The U.S. Supreme Court has upheld a Tennessee law that prohibits body-mutilating surgeries and hormone treatments for trans-identified minors, affirming a lower court ruling.
In the case of United States v. Skrmetti, the high court ruled 6-3 that Tennessee’s Senate Bill 1 does not violate the Equal Protection Clause of the U.S. Constitution.
Chief Justice John Roberts delivered the majority opinion, joined by Justices Clarence Thomas, Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett. Justice Samuel Alito concurred with the judgment.
Roberts rejected the plaintiffs’ claim that the law engaged in sex-based discrimination, writing that “the law does not prohibit conduct for one sex that it permits for the other.” He explained, “Under SB1, no minor may be administered puberty blockers or hormones to treat gender dysphoria, gender identity disorder, or gender incongruence; minors of any sex may be administered puberty blockers or hormones for other purposes.”
Roberts also noted, “The plaintiffs fail to note that Tennessee also proclaimed a ‘legitimate, substantial, and compelling interest in protecting minors from physical and emotional harm.’ … And they similarly fail to acknowledge that Tennessee found that the prohibited medical treatments are experimental, can lead to later regret, and are associated with harmful — and sometimes irreversible — risks.”
Roberts emphasized the legitimate medical concerns over the use of puberty blockers for minors, citing recent developments in the United Kingdom, where the government has banned such drugs for children except for clinical trials for the foreseeable future.
“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.”
He concluded, “The Equal Protection Clause does not resolve these disagreements. Nor does it afford us license to decide them as we see best. … Having concluded it does not, we leave questions regarding its policy to the people, their elected representatives, and the democratic process.”
Justice Sonia Sotomayor authored a dissenting opinion, joined by Justice Ketanji Brown Jackson and, in part, by Justice Elena Kagan. “Tennessee’s law expressly classifies on the basis of sex and transgender status, so the Constitution and settled precedent require the Court to subject it to intermediate scrutiny. The majority contorts logic and precedent to say otherwise,” Sotomayor wrote.
“Thus, the majority subjects a law that plainly discriminates on the basis of sex to mere rational-basis review. 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,” she stated.
In March 2023, Tennessee passed Senate Bill 1, banning healthcare providers from performing genital mutilation surgeries or administering puberty-suppressing drugs to minors with gender dysphoria. In response, Multiple progressive groups supported by the Biden administration’s Justice Department sued to overturn the law, arguing on behalf of trans-identified children and their families.
