The United States Supreme Court confirmed on Wednesday the Tennessee law that prohibits gender affirmation medical care for transgender minors, in a significant setback for transgender rights in the country.
With a 6-3 vote, the conservative majority of the court determined that the state law does not violate the equal protection clause of the Constitution, which requires the government to treat people in similar situations equally. The decision shields similar laws passed in at least 26 states under Republican governments from legal challenges and supports initiatives driven by President Donald Trump’s administration to restrict protections for transgender individuals.
The Chief Justice of the Supreme Court, John Roberts, wrote the majority opinion and acknowledged the complexity of the debate surrounding these medical treatments: “This case carries the weight of intense scientific and political debates on the safety, efficacy, and desirability of medical treatments in an evolving field. The voices in this debate raise genuine concerns; the implications are profound for all. The equal protection clause does not resolve these disagreements. Nor does it give us license to decide them as we see fit.”
On her part, Judge Sonia Sotomayor, representing the three liberal justices, read her dissent out loud in the courtroom: “By withdrawing from a significant judicial review just when it matters most, the court abandons transgender children and their families to political uncertainty. Sadly, I dissent.”
The Supreme Court’s decision comes in a context of multiple state and federal efforts to restrict the rights of transgender individuals, including measures on which sports they can play and which bathrooms they can use. In April, the Trump administration sued the state of Maine for not complying with the federal directive to ban the participation of transgender athletes in women’s sports.
The Republican government has also sought to block the use of federal funds to provide gender affirmation medical care to individuals under 19 years old and to favor conversion therapies. In addition, the Supreme Court has already allowed the expulsion of transgender individuals from the military amid ongoing litigation. Furthermore, the president signed an executive order to define sex exclusively as male or female.
While some states where this medical care is not prohibited have passed laws or decrees to protect it, the landscape has changed following Trump’s executive order. Some providers have restricted their services: for example, Penn Medicine in Philadelphia announced last month that they will no longer perform surgeries on individuals under 19 years old.
The president of the American Academy of Pediatrics, Dr. Susan Kressly, criticized the Supreme Court’s decision and reaffirmed the organization’s support for gender-affirming healthcare. “We stand firm in our support. We stand in solidarity with pediatricians and families who make medical decisions together, without political interference,” she stated. Kressly warned that the ruling “sets a dangerous precedent for legislative interference in medical practice and the doctor-patient relationship.”
The ruling of the US Supreme Court comes a month after the highest court in the UK also handed down a setback to trans rights, unanimously determining that the British Equality Act allows for the exclusion of trans women from certain spaces and services exclusive to women, such as changing rooms, shelters, pools, and medical or counseling services.