U.S. top court upholds ban on gender-affirming care for minors
The U.S. Supreme Court on Wednesday (June 18, 2025) upheld a state law banning gender-affirming medical treatments for transgender minors – an issue at the heart of the American culture wars.
The court voted 6-3 to uphold a Tennessee law barring hormone therapy, puberty blockers and gender transition surgery for those under the age of 18.
The six conservative justices on the top court rejected a challenge to the law while the three liberals dissented.
Two dozen Republican-led states have enacted laws restricting medical care for transgender youth, and the case will have repercussions for the prohibitions across the country.
'This case carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field,' wrote Chief Justice John Roberts, author of the majority opinion.
'The Court's role is not 'to judge the wisdom, fairness, or logic' (of the law) but only to ensure that the law does not violate equal protection guarantees,' Mr. Roberts said.
'It does not. Questions regarding the law's policy are thus appropriately left to the people, their elected representatives, and the democratic process,' he added.
The Supreme Court heard the case in December, and the Justice Department of then-president Joe Biden joined opponents of the law, arguing that it violated the Constitution's Equal Protection Clause since it denies transgender minors access to medical treatments permitted to others.
Republican President Donald Trump has since taken office, and he signed an executive order in January restricting gender transition procedures for people under the age of 19.
While there is no U.S.-wide law against gender-affirming medical treatments for transgender youth, the Mr. Trump order ended any federal backing for such procedures.
Reacting to the ruling, the American Academy of Pediatrics (AAP) said it 'sets a dangerous precedent for legislative interference in the practice of medicine.'
'Gender-affirming care is medically necessary for treating gender dysphoria and is backed by decades of peer-reviewed research, clinical experience, and scientific consensus,' the AAP said.
'Denying patients access to this care not only undermines their health and safety, but it also robs them of basic human dignity.'
'Must end'
The Alliance Defending Freedom, a conservative legal group, welcomed the ruling as a 'huge win for children' and a 'step toward ending dangerous experiments on kids.'
During oral arguments in December, Tennessee Solicitor General Matthew Rice told the court the law was designed to 'protect minors from risky, unproven medical interventions' with 'often irreversible and life-altering consequences.'
Chase Strangio, an American Civil Liberties Union attorney representing three transgender adolescents, their parents, and a Memphis-based doctor, countered that the law has 'taken away the only treatment that relieved years of suffering.'
'What they've done is impose a blunderbuss ban, overriding the very careful judgment of parents who love and care for their children and the doctors who have recommended the treatment,' said Mr. Strangio, the first openly transgender lawyer to argue before the court.
Mr. Trump, in his inauguration speech, said his government would henceforth only recognise two genders – male and female – and he issued his executive order a week later restricting gender transition procedures for minors.
'Across the country today, medical professionals are maiming and sterilising a growing number of impressionable children,' the executive order said. 'This dangerous trend will be a stain on our Nation's history, and it must end.'
Mr. Trump's order said it would now be U.S. policy that it would 'not fund, sponsor, promote, assist, or support the so-called 'transition' of a child from one sex to another.'
The order bars funding for gender transition under the Medicaid health insurance program for poor families, the Medicare scheme used by retirees, and Defense Department health insurance that covers some two million children.
According to a study by UCLA's Williams Institute, an estimated 1.6 million people aged 13 and older in the United States identify as transgender.
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