Topline
The Supreme Court upheld Tennessee’s law restricting gender-affirming medical treatments for minors, dealing a blow Wednesday to transgender rights that could have consequences nationwide, as more than two dozen states have imposed similar laws.
A transgender rights supporter rallies outside the U.S. Supreme Court on December 4, 2024 in … More Washington, DC.
Key Facts
The Supreme Court ruled 6-3 along party lines to uphold a federal appeals court ruling that backed Tennessee’s law, which ensures the law will stay in place.
The court was asked to weigh in on the legality of Tennessee’s law, which bans medication treatments that enable “a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex” or treat “purported discomfort or distress from a discordance between the minor’s sex and asserted identity.”
Chief Justice John Roberts wrote for the court’s majority that Tennessee’s law is not subject to a heightened level of judicial review—which would make it easier to strike down—and doesn’t unlawfully discriminate on the basis of sex, because it’s only based on a person’s age and their medical condition, in that it doesn’t allow treatments for minors who have gender dysphoria and other similar conditions.
Roberts argued the law also doesn’t discriminate based on a person’s transgender status, because transgender people could still seek medical treatments like puberty blockers for other medical conditions besides gender dysphoria.
The ruling upholds state bans on gender-affirming care for minors, but does not affect states where such treatments are still allowed, and does not make an overarching decision on whether or not the treatments should be outlawed—with Roberts writing the issue should be “appropriately left to the people, their elected representatives, and the democratic process.”
Liberal Justices Sonia Sotomayor and Ketanji Brown Jackson dissented from the opinion—with Sotomayor writing the court was “retreating from meaningful judicial review exactly where it matters most” and “abandon[ing] transgender children and their families to political whims”—and Justice Elena Kagan also dissented, but said while she thinks the law should be subject to greater scrutiny, she doesn’t have a view on whether or not it would be upheld under a stricter legal test.
Crucial Quote
“Our role is not ‘to judge the wisdom, fairness, or logic’ of the law before us … but only to ensure that it does not violate the equal protection guarantee of the Fourteenth Amendment,” Roberts wrote in his opinion for the court, noting the “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.”
What To Watch For
The court’s ruling was focused on Tennessee’s law specifically, so while it’s likely to make it harder for other similar state laws to be struck down, it does not prevent transgender rights advocates from bringing other lawsuits in the future challenging anti-transgender policies. It also does not affect other protections for LGBTQ rights that the court has previously issued, such as its ruling in 2020 that ensured workplace protections from LGBTQ-based discrimination.
Chief Critic
The American Civil Liberties Union and Lambda Legal, which brought the case against the Tennessee law, denounced the court’s decision on Wednesday, with Chase Strangio, Co-Director of the ACLU’s LGBTQ & HIV Project, describing it as “a devastating loss for transgender people, our families, and everyone who cares about the Constitution.” The ruling “mak[es]
it more difficult for transgender youth to escape the danger and trauma of being denied their ability to live and thrive,” Sasha Buchert, Counsel and Director of the Nonbinary and Transgender Rights Project at Lambda Legal said in a statement, adding that “the implications [of the ruling] will reverberate for years and across the country, but it does not shake our resolve to continue fighting.”
What Is Gender-Affirming Care?
The term “gender-affirming care” broadly refers to treatments “designed to support and affirm an individual’s gender identity,” according to the World Health Organization. Leading medical organizations in the U.S. broadly support the use of such care, including for minors, with the American Medical Association arguing “trans and non-binary gender identities are normal variations of human identity and expression, and … forgoing gender-affirming care can have tragic health consequences, both mental and physical.” The Tennessee case specifically focuses on medical treatments of providing puberty blockers or hormones, but gender-affirming care could also refer to psychological or behavioral treatments as well, like counseling or speech therapy. Hormone treatments help people physically transition genders, while puberty blockers are designed to delay the physical changes of puberty for transgender or gender non-conforming youth. The Mayo Clinic notes they are not permanent and puberty changes would resume whenever a person stops taking