What the US Supreme Court Will Consider When It Rules on Gender-Affirming Care for Trans Children

'Encouraging minors to appreciate their sex'

In 2023, Tennessee Gov. Bill Lee signed into law Tennessee Senate Bill 1, known as SB1. SB1 bans gender-affirming medical care for trans people under the age of 18.

It does this by prohibiting health care providers from offering medical care designed to help minors identify with a gender that differs from the one they were assigned at birth. It also prohibits certain forms of medical care designed to treat gender dysphoria – the discomfort or distress due to having a gender identity that differs from one's sex assigned at birth or one's sex-related physical characteristics.

The Tennessee law prohibits anyone from providing puberty blockers or hormones such as estrogen or testosterone to trans youth for these purposes. But the law still allows the provision of puberty blockers and sex hormones for other medical purposes, such as treating congenital defects, early puberty or physical injury.

The Tennessee legislature claims in the text of the law that "this state has a legitimate, substantial, and compelling interest in encouraging minors to appreciate their sex" and in protecting the ability of minors to grow into adults "who can create children of their own."

Shortly after SB1 was passed, the American Civil Liberties Union sued Tennessee on behalf of various trans youth and their parents. They claimed that the law discriminated based on sex in violation of the equal protection clause of the U.S. Constitution.

A district court judge granted the the ACLU's request for a preliminary injunction. This temporarily stopped the enforcement of SB1. But a divided panel of federal judges later reversed the district court's judgment, allowing the law to go into effect.

The ACLU and the Biden administration then appealed to the Supreme Court, which agreed to review the case.