The Supreme Court upheld the state of Tennessee’s ban on irreversible transgender procedures for minors, a major victory for parental rights advocates and those seeking to protect distressed children from harmful operations.
The justices ruled 6-3 in United States v. Skrmetti, with all of the conservative justices opting to allow Tennessee’s ban to remain in place and the liberal justices dissenting. The ruling will likely allow similar bans in more than 20 other red states to be upheld in the face of legal challenges.
“Tennessee’s law prohibiting certain medical treatments for transgender minors is not subject to heightened scrutiny under the Equal Protection Clause of the Fourteenth Amendment and satisfies rational basis review,” the court’s opinion reads.
Chief Justice John Roberts wrote the majority opinion, with justices Amy Coney Barrett, Clarence Thomas, and Samuel Alito writing concurring opinions. Justices Sonia Sotomayor and Elena Kagan filed dissenting opinions.
“I applaud today’s Supreme Court decision that allows states to protect vulnerable children from genital mutilation and other so-called “gender-affirming care” that leaves children permanently disfigured and scarred,” said U.S. Attorney General Pam Bondi.
“This Department of Justice will continue its fight to protect America’s children and parental rights. I encourage other states to follow Tennessee’s lead and enact similar legislation to protect our kids.”
A group of plaintiffs including three minors claiming to be transgender brought the case, with the Biden Justice Department intervening in their favor. The American Civil Liberties Union, a left-wing legal activist organization, represented the plaintiffs.
“Landmark VICTORY for Tennessee at SCOTUS in defense of America’s children!” Tennessee Attorney General Jonathan Skrmetti said on social media.
The Supreme Court determined that Tennessee’s law did not violate the 14th Amendment’s equal protection clause as the plaintiffs had argued. They also argued that Tennessee’s law made classifications based on sex, even though the ban is based on age and addresses the use of medical treatments for a specific purpose.
“Today the Court blocked an attempt to shoehorn current scientific and policy debates into the Constitution’s Equal Protection Clause. The voters of Tennessee—and those of many other concerned states—may choose to protect minors from life-altering gender-transition treatments,” said conservative legal expert Carrie Severino, president of Judicial Crisis Network.
“The constitutional checks and balances worked in this case as Tennessee defended its rights over federal power grabs and the Court refused to engage in judicial second-guessing of democratic decision-making.”
In his majority opinion, Roberts alluded to the growing body of scientific literature coming out of advanced Western democracies — including the United Kingdom, Norway, and Finland — exposing the lack of evidence demonstrating that the benefits of transgender operations outweigh the considerable harms.
“The Supreme Court’s strong decision today is a massive win in the fight to protect children from harmful gender ideology. Transgender treatments for minors is experimental medicine not backed by reliable evidence,” said Kristina Rasmussen, executive director of Do No Harm, a medical watchdog organization opposed to transgender operations on minors.
The Trump administration’s Department of Health and Human Services recently reviewed existing medical literature on transgender operations and found little evidence to support activist claims that such treatments are an effective way of improving the mental health of minors. The HHS report adds to the growing body of evidence in the U.S. disproving claims from transgender activists who insist life-changing hormonal and surgical treatments are necessary for mentally unwell minors who identify as the opposite gender.
A growing number of detransitioners have spoken up about being rushed into transgender operations when they suffered from mental health issues as teenagers, only to regret it later on and try to switch back to their biological sex. Some of the detransitioners have filed lawsuits against the medical practitioners and institutions for allowing them to undergo the transgender treatments without obtaining informed consent.
The inability of children to fully comprehend the life-changing transgender operations was known to the World Professional Association for Transgender Health (WPATH), the leading transgender medical organization, according to bombshell internal documents released last year. The WPATH documents contradicted the organization’s public position in favor of transgender operations and hormone treatments for minors without any guardrails.
Justice Barrett acknowledged the existence of detransitioners in describing the lack of a clear definition of what a transgender person is, given the fact that people begin to identify as transgender and sometimes return to identifying with their biological sex. Barrett suggets the variation in gender identity distinguishes it from immutable characteristics people are born with like race or sex.
“The boundaries of the group, in other words, are not defined by an easily ascertainable characteristic that is fixed and consistent across the group,” Barrett said.
The irreparable medical damage caused by transgender procedures and lack of evidence supporting the supposed benefits have motivated red states to ban them for minors, particularly because of the prevalence of mental health issues in minors identifying as transgender. More broadly, conservatives believes the ideology behind transgenderism falsely claims there are more than two genders, undermining biological and social reality.
The transgender issue has become particularly contentious in women’s sports, where males are winning competitions and breaking records by identifying as women. The American public’s overwhelming opposition to males in women’s spaces, especially sports leagues, helped President Trump defeat former Vice President Kamala Harris in the 2024 election. Trump’s most effective campaign ad tied Harris to people with “they/them” pronouns to paint her as an out of touch progressive.