American Medical Association, endorse gender-affirming care for minors diagnosed with gender dysphoria.
- KFF policy experts warned last year that allowing the ban to stand leaves in place a patchwork of state laws on care access.
Flashback: In 2023, the ACLU and other legal advocates sued on behalf of a group of families and a medical provider to block the state's ban.
- The 6th U.S. Circuit Court of Appeals rejected a request to block the law.
Go deeper: Gender-affirming care drugs seldom used by kids: study
