United States v. Skrmetti (teaching reference) (Unspecified, teaching re)
The Facts
Tennessee enacted SB1 prohibiting medical providers from administering puberty blockers or hormone therapy to minors for purposes of gender transition. Plaintiffs challenged the law under the Equal Protection Clause, arguing it discriminated based on sex. The Sixth Circuit upheld the law.
The Issue
Whether a state law banning gender-affirming medical care for transgender minors violates the Equal Protection Clause
The Rules
Fourteenth Amendment Equal Protection Clause
Sex discrimination standard of review — intermediate scrutiny
State authority to regulate medical practice
The Application
The Court applied rational basis review rather than heightened scrutiny by finding that Tennessee's law did not classify individuals based on sex, but rather on the purpose of medical treatment—permitting puberty blockers and hormone therapy for all minors when medically necessary for non-transition purposes while prohibiting them when used for gender transition. Under this framework, the differential impact on transgender youth did not trigger sex-based classification analysis because the law's text and design treated all minors uniformly regardless of sex. Applying rational basis review, the Court found that Tennessee's stated interest in protecting minors' health and development and ensuring informed decision-making was rationally related to the prohibition, satisfying the Equal Protection Clause despite the law's disparate practical effect on transgender individuals.
The Conclusion
Supreme Court upheld Tennessee's ban 6-3 in Skrmetti (2025). Majority held the law did not discriminate based on sex under equal protection. Justices Sotomayor, Kagan, and Jackson dissented.
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