Supreme Court of the United States.
Liam James Doyle/NPR
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Liam James Doyle/NPR
The U.S. Supreme Court re-entered the culture wars on Monday, agreeing to hear a challenge to a Tennessee law banning gender-affirming hormone treatments for patients under 18. 2025.
The challengers were three teenagers aged 13 to 16 who received puberty blockers as they changed their birth sex. Teenagers and their parents argue that the law violates the Constitution’s guarantee of equal protection of the laws and the right of parents to determine their children’s medical treatment.
The justices agreed to hear only claims that Tennessee law denies transgender minors equal protection under the law. Specifically, it allows the use of hormone treatments for some minors, such as those who enter puberty prematurely, but prohibits the treatment for transgender patients under 18. This is a limited issue. Specifically, whether such laws should be subject to greater judicial scrutiny.
The Sixth Circuit Court of Appeals applied minimal scrutiny in its ruling in the Tennessee case, finding the Legislature had a “reasonable basis” for enacting the law. “There is no reason to subject these laws to skepticism, rigor or any other form of critical scrutiny,” Chief Justice Jeffrey Sutton wrote on a divided panel. The Biden administration and the American Civil Liberties Union, which represents transgender patients, countered that the law should be subject to “strict scrutiny” because the statute explicitly treats transgender minors differently than minors receiving hormone therapy for other reasons. And the treatment is poor.
The Supreme Court has ruled on transgender issues only three times. Most recently, in 2020, a judge ruled that the 1964 Civil Rights Act, which prohibits employment discrimination, applies to gay, lesbian and transgender employees.
Currently, about 25 Republican-led states have enacted various bans on gender-affirming hormone treatments for minors. Tennessee law, like many others, prohibits surgery. But in this case, surgical issues were not an issue.
The law banning gender-affirming hormone treatments for minors has faced fierce opposition from major medical groups, including the American Academy of Pediatrics and the American Medical Association. For example, the American Medical Association sent a letter to the National Governors Association in 2021, citing evidence that gender-affirming care can lead to “significant reductions in suicide attempts and lower rates of depression and anxiety” among young people.
In addition to the Sixth Circuit Court of Appeals, the Eleventh Circuit also rejected a legal challenge to the ban. The Supreme Court declined to block those rulings when it considers the issue next term.
