United States v. Skrmetti

In United States v. Skrmetti, the U.S. Supreme Court considered a Tennessee law prohibiting gender-affirming medical care for minors, including puberty blockers, hormone therapy, and surgery. The Biden administration and families of transgender adolescents challenged the law as unconstitutional sex discrimination. On June 18, 2025, the Court ruled 6-3 that the law does not constitute sex discrimination and falls within the state's legitimate authority to regulate medical practices. The majority reasoned that the law draws a line based on age and medical purpose rather than sex, applying rational basis review. The decision upheld Tennessee's ban and allowed similar restrictions in other states.

The U.S. Supreme Court, in a 6-3 decision, upheld the Tennessee law, holding that it does not constitute sex-based discrimination and is rationally related to the state's interest in protecting minors and regulating medical procedures.

Whether Tennessee's ban on gender-affirming care for minors discriminates on the basis of sex or transgender status, thereby violating the Equal Protection Clause, and what level of judicial scrutiny should apply to such state regulations.

The ruling significantly restricts access to gender-affirming medical care for transgender minors across the United States, emboldens states to enact similar bans, and intensifies the national political and legal debate over transgender rights and the limits of medical autonomy for adolescents.