In a landmark 6–3 decision issued Wednesday, the U.S. Supreme Court upheld Tennessee’s ban on transgender medical treatments for minors, ruling that the law does not violate the 14th Amendment’s Equal Protection Clause. The ruling in United States v. Skrmetti marks a significant victory for parental rights advocates, medical ethicists, and state legislatures seeking to restrict such interventions on children.
Chief Justice John Roberts, writing for the majority, rejected the plaintiffs’ arguments that the law discriminates based on sex. Instead, the Court emphasized that Tennessee’s law prohibits all minors, regardless of sex, from receiving puberty blockers or hormone therapy specifically for gender dysphoria, while still allowing their use for other medical conditions. Roberts clarified that the plaintiffs’ framing ignored a core medical standard: the necessity and purpose of the treatment.
“Notably absent from their framing is a key aspect of any medical treatment: the underlying medical concern the treatment is intended to address,” Roberts wrote.
BREAKING: In a 6-3 decision, the Supreme Court has upheld Tennessee’s law banning genital mutilation of minors under the guise of so-called “trans” surgery.
“The Court’s role is not ‘to judge the wisdom, fairness, or logic’ of [the ban on surgically mutilating minors], but only… pic.twitter.com/AC2TZYpXMQ
— Sean Davis (@seanmdav) June 18, 2025
The Court highlighted rising global debate and medical uncertainty surrounding pediatric gender treatments, citing increased restrictions in European countries such as the U.K., Sweden, and Norway.
Justice Clarence Thomas, in a separate concurring opinion, argued that there is “no medical consensus on how best to treat gender dysphoria in children,” and expressed concern over the ideological motivations influencing some clinical guidance. Justice Amy Coney Barrett and Justice Samuel Alito also penned concurring opinions supporting the constitutionality of state-level restrictions.
Justice Sonia Sotomayor, joined by Justices Kagan and Jackson, dissented. Sotomayor argued that the Tennessee law infringes on both the rights of parents and the medical needs of transgender-identifying youth. She characterized gender-affirming treatments as potentially life-saving and said the law imposes unjust restrictions under the guise of neutrality.
“Access to care can be a question of life or death,” she wrote.
The Tennessee law, SB1, bans all transgender-related medical interventions for minors, including puberty blockers, cross-sex hormones, and gender surgeries. Physicians who violate the law risk losing their licenses and facing fines up to $25,000. The law also empowers families to sue providers if harm results from the banned procedures.
Three years ago, we launched our investigation into Vanderbilt’s child mutilation practices. We rallied in the state capital. Our lawmakers responded with a law banning child mutilation in the state. Today the Supreme Court upheld our law, which means child mutilation can be…
— Matt Walsh (@MattWalshBlog) June 18, 2025
The legislative push was partially inspired by Daily Wire commentator Matt Walsh’s investigation into the practices at Vanderbilt University’s gender clinic, which triggered national scrutiny and calls for oversight.
Despite immediate legal challenges, the law was upheld by the Sixth Circuit Court of Appeals, and the case later reached the Supreme Court with backing from the Trump administration, which urged the justices to resolve what it called “profound uncertainty” among federal courts on the constitutionality of such laws.
