Decision Marks Win For Child Safety
In a landmark 6–3 decision, the U.S. Supreme Court has upheld Tennessee’s law banning transgender medical procedures for minors, marking a major legal and cultural victory for advocates seeking to protect children from harmful and experimental treatments.
The ruling in United States v. Skrmetti affirms the constitutionality of Tennessee’s 2023 “Save Adolescents from Experimentation (SAFE) Act,” also known as SB1, which prohibits doctors from prescribing puberty blockers, cross-sex hormones, or performing surgical gender transitions on minors. The decision is expected to strengthen similar laws in at least 26 other states.
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“Not a Violation of Equal Protection”
Writing for the majority, Chief Justice John Roberts made clear that the Court’s decision is limited to the constitutional question of whether Tennessee’s law violates the Equal Protection Clause.
“Having concluded that it does not,” Roberts wrote, “we leave questions regarding its policy to the people, their elected representatives, and the democratic process.”
During oral arguments in December 2024, several justices had raised concerns about whether the Due Process or Equal Protection Clauses could be used to prohibit states from banning gender-related medical procedures for minors, especially in light of the lack of international consensus on such treatments.
The majority opinion ultimately found that Tennessee’s law does not discriminate on the basis of sex because it applies equally to boys and girls, and that the state has a legitimate interest in protecting children from medical risks. The Court applied a “rational basis” standard—one of the most deferential forms of judicial review—deferring to the state’s judgment in regulating these sensitive medical matters.
Background and Political Shift
The Biden administration had initially supported the plaintiffs—three families with gender-dysphoric children—arguing that the law constituted unconstitutional discrimination. However, in February 2025, the Trump administration reversed that position, formally notifying the Court that it considered Tennessee’s law constitutional.
The Trump administration’s brief called the procedures “barbaric” and cited an executive order halting federal funding to organizations that promote or provide gender transition surgeries to minors under the age of 19. The administration urged the Court to issue a clear ruling to provide legal clarity for the growing number of related cases across the country.
Law Allows Lawsuits Against Violators
Tennessee’s SAFE Act not only bans these medical interventions for minors but also includes provisions allowing families to sue providers if a child is harmed by treatments that violate the law. The state framed the law as a measure to protect children from experimental and irreversible procedures that carry long-term health risks.
The Sixth Circuit Court of Appeals had previously upheld the law, finding that protecting minors from such interventions is a legitimate state interest and that banning these procedures does not amount to sex discrimination. That ruling was now affirmed by the Supreme Court.
Dissent from Liberal Justices
Justice Sonia Sotomayor, joined by Justices Elena Kagan and Ketanji Brown Jackson, issued a strong dissent, warning that the ruling authorizes “untold harm to transgender children.”
“By withholding treatment from transgender minors—and only transgender minors—Tennessee sends a clear message: Transgender youth are lesser, their identities less worthy, their lives less valuable,” Sotomayor wrote.
She argued the ruling creates a “legal limbo” for trans youth and criticized the majority for deferring to legislative bodies rather than protecting what she described as fundamental rights.
Liberty Counsel Praises the Ruling
Liberty Counsel Founder and Chairman Mat Staver called the decision “a victory for children everywhere and for the rule of law.”
“The Constitution does not allow for the harming of children with dangerous drugs and irreversible, experimental surgeries,” Staver said. “Banning experimental gender interventions on children for both sexes is not an Equal Protection issue—it is a child safety issue. All states need to follow suit and ban child medical mutilation.”
What’s Next?
Faith-based and family organizations applauded the ruling as a step toward protecting children. The case underscores a return to common-sense lawmaking in our country, where the innocence of our nation’s youth is protected.
