The Supreme Court on Wednesday upheld a Tennessee law that prohibits some medical treatments for transgender youths, rejecting arguments that it violated the Constitution and shielding similar laws in more than 20 other states.
The decision, which came amid the Trump administration’s fierce assaults on transgender rights, was a bitter setback for their proponents, who only five years ago celebrated a decision by the court to protect transgender people from workplace discrimination.
The vote was 6 to 3, with the court’s three liberal members in dissent. Chief Justice John G. Roberts Jr., writing for the majority, acknowledged the “fierce scientific and policy debates about the safety, efficacy and propriety of medical treatments in an evolving field. The voices in these debates raise sincere concerns; the implications for all are profound.”
But he said these questions should be resolved by “the people, their elected representatives and the democratic process.”
The Tennessee law, enacted in 2023, prohibits medical providers from prescribing puberty-delaying medication, offering hormone therapy or performing surgery to treat the psychological distress caused by incongruence between experienced gender and that assigned at birth. It was part of a sweeping national pushback to expanding rights for transgender people. Since then, controversies about military service, athletes, bathrooms and pronouns have played a role in President Trump’s second-term agenda.
In a measure of the shifting politics around transgender issues, the Biden administration intervened on those fighting the ban. After Mr. Trump took office, his administration issued an executive order directing agencies to take steps to curtail surgeries, hormone therapy and other gender transition care for youths under 19. And in February, his administration formally reversed the government’s position in the case and urged the justices to uphold the law.
The doctor and three families who sued to challenge the Tennessee law said it discriminated based on both sex and transgender status in violation of the Constitution’s equal protection clause. They noted that the law specified that the prohibited treatments were allowed when undertaken for reasons other than gender transition care.
Adam Liptak covers the Supreme Court and writes Sidebar, a column on legal developments. A graduate of Yale Law School, he practiced law for 14 years before joining The Times in 2002.
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