The Supreme Court will hear arguments on Wednesday over whether a Tennessee law denying some kinds of medical care to transgender youth runs afoul of the Constitution.

Twenty-three other states have similar laws. The court’s decision, expected by June, will almost certainly yield a major statement on transgender rights against the backdrop of a fierce public debate over the role gender identity should play in areas as varied as sports, bathrooms and pronouns.

The Tennessee law prohibits medical providers from prescribing puberty-delaying medication, providing hormone therapy or performing surgery to treat what the law called “purported discomfort or distress from a discordance between the minor’s sex and asserted identity.” But the law allows those same treatments for “a congenital defect, precocious puberty, disease or physical injury.”

Three families and a doctor sued to challenge the law, and the Biden administration intervened on their side. The challengers said the law violated the Constitution by denying equal protection to transgender people, primarily by discriminating against them based on sex.

Whether the law draws distinctions based on sex matters because the Supreme Court has said that such discrimination subjects state laws to a demanding form of judicial review called “heightened scrutiny.”

The court has never said that about discrimination based on transgender status as such, and it is very unlikely to do so now. Unless the court rules that heightened scrutiny applies, it will almost certainly uphold the law. If such scrutiny does apply, the justices will probably return the case to the lower courts to apply it.