The Supreme Court Rules that States Can Ban Gender-Affirming Care for Trans Youth
- Juhi Page
- Jun 19
- 3 min read
News & Opinion
Yesterday, the Supreme Court of the United States of America made a decision in the U.S. v. Skrmetti case. This decision will have a catastrophic impact on thousands of transgender youth across the nation and their care.
In March 2023, the Tennessee Governor signed Senate Bill 1 into law. This particular bill banned gender affirming care for persons under the age of 18, including hormone treatments and puberty blockers. Shortly after this bill was signed, a doctor and three families with transgender children filed a federal lawsuit challenging the law.
The lawsuit argued that the law directly violates the Constitution of the United States which guarantees equal protection as well as, the Affordable Care Act, which bans discrimination on the basis of sex in health care.
On December 4, 2024, for the first time in the country's history, the Supreme Court heard oral arguments surrounding the constitutionality of gender-affirming care for transgender youth.
We previously reported on this issue, and you can read it here.
The final decision in U.S. v. Skrmetti affirms that each state may ban transgender minors from receiving gender- affirming care. This decision is an unprecedented blow to the LGBTQ+ community and a cause for deep concern for trans youth across the United States. In a decision that was voted 6-3, justices upheld that this law and its restrictions do not violate the Equal Protection Clause of the 14th Amendment of the U.S. Constitution.
On behalf of the majority voters, and in defense of the ban supposedly not violating the Constitution, Chief Justice John Roberts had the following to say:
“SB1 prohibits healthcare providers from administering puberty blockers or hormones to minors to treat gender dysphoria, gender identity disorder, or gender incongruence, regardless of the minor’s sex,” Roberts wrote. “The Equal Protection Clause does not resolve these disagreements.”
Justice Sonia Sotomayor (the first Latina Supreme Court justice in U.S. history) countered that the Supreme Court was “retreating from meaningful judicial review exactly where it matters most,” and also that in this vote, the majority has now opened the door for “transgender Americans doubly vulnerable to state-sanctioned discrimination.”
She also wrote that the court has also done “irrevocable damage to the Equal Protection Clause and invite[d] legislatures to engage in discrimination by hiding blatant sex classifications in plain sight.”
She continued by adding that access to care “can be a question of life or death,” pointing to the fact that untreated gender dysphoria can lead to a wide gamut of other concerning conditions, including depression, anxiety, and even self-harm and suicidality. This counter also plainly highlights that this decision will have life-threatening implications on those seeking gender affirming or medically recommended care.
Many LGBTQ+ advocates denounced the ruling, with some stating that the ruling abandons “vulnerable children and the parents who love them,” and that “this decision will cause real harm.”
Studies have shown that trans youth have disproportionately higher rates of suicide attempts and suicidality, a trend that could effectively be stemmed with access to medical gender-affirming care. Without access to care, trans youth also have a higher risk of becoming targets for transphobic-related attacks and crimes.
In stripping away access to life-saving care under the guise of constitutional neutrality, the U.S. Supreme Court has sanctioned a new chapter of institutional abandonment. For trans youth, who already navigate a world lined with discrimination, violence, misunderstanding, and isolation, this decision is a huge setback.
As states now have a green light to legislate the ways that identities make themselves known, the weight falls on communities, advocates, and allies to resist, to protect, and to fight for futures that this ruling seeks to erase.
