The Supreme Court recently ruled to uphold a Tennessee law banning gender-affirming medical care for transgender youth under 18. What does this ruling mean for transgender health care services, and what does it mean for the movement against Trump’s far-right agenda?
In 2023, Tennessee legislators passed a law, SB1, that banned gender-affirming hormone therapies (including puberty blockers) and surgeries for transgender minors. Three transgender youth, their parents, and a health care provider challenged this in court, claiming the law violates the 14th Amendment’s Equal Protection Clause that prohibits discrimination on the basis of sex and gender identity.
The Supreme Court ruled that SB1 did not violate this clause, claiming the law does not discriminate on the basis of either sex or gender identity.
In Tennessee, hormone therapies and puberty blockers are not permitted if you are both a minor and if the therapy would support you in attaining or living a gender identity that is inconsistent with your sex assigned at birth.
It does not ban all hormone therapies for minors, only if the child is transgender. A cisgender child, meaning a child who is not transgender, may receive puberty blockers for early onset puberty, or may seek surgery for reasons other than their gender identity. These same exact medical treatments are not outlawed for all children, only for transgender children looking to address their gender dysphoria.
In the original bill, the Tennessee legislature says, “This state has a legitimate, substantial, and compelling interest in encouraging minors to appreciate their sex, particularly as they undergo puberty.” Yet SCOTUS claimed that this is not sex-based discrimination!
This ruling does not immediately greenlight similar laws in other parts of the country, and does not automatically extend to other cases concerning discrimination on the status of sex and gender identity. But this case could be used as an example or set a precedent for other court rulings in the future.
Medical professionals, researchers, and the experiences of transgender people and their families confirm that gender-affirming medical care is life saving for transgender youth. When trans youth have access to hormone replacement therapy and puberty blockers, they have lower rates of depression and are at a lower risk for suicide. One study found that suicidal ideation in transgender youth can drop by over 70% when they are given access to puberty blockers, compared to trans youth without access. When transgender youth have access to hormone therapies, they have better mental health overall as adults compared to trans people who didn’t start hormone therapy until adulthood.
One of the plaintiffs in the case, whose name has been changed to protect his anonymity, reported that he “felt as early as elementary school that he ‘was a boy.’”
Before puberty, Ryan thought ‘there wasn’t that much of a difference between boys and girls’ and that he ‘could manage existing in the middle.’ As puberty approached, however, Ryan grew increasingly anxious about the impending changes to his body. He started throwing up every morning before school. As his voice changed, Ryan contemplated going mute. Eventually, after two years of psychotherapy and extensive consultations with his parents and doctors, Ryan’s physicians prescribed him testosterone. Ryan began to find his voice again. He started raising his hand in class, participating in school, and looking at himself in the mirror. Ryan attests that ‘[g]ender-affirming health care saved [his] life.’
Why are Tennessee lawmakers and the Supreme Court so obsessed with regulating the lives of trangender people?
The Trump administration has targeted both immigrants and trans people as scapegoats, restricting access to health care, education, legal recognition and the right to exist in public. It’s the same old tactic of divide and conquer. They want to distract us and have working class people fight among ourselves while Trump and his billionaire friends loot the working class.
Bigoted lawmakers attack the rights of transgender people in the name of “protecting” children. But life-saving medical care isn’t harming children: billionaires are.
Trump’s “Big Beautiful Bill” will harm children with cuts to vital programs like Medicaid, the Child Health Insurance Program and the Supplemental Nutrition Assistance Program. Medicaid covers approximately 40% of all children in the United States and more than 40% of all births. SNAP provides food assistance to one out of every five children in the United States. More than 2 million children will have food assistance to their families significantly cut or terminated. And Trump and his administration want to completely dismantle the Department of Education!
ICE raids that separate children from their parents aren’t protecting children. Adding $153 billion to the United States military budget will harm children across the globe. Every dollar spent on ICE raids and war is a dollar stolen from essential social services in the United States. And of course children are not immune to the U.S. bombs dropped in Iran, Iraq, Syria, Afghanistan, Yemen, and Palestine. It’s clear who our real enemies are.
Every year since 2019, a new record has been set in the number of anti-trans bills that are passed across the country. In 2015, there were 21 anti-trans bills considered. Only half way into 2025, 946 anti-trans bills against both minors and adults have been considered. But more than five times as many bills have failed than passed.
Advocates for transgender and LGBTQ rights will continue to fight these bills in the courts to stop as many as possible from becoming law. But if the highest court in the country will rule in favor of legal medical discrimination, it’s clear we also need a mass movement to defend our basic human rights in our schools, unions and in the streets.
Feature image by Luna Lyons – Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=134555290
