The Supreme Court on June 18 delivered a landmark 6-3 decision upholding Tennessee’s law protecting children from being subjected to “transgender” medical procedures, marking a major victory for child advocate groups and opening the door for other states to enact similar protections.
At the center of the case, United States v. Skrmetti, was Tennessee’s 2023 Senate Bill 1, which prohibits the use of puberty blockers, cross-sex hormones, and surgical interventions on gender-dysphoric minors. State lawmakers defended the law as a necessary safeguard against irreversible harm.
The Biden administration’s Department of Justice, joined by activist groups including the American Civil Liberties Union, challenged the law, claiming it violated the Equal Protection Clause of the 14th Amendment.
Writing for the majority this week, Chief Justice John Roberts rejected that argument, emphasizing that such policy debates do not belong in the courtroom.
“The Equal Protection Clause does not resolve these disagreements. Nor does it afford us license to decide them as we see best,” Roberts wrote. “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.
“Having concluded it does not,” he continued, “we leave questions regarding its policy to the people, their elected representatives, and the democratic process.”
The opinion cited Tennessee’s legislative findings that these procedures “‘can lead to the minor becoming irreversibly sterile, having increased risk of disease and illness, or suffering from adverse and sometimes fatal psychological consequences.’”
Notably, all three liberal justices dissented, with Justice Sonia Sotomayor claiming the Tennessee law “discriminates on the basis of sex.”
Alliance Defending Freedom (ADF), which filed an October 2024 friend-of-the-court brief in support of Tennessee, praised the ruling as a “monumental victory for children, science, and common sense.”
“No one has the right to harm a child,” ADF CEO and President Kristen Waggoner said. “The Biden administration and ACLU asked the court to create a ‘constitutional right’ to give children harmful, experimental drugs and surgeries that turn them into patients for life. This would have forced states to base their laws on ideology, not evidence — to the immense harm of countless children.”
Twenty-six other states have enacted similar laws, according to ADF.
The ruling comes amid growing public opposition against the promotion of “transgender” procedures for minors.
In May, a Department of Health and Human Services (HHS) report found “very weak” scientific evidence supporting so-called “gender-affirming care,” while warning of serious long-term risks.
Several hospitals have also suspended the harmful procedures after President Donald Trump signed a January executive order against the “mutilation” of children.