Supreme Court appears divided over state bans on gender transition ‘treatments’ for minors

The Supreme Court appeared divided Wednesday over the constitutionality of state laws banning gender-affirming medical care for minors, a politically charged issue dealing with transgender rights. The justices heard nearly two-and-a-half hours of tense oral arguments over a challenge to a Tennessee law.

At issue is whether the equal protection clause — which requires the government to treat similarly situated people the same — prohibits states from allowing medical providers to deliver puberty blockers and hormones to facilitate a minor’s transition to another sex.

The three justices appointed by former President Trump could be the key to deciding the socially divisive question. Justices Brett Kavanaugh and Amy Coney Barrett asked tough questions of both sides, and Justice Neil Gorsuch did not speak during the marathon public session.

Justice Samuel Alito cited “overwhelming evidence” from some medical studies that cited the negative consequences from teens that underwent gender-affirming care. But Justice Sonia Sotomayor countered with evidence from underage individuals that were denied treatment to address gender dysphoria.

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Chief Justice John Roberts voted in the majority in a 2020 case favoring transgender employees who claim workplace discrimination. That opinion was authored by Gorsuch. But in Wednesday’s arguments, Roberts suggested state legislatures – rather than courts – were in a better position to decide such questions over regulating medical procedures.

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“The Constitution leaves that question to the people’s representatives, rather than to nine people, none of whom is a doctor,” Roberts told ACLU lawyer Chase Strangio, who was representing transgender minors, parents and a doctor. Strangio is the first openly transgender attorney to argue a case before the Supreme Court.

He appeared alongside the U.S. solicitor general, representing the Biden administration in opposing the law in Tennessee, one of about two dozen with similar bans. Trump, who takes office again next month as president, had promised in his re-election campaign to implement certain policy changes that would affect transgender individuals across various sectors.

A ruling is expected by late June 2025.

The case is U.S. v. Skrmetti (23-477).