The Supreme Court has upheld a controversial Tennessee law banning gender-affirming healthcare for minors, dealing a significant blow to trans rights across the United States.
In a 6–3 decision, the court ruled that the law, which prohibits doctors from prescribing puberty blockers or hormone treatments to under-18s for gender dysphoria, does not breach the Equal Protection Clause of the 14th Amendment. The clause was designed to prevent discriminatory laws, but the majority of justices argued that the Tennessee legislation does not discriminate, as it applies regardless of a minor’s sex.
Chief Justice John Roberts, writing for the majority, stated, “The Equal Protection Clause does not resolve these disagreements.” The court found that the law restricts specific treatments rather than targeting individuals based on gender identity.
In a strong dissent, Justice Sonia Sotomayor said, “This case is about whether Tennessee can forbid doctors from providing necessary medical care to transgender teenagers. The answer should be a resounding no.” She argued that the legislation intrudes on the essential relationship between doctors and patients and diminishes the dignity of transgender people. “The Constitution demands nothing less,” she added.
Justices Ketanji Brown Jackson and Elena Kagan joined Sotomayor in dissent.
The case, United States v. Skrmetti, was brought forward by families of transgender minors and healthcare providers who challenged the law. Despite their arguments, the court’s decision now sets a precedent that could see more states adopt similar bans.
Critics of the ruling say it disproportionately impacts transgender youth and undermines their access to life-saving medical care. They argue the law unfairly restricts treatments based on gender identity, as similar medical procedures remain available to non-trans youth.
Advocates warn that the decision will further stigmatise trans youth and intensify mental health challenges already affecting the community. Over 500 anti-LGBTQ+ bills have been introduced across the country in 2025, with over 100 targeting healthcare access.
The court’s ruling effectively allows states to enforce laws denying medically recognised treatments for trans adolescents, even as major medical bodies continue to affirm their benefits.
