United States v. Skrmetti
Case Overview
The Supreme Court considers whether Tennessee's law banning gender-affirming medical care for minors — including puberty blockers and hormone therapy — violates the Equal Protection Clause. The Biden administration challenged the law on behalf of affected families. The case marks the Court's first direct ruling on transgender-specific healthcare restrictions.
BrynoDC Coverage 2 videos
The Facts
Tennessee enacted SB1 in 2023, prohibiting healthcare providers from administering puberty blockers or hormone therapy to minors for the purpose of gender transition. The law created criminal penalties for providers and civil liability. Transgender adolescents and their parents, represented by the United States, challenged the law as discriminatory sex classification under the Fourteenth Amendment. The Sixth Circuit upheld the law, creating a circuit split with the Fourth Circuit, which had struck down a similar Virginia provision.
The Application
The Court examined whether Tennessee's prohibition on puberty blockers and hormone therapy for transgender minors constitutes a sex-based classification under the Equal Protection Clause. The majority concluded the law does not facially discriminate on the basis of sex, reasoning that the restriction targets the medical purpose of gender transition rather than the sex of the patient, because these treatments are permitted for other medical conditions in both male and female minors. By treating the classification as purpose-based rather than sex-based, the Court avoided applying intermediate scrutiny and upheld the law under rational basis review. This framing effectively shields transgender healthcare restrictions from Equal Protection sex discrimination challenges by characterizing gender identity-related classifications as separate from sex classifications.
The Conclusion
**Decided June 18, 2025. The Supreme Court upheld Tennessee's ban 6-3, with the majority holding the law does not facially discriminate on the basis of sex.** Justice Kavanaugh wrote for the Court. The ruling allows similar state bans to remain in effect and forecloses federal Equal Protection challenges to transgender healthcare restrictions on this theory.
No circuit court data for this case.
Flag an issue
This tracker is maintained by BrynoDC and is free because readers fund it. Support