The Supreme Court on Wednesday upheld a Tennessee law banning certain gender-affirming care treatment for minors.
The court ruled 6-3, with Chief Justice John Roberts authoring the opinion. The court’s three liberal justices dissented.
The decision in the case, U.S. v. Skrmetti, is one of the most significant LGBTQ rulings to come from the Supreme Court and marks the first time the justices have weighed in on an anti-trans state law.
“This case carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field,” Roberts wrote. “The voices in these debates raise sincere concerns; the implications for all are profound.”
The chief justice wrote that the court’s majority found the Tennessee law did not violate the equal protection guarantee of the Fourteenth Amendment, and it was leaving “questions regarding its policy to the people, their elected representatives, and the democratic process.”
“The Equal Protection Clause does not resolve these disagreements. Nor does it afford us license to decide them as we see best. Our role is not “to judge the wisdom, fairness, or logic” of the law before us … but only to ensure that it does not violate the equal protection guarantee of the Fourteenth Amendment,” he wrote.

The Supreme Court is seen, June 16, 2025, in Washington.
Mariam Zuhaib/AP
Tennessee is one of 24 states with laws in effect banning all gender-affirming care for transgender minors.
There are 1.6 million Americans over 13 who identify as transgender, including an estimated 300,000 ages 13-17. A third of those people live in states that ban gender-affirming care, according to the Williams Institute at UCLA.
Roberts rejected arguments by a group of transgender teenagers and their parents that denying the kids access to puberty blockers and hormone therapy amounts to sex discrimination.
He said the playing field is level for all under Tennessee’s law, SB1: “No minor may be administered puberty blockers or hormone therapy to treat gender dysphoria,” he wrote.
Justice Sonia Sotomayor read her dissent from the bench, sharply disagreeing with the majority’s ruling.
The decision “invites legislatures to engage in discrimination,” she wrote. It will “authorize untold harm to transgender children and parents and families who love them.”
“By retreating from meaningful judicial review exactly where it matters most, the Court abandons transgender children and their families to political whims. In sadness, I dissent,” she wrote.
ACLU attorney Chase Strangio was the first openly transgender person to argue a case before the Supreme Court in Skrmetti. He called the decision a “devastating loss.”
“Though this is a painful setback, it does not mean that transgender people and our allies are left with no options to defend our freedom, our health care, or our lives,” Strangio said. “The Court left undisturbed Supreme Court and lower court precedent that other examples of discrimination against transgender people are unlawful. We are as determined as ever to fight for the dignity and equality of every transgender person and we will continue to do so with defiant strength, a restless resolve, and a lasting commitment to our families, our communities, and the freedom we all deserve.”
This is a developing story. Please check back for updates.