The Supreme Court’s conservative majority signaled support for state laws restricting hormone treatments for transgender teens, emphasizing judicial restraint on such issues. Chief Justice John G. Roberts Jr. highlighted the global debate over puberty blockers and sex hormones, noting that nations like Britain, Sweden, and Finland have recently limited these treatments for adolescents.
Roberts and Justice Brett M. Kavanaugh questioned the role of the judiciary in such medical controversies, suggesting that legislative bodies are better suited to make these decisions. Both justices stressed the evolving nature of the debate and expressed skepticism about constitutionalizing the matter.
Conservative justices Clarence Thomas, Samuel A. Alito Jr., and Amy Coney Barrett appeared to agree, casting doubt on claims of a medical consensus in favor of these treatments. Alito challenged the Biden administration’s assertion of broad professional agreement, while Solicitor General Elizabeth Prelogar responded that even restrictive policies abroad, like Britain’s, do not impose outright bans.
Justice Neil M. Gorsuch, a key figure in earlier transgender rights cases, refrained from questioning during the arguments. Meanwhile, liberal justices argued that the state laws unfairly target transgender youth and infringe on parental rights to make medical decisions for their children.
The liberal wing of the court, led by Justice Sonia Sotomayor, argued that these restrictions violate constitutional principles of equality and parental autonomy. Sotomayor questioned Tennessee’s decision to override parental authority in determining medical care.
Since 2021, Tennessee and 23 other states have enacted laws banning hormone treatments for minors seeking gender transition, citing concerns over safety and efficacy. Tennessee Attorney General Jonathan Skrmetti defended the restrictions, asserting that regulating medical practices is a state responsibility and that such treatments remain controversial and unproven for adolescents.
The Biden administration, along with ACLU attorney Chase Strangio, pushed back against these laws, arguing they are discriminatory and violate constitutional protections against gender-based bias. They urged the court to strike down the laws or at least remand the case to lower courts for further review.
Strangio emphasized the impact on transgender teens, arguing that the restrictions eliminate treatments essential to alleviating their suffering. The plaintiffs maintain that these laws impose undue harm on vulnerable adolescents and disregard established medical practices.
If the court sides with Tennessee, conservative states would see their restrictions reinforced, while Democratic-led states like California would remain unaffected. A broader ruling could influence federal policy, particularly under a Trump administration, which has vowed to curb support for gender-transition programs.
The case also leaves unresolved issues, such as transgender participation in sports, which some justices touched on during the proceedings. However, the immediate focus remains on whether the Tennessee law will stand as constitutional.