The Supreme Court ruled Wednesday, June 18, that the Tennessee law banning puberty blockers and hormone therapy for minor-aged children who identify as transgender does not violate the U.S. Constitution.
The 6-3 decision in United States of America v. Skrmetti upholds the legality of Tennessee's law. The majority opinion was authored by Chief Justice John Roberts, who was joined by Justices Clarence Thomas, Neil Gorsuch, Brett Kavanaugh, Amy Barrett, and Samuel Alito.
The dissent was authored by Justice Sonia Sotomayor. Justices Elena Kagan and Katanji Brown Jackson joined.
“No one has the right to harm a child,” said Alliance Defending Freedom (ADF) CEO and President Kristen Waggoner.
ADF is a "non-profit legal organization committed to protecting religious freedom, free speech, parental rights, and the sanctity of life." The organization filed a friend-of-the-court brief last year supporting the Tennessee law.
“The Biden administration and ACLU asked the court to create a ‘constitutional right’ to give children harmful, experimental drugs and surgeries that turn them into patients for life," said Waggoner.
"This would have forced states to base their laws on ideology, not evidence — to the immense harm of countless children. The court’s rejection of that request is a monumental victory for children, science, and common sense. States are free to protect children from the greatest medical scandal in generations — and that’s exactly what states like Tennessee have done.”
In 2023, Tennessee was one of several states who passed legislation banning puberty blockers and other treatments for minor-aged children who identify as transgender.
As of 2025, 26 states have laws similar to Tennessee's.
Irreversible changes
In the decision, Roberts noted that the issue of child gender transition "carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field.”
Nevertheless, Roberts said that the Supreme Court's role was to rule on the constitutionality of the law.
The court found that the law is "plainly rationally related" to how the use of puberty blockers and cross-sex hormones in children can have lifelong, irreversible consequences.
These treatments “can lead to the minor becoming irreversibly sterile, having increased risk of disease and illness, or suffering from adverse and sometimes fatal psychological consequences,” said the Supreme Court.
