In a 6-3 decision on Wednesday, the US Supreme Court sided with Tennessee’s law that bans medical treatments for minors whose parents are seeking gender transitions. The court said that such laws do not automatically violate the Constitution’s Equal Protection Clause.
Authored by Chief Justice John G. Roberts, the ruling is a major legal victory for states pursuing limits on youth gender transitions. It affirms Tennessee’s Senate Bill 1 law, which bars medical professionals from providing puberty blockers, cross-sex hormones, and surgeries to minors for the purpose of gender transition.
“The voices in these debates raise sincere concerns; the implications for all are profound,” Roberts wrote. “The Equal Protection Clause does not resolve these disagreements.” The opinion emphasized the need for “legislative flexibility” as states navigate complex questions around medicine, ethics, and identity.
The decision affirms that laws related to transgender individuals do not inherently trigger heightened scrutiny under the Equal Protection Clause, offering states broader authority to regulate treatments as the debate over gender-affirming care continues to evolve.
Alabama had filed an amicus brief that questioned the medical consensus on “gender-affirming care,” led by Attorney General Steve Marshall. Twenty-four states total have enacted restrictions on gender-affirming care for minors, such as bans on puberty blockers or hormone therapy. These include states like Idaho, Indiana, Kentucky, and Missouri, among others. Alaska has no such ban and has a legislature that has refused to take up legislation.
Rep. Jamie Allard (R-Eagle River) has been a key legislator championing restrictions on gender-affirming care and related transgender issues for minors. In early 2024, she introduced a bill aimed at holding medical professionals legally accountable for performing gender transition treatments on minors, but the bill only received one hearing in the House Judiciary Committee and did not advance further due to insufficient Republican and Democrat support.

The high court’s three liberal justices dissented from today’s ruling, led by Justice Sonia Sotomayor.
“By retreating from meaningful judicial review exactly where it matters most, the Court abandons transgender children and their families to political whims,” Sotomayor wrote. She believes gender identity is closely tied to sex and therefore should receive the same constitutional protections under the Equal Protection Clause.
Tennessee’s law, enacted in 2023, was one of the first in the nation to bar minors from receiving hormone-related treatments for gender transition. Supporters argue it protects vulnerable youth from irreversible medical interventions and the influence of profit-driven medical practices.