Last week, the Supreme Court heard oral arguments in United States v. Skrmetti, a landmark case challenging Tennessee’s law banning transgender medical procedures for minors. The law, aimed at protecting children from irreversible medical interventions, has been targeted by the Biden administration and activist groups, who claim it constitutes sex discrimination under the Equal Protection Clause. This rests on the idea that one’s “sex” is whatever they say it is.
Opponents of these procedures point out that the treatments are experimental, often harmful, and profit-driven, forming part of a multibillion-dollar industry where drug companies receive life-long customers.
During oral arguments, Justice Samuel Alito confronted the Biden administration’s solicitor general, citing the Cass Review — an independent review of gender identity services for children and young people in the United Kingdom, which found no evidence that puberty blockers or hormones reduce suicide rates among transgender-identifying youth.
Justice Amy Coney Barrett and Chief Justice John Roberts suggested the issue belongs in state legislatures, emphasizing the lack of scientific consensus. Justice Clarence Thomas is arguably the most conservative member of the court, so despite his usual quietness during oral arguments, he is likely to be in favor of the Tennessee ban.
Justice Ketanji Brown Jackson likened Tennessee’s protections for minors to bans on interracial marriage, a comparison that drew mockery from conservatives online.
Although Justice Neil Gorsuch often aligns with the conservatives, he joined Roberts and the court's liberals in the 2020 Bostock v. Clayton County decision, which extended Civil Rights Act protections to employees facing discrimination based on their “gender identity” — a stance strongly opposed by the other conservative justices. As of now, Gorsuch remains a wild card.
The court’s ruling could have major implications, impacting similar laws in over 25 states. With Tennessee leading the way, the case will decide the fate of countless children who could be prescribed surgeries, cross-sex hormones, and puberty blockers to attempt to transition to a different gender. A decision is expected by June 2025.
