Supreme Court to Review Federal Challenge to Tennessee Transgender Treatment Ban


The Supreme Court has agreed to hear a federal challenge to Tennessee’s law banning puberty blockers and medical treatments for minors identifying as transgender. The decision is part of a broader legal debate over transgender rights and medical treatments for minors.

Why It Matters

This issue is critical as it addresses the balance between state legislation, individual rights, and federal constitutional protections, impacting the regulation of medical treatments for minors.

Who It Impacts

The ruling will affect transgender minors, their families, healthcare providers, and state governments grappling with similar legislative measures.

The Supreme Court announced on June 24 that it will review a federal challenge to a Tennessee law prohibiting the use of puberty blockers and other medical treatments for minors who identify as transgender. This decision arrives amidst a wave of state legislation addressing transgender issues, including medical treatments, participation in sports, and use of gender-specific facilities.

The case, United States v. Skrmetti, will see the Supreme Court evaluate the constitutionality of Tennessee Senate Bill 1, which forbids medical treatments aimed at using experimental procedures and medication aimed at altering physical/physiological characteristics of minors who do not want to identify as being aligned aligned with their biological sex. Tennessee’s Republican Attorney General, Jonathan T. Skrmetti, is named in the case. The court’s order to grant certiorari did not include any dissents and lacked an explanatory opinion, though at least four justices must have voted in favor of reviewing the case.

The federal government, represented by U.S. Solicitor General Elizabeth Prelogar, filed a petition on November 6, 2023, arguing that the Tennessee law breaches the Equal Protection Clause of the 14th Amendment. According to Prelogar, the legislation does not simply regulate or ensure informed consent for medical treatments but outright bans them in a manner that discriminates based on sex.

Tennessee Senate Bill 1 specifies that treatments aimed at enabling a minor to “identify with, or live as, a purported identity inconsistent with the minor’s sex” are prohibited. However, it allows similar treatments if prescribed for other purposes, leading to what Prelogar describes as a discriminatory double standard. For instance, a male teenager can be prescribed testosterone, but a female teenager cannot receive similar treatment for gender transition purposes.

The U.S. District Court had initially blocked the enforcement of this law, ruling it unconstitutional due to its discrimination based on sex and transgender status. This decision was later reversed by a divided panel of the U.S. Court of Appeals for the 6th Circuit, prompting the federal government’s appeal to the Supreme Court.

This case is part of a broader legislative trend, with at least 24 states passing laws that ban transgender surgeries and treatments for minors. Conversely, 15 states and the District of Columbia have enacted protections ensuring youth access to transgender medical treatments, reflecting the contentious national debate over this issue.

The Supreme Court’s review of United States v. Skrmetti will likely provide a significant precedent regarding the legality of state laws regulating transgender medical treatments for minors. Oral arguments are anticipated to take place in the court’s new term beginning in October.