High Court Backs State Authority in 6-3 Ruling
In United States v. Skrmetti, the U.S. Supreme Court upheld a Tennessee law banning certain medical procedures for minors seeking gender transition. The 6-3 decision marked a major legal victory for Tennessee Attorney General Jonathan Skrmetti, who called it a “big win for democracy.” The Court ruled that Tennessee’s SB 1 does not violate the Equal Protection Clause of the Fourteenth Amendment, applying the least intensive form of judicial review—rational basis review.
Law Aims to Restrict “Irreversible” Interventions
SB 1 prohibits healthcare providers from administering puberty blockers, hormones, or surgeries to minors for gender transition purposes. The bill, signed into law by Gov. Bill Lee in March 2023, claims such treatments are experimental and lacking long-term scientific validation. Supporters argue the law protects children from potential long-term harm and ensures decisions are rooted in evidence-based care.
Legal Challenge Highlights Constitutional Concerns
Three transgender minors, their parents, and a doctor challenged the law, alleging it discriminates based on sex and transgender status. The plaintiffs argued SB 1 violated their Equal Protection and Due Process rights by preventing access to medically necessary care. The Department of Justice, under President Biden, initially joined the suit. However, the DOJ reversed its position following the 2025 administration change, stating SB 1 does not violate the Constitution.
Majority Opinion Rejects Heightened Scrutiny
Chief Justice John Roberts, writing for the majority, determined SB 1 does not target a protected class and is therefore subject to rational basis review. He noted the law applies equally to all minors and distinguishes based on medical purpose, not sex or gender identity. Roberts concluded that Tennessee had a legitimate interest in responding to ongoing medical debates about gender-related treatments.
Dissent Warns of Impact on Transgender Youth
Justice Sonia Sotomayor dissented strongly, accusing the majority of abandoning vulnerable children to “political whims.” She called the law a “categorical ban on lifesaving medical treatment.” Critics argue the ruling allows states to impose ideology-driven restrictions on evidence-backed medical care, setting a dangerous precedent.
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