The Supreme Court on Wednesday upheld Tennessee's ban on gender-affirming care for transgender youth.
Three transgender minors, their parents and a doctor challenged Tennessee law SB1 that was enacted in 2023.
SB1 prohibits healthcare providers from prescribing, administering or dispensing puberty blockers or hormones to any minor for the purpose of enabling the minor to identify with, or live as, a purported identity inconsistent with the minor's biological sex. It also bans providers from treating purported discomfort or distress from a discordance between the minor's biological sex and asserted identity.
It does allow healthcare providers to administer puberty blockers or hormones to treat a minor's congenital defect, precocious puberty, disease or physical injury, according to the court.
The Tennessee law was challenged under the Fourteenth Amendment, which addresses equal protections under the law.
In a 6-3 vote in the United States v. Skrmetti, with Chief Justice John Roberts delivering the opinion of the court, the Justices upheld the law. Roberts wrote for a conservative majority that the law banning puberty blockers and hormone treatments for trans minors doesn't violate the Constitution's equal protection clause.
The decision protects from legal challenges many efforts by President Donald Trump's administration and state governments to roll back protections for transgender people, according to AP. Another 26 states have laws similar to Tennessee's, the AP report said.
The law limits parents' decision-making ability for their children's healthcare, said Justice Sonia Sotomayor, representing the court's three dissenting liberal justices.
"By retreating from meaningful judicial review exactly where it matters most, the court abandons transgender children and their families to political whims," she said.
WHAT THIS MEANS FOR PROVIDERS
Doctors may prescribe puberty blockers and hormone therapy to minors of any sex to treat some disorders, but not those relating to transgender status.
Some providers stopped transgender treatment after Trump issued an executive order earlier this year on gender affirming care.
For instance, Penn Medicine in Philadelphia announced last month it wouldn't provide surgeries for patients under 19, according to AP.
Dr. Jamila Perritt, an ob/gyn and president & CEO of Physicians for Reproductive Health said: "Let me be as direct as possible: The impact from this SCOTUS decision will harm transgender youth and criminalize providers for offering care to those who need it. Research has shown that access to gender affirming care is lifesaving for many young people, reducing the rates of depression, suicidal ideation and suicide attempts. Limiting or eliminating this care will have deadly consequences for these communities."
THE LARGER TREND: REACTION
Andy Marra, executive director of Advocates for Trans Equality (A4TE), said: "Transgender youth who are denied access to evidence-based medical care will now face increased risk of depression, anxiety, and suicide. Parents and families who have done everything to provide care and support for their children are now being told by the Court that their children's medical needs don't matter and that their children should be treated as second-class citizens."
Brittany Fonteno, CEO at the National Abortion Federation (NAF), said: "Today, the Supreme Court yet again failed to protect people's privacy, bodily autonomy, and freedom by allowing politicians to target transgender youth's healthcare. Very often, the same clinics offering abortion care are the ones providing gender-affirming care, including many NAF member clinics. Just like abortion bans, these politically-driven bans on essential healthcare are a threat to people's well-being and are not informed by medical expertise."
Email the writer: SMorse@himss.org