The U.S. Supreme Court held that Tennessee’s law banning adolescent blockers and hormone therapy for transgender minors does not violate the U.S. Constitution and therefore remains in effect.
Wednesday’s decision was split along the ideological boundaries, with six conservative High Court judges lined up with Tennessee, with three left-leaning judges challenging.
Secretary John Roberts wrote the majority opinion. In it, he explained that the plaintiffs (three trans minors, their parents and doctors) have not successfully demonstrated a violation of the 14th amendment to the Constitution, which ensures equal protection under the law.
The plaintiffs sought to lift the ban and alleged that Tennessee law, known as SB1, discriminated against them based on their gender and gender.
However, Roberts disagreed. He noted that the ban applies equally to young men and women.
“SB1 does not hide its sex-based classification,” he writes. “The law does not prohibit any acts that allow one sex to behave in the other gender. Under SB1, adolescent blockers or hormones cannot be administered to treat gender discomfort, gender identity disorder, or gender inconsistency.”
Roberts also said adolescent blockers remain available under Tennessee law and are available to treat birth defects, early adolescence, illness or injury. Similarly, the application was allowed regardless of sex, he wrote.
“SB1 does not exclude individuals from medical treatment based on their transgender status, but removes a set of diagnoses such as gender discomfort, gender identity disorder, and gender inconsistencies from the range of treatment conditions,” Roberts said.
Transgender youth can be hormone inhibitors prescribed to slow the onset of adolescents, thereby halting the development of secondary sexual traits such as breast, voice-deepening, and facial hair.
LGBTQ advocates say such gender-affirming care is essential to reduce the stress of such changes and to reduce the potential need for surgery later. Adolescent blockers are widely considered safe and their effects are temporary.
However, Roberts noted that some healthcare providers are seeking more research into the long-term effects of drugs, referring to “open issues” in the healthcare field.
“Health authorities in many European countries have raised serious concerns about the potential harms associated with the use of adolescent blockers and hormones to treat transgender minors,” writes Roberts.
“Recent developments only highlight the need for legislative flexibility in this area,” he continued.
The majority opinion was met by fierce opposition written by Justice Sonia Sotomayor. She noted that adolescent blockers can save lives given the high rates of suicide, self-harm and bullying among transgender youth.
“The logic and precedent of the majority inexplicably declares that otherwise, “rationally conceivable states of fact” must support a category ban on life-saving healthcare in Tennessee, as long as it justifies it,” writes Sotomayor.
“By retreating from a meaningful judicial review where it matters most, the court will abandon transgender children and their families on a political whim. In grief, I object.”
She emphasized that the consensus in the US medical community is “appropriate and medically necessary” for the comprehensive and clinical diagnosis of gender discomfort.
“The hormones and access to adolescent blockers in transgender adolescents (known as gender-affirming care) is not just a matter of beauty preference,” Sotomayor said. “On the contrary, access to care can be a matter of life and death.”
She questioned why Tennessee lawmakers must have the power to regulate medical decisions, and whether adolescent blockers can still be used to address issues like teenage girls’ unnecessary facial hair.
“The Tennessee ban is irrespective of what the parents and doctors of minors think.
The mental health condition of a minor, or to some extent medical treatment is needed for individual children,” Sotomayor said.
Wednesday’s decision is at a time of uncertainty for the US transgender community.
Since taking office in January for his second term, US President Donald Trump has taken steps to limit the rights of transgender people. On the first day of his return to the White House, Republican leaders issued an executive order announcing that the federal government would recognize only two genders: male and female.
A few days later, on January 27th, he issued another executive order, effectively setting the stage for a ban on transgender forces in the military. Trump accused transgender people of “expressing false ‘gender identities'” and described their identity as “a conflict with soldiers’ commitment to an honorable, true, and disciplined lifestyle.”
The Supreme Court also upheld the ban. June 6 marked the first deadline for transgender forces to self-identify and voluntarily leave the army.
Additionally, Trump said his administration would withhold federal funds from schools that would allow transgender girls and women to participate in women’s sports. That decision led to clashes with states like Maine, where Democratic Gov. Janet Mills promised to stand up to Trump.
Amid a similar wave of law, the fight over the ban on adolescent blockers in Tennessee has banned 25 states banning gender-affirming healthcare for transgender youth, according to the American Civil Liberties Union (ACLU).
The group estimates that these laws leave around 100,000 trans minors out of needy health care.
The overwhelmed Supreme Court ban on Wednesday initially faced an injunction from a lower court, but the Sixth Circuit lifted the injunction until the appeal was pending.
The ACLU called the Supreme Court decision a setback but pledged to continue to file legal assignments. In a statement, the Supreme Court noted that it has not overturned the broader precedent that discrimination against transgender people is illegal.
Chase Strangeo, co-director of ACLU’s LGBTQ and HIV projects, said:
“We are as determined as ever to fight for the dignity and equality of all trans people.”
