The Supreme Court Wednesday upheld Tennessee’s ban on transgender procedures on minors, ruling 6-3 that the state law is nondiscriminatory.

The law, known as SB1, was signed by Republican Tennessee Gov. Bill Lee in March 2023. The law bans hormone therapy, puberty blockers and other transgender treatments on children under 18. Under the law, healthcare providers who break the rule are subject to lawsuits, fines and penalties.

The law cites health risks posed on children by take such treatments, including “becoming irreversibly sterile, having increased risk of disease and illness, or suffering from adverse and sometimes fatal psychological consequences.” It also acknowledges that the many of the procedures on minors “are experimental in nature and not supported by high-quality, long-term medical studies.”

In April 2023, the law was contested by three transgender youth and their families who filed suit against the state, with the Biden administration joining in the challenge. The Supreme Court heard oral arguments in December 2024.

Todd Chasteen, vice president of public policy and general counsel for Samaritan’s Purse, traveled to the Supreme Court to hear the case and attended portions of the hearing.

“Over 20 other states have laws protecting children from harm and danger of transgender hormone-blocking, cross-sex hormones and surgery,” Chasteen told Decision. “This decision will help those laws stand and protect children from irreversible harm.”

Kristen Waggoner, CEO and president of Christian legal organization Alliance Defending Freedom, celebrated the ruling.

“No one has the right to harm a child,” said Waggoner. “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. 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.”

The American Civil Liberties Union, the ACLU of Tennessee, Lambda Legal and Akin Gump Strauss Hauer & Feld LLP, who filed suit on behalf of the families, contended that the rule violates the Equal Protection Clause of the 14th Amendment.  

However, the Supreme Court’s conservative majority held that the law does not violate the law, it said, because SB1 is not a civil rights issue but rather a medical issue, and the restrictions are based on age-related considerations.

“SB1 does not exclude any individual from medical treatments on the basis of transgender status,” the majority opinion penned by Chief Justice John Roberts states. “Rather, it removes one set of diagnoses—gender dysphoria, gender identity disorder, and gender incongruence—from the range of treatable conditions.”

“In today’s historic Supreme Court win, the common sense of Tennessee voters prevailed over judicial activism,” said Tennessee Attorney General Jonathan Skrmetti. 

Supporters of the ban stood outside the U.S Supreme Court, which was hearing the December 2024 oral argument. Photo: ZUMA Press, Inc. / Alamy Stock Photo