Supreme Court Upholds Tennessee's Ban on Gender Transition Medical Care for Minors, 6-3
On June 18, 2025, the U.S. Supreme Court ruled 6-3 to uphold Tennessee's ban on gender transition medical care for minors, holding that the law does not violate the Equal Protection Clause of the Fourteenth Amendment. The law at issue is Senate Bill 1, the Prohibition on Medical Procedures Performed on Minors Related to Sexual Identity, enacted in 2023 by the Tennessee legislature, which sits in Nashville, Davidson County, Tennessee.
SB1 prohibits healthcare providers from prescribing, administering, or dispensing puberty blockers or hormones to any minor for two purposes: enabling the minor to identify with, or live as, a purported identity inconsistent with the minor's biological sex, or treating purported discomfort or distress from a discordance between the minor's sex and asserted identity. The same medications remain available for other conditions, such as precocious puberty, and for adults.
Three transgender minors, their parents, and a physician challenged the law, and the United States intervened in support of the plaintiffs. A district court applied heightened scrutiny and preliminarily blocked the law; the U.S. Court of Appeals for the Sixth Circuit reversed, holding that the law did not trigger heightened scrutiny and satisfied rational basis review.
Writing for the majority, Chief Justice John Roberts said SB1 classifies on the basis of age and medical use, not on the basis of sex or transgender status, so heightened scrutiny does not apply. Under rational basis review, the majority held, the law's age- and diagnosis-based classifications are rationally related to the state legislature's findings about the risks of such treatments and to the state's objective of protecting minors' health and welfare.
Justices Clarence Thomas, Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett joined the majority in full, and Justice Samuel Alito joined in most of it; Thomas, Barrett, and Alito also wrote concurring opinions. Justice Sonia Sotomayor dissented, joined in full by Justice Ketanji Brown Jackson and in large part by Justice Elena Kagan, arguing that SB1 classifies on the basis of sex and should have faced heightened scrutiny.
The case is No. 23-477, cited as 605 U.S. 495, and was argued on December 4, 2024. Tennessee is one of a growing number of states that have restricted gender transition medical care for minors in recent years, and the ruling means such state laws are unlikely to fall to Equal Protection challenges.
(Source: Supreme Court of the United States)
Source: Supreme Court of the United States
Published by GSM · USA (original Chinese edition)
Photo: 图：位于 Nashville 的田纳西州议会大厦，涉案法律 SB1 由田纳西州议会在此通过。w_lemay 摄，CC BY-SA 2.0，经 Wikimedia Commons。 / Photo: The Tennessee State Capitol in Nashville, where the Tennessee legislature passed SB1, the law at issue. Photo by w_lemay, CC BY-SA 2.0, via Wikimedia Commons.
