Courthouse Steps Decision: United States v. Skrmetti

In the last several years, numerous minors who identify as transgender have undergone surgery and other medical procedures to mirror common physical features of the opposite sex.
In March 2023, Tennessee enacted Senate Bill 1, which prohibits medical procedures for the purpose of either (1) enabling a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex, or (2) treating purported discomfort or distress from a discordance between the minor’s sex and asserted identity. Individuals, joined by the United States, brought suit against Tennessee. They alleged that a ban on “gender affirming care” violates the Equal Protection Clause and that the Due Process Clause’s “substantive” component gives parents a right to demand medical interventions for their children, even if a state has found them to be unproven and risky.
On June 18th, 2025, the Supreme Court ruled in a 6-3 decision that Tennessee’s law prohibiting certain medical treatments for transgender minors is not subject to heightened scrutiny under the Equal Protection Clause of the Fourteenth Amendment and satisfies rational basis review.
Featuring:

Erin M. Hawley, Senior Counsel, Vice President of Center for Life & Regulatory Practice, Alliance Defending Freedom
(Moderator) Ilya Shapiro, Senior Fellow and Director of Constitutional Studies, Manhattan Institute