History was made earlier in June when the U.S. Supreme Court handed down a decision in United States v. Skrmetti. In a 6-3 majority, the Court upheld the constitutionality of a Tennessee law (SB 1) which banned untested and dangerous hormone therapy for gender dysphoric children. The decision also set a precedent that shields twenty-four similar state bans from Equal Protection challenges, including Kentucky’s SB 150.
The decision is rife with political controversy. But both legally and ethically, the Court’s decision is clearly the right one.
In February of 2023 a bi-partisan supermajority in the Tennessee legislature adopted SB 1, which prohibited healthcare providers from “Enabling a minor to identify with, or live as, a purported identity inconsistent with the immutable characteristics of the reproductive system that define the minor as male or female.” In effect, the bill banned gender-transitions for those under 18. In March the bill was signed into law by Governor Bill Lee.
In April of the same year, the American Civil Liberty Union (ACLU), the ACLU of Tennessee, Lambda Legal, and Akin Gump Strauss Hauer & Feld LLP sued the State of Tennessee to block the bill. Eventually, the case made it to the U.S. Supreme Court and was argued on December 4, 2024.
President Biden’s Department of Justice argued that SB 1 was a violation of The Equal Protection Clause of the Fourteenth Amendment insofar as it allowed for sex discrimination against transgender persons. The majority, however, held that though there are “fierce scientific and policy debates” concerning the transgender issue, “The Equal Protection Clause does not resolve these disagreements.”
Chief Justice Roberts went on to say that the role of the Court is not to judge “the wisdom, fairness, or logic” of Tennessee’s bill. Rather, “Questions regarding the law’s policy are thus appropriately left to the people, their elected representatives, and the democratic process.”
The majority got this decision right. States have the right to protect children from harmful and irreversible gender transition treatments. Indeed, to do so is not only a right—it’s a duty.
Though LGBTQ+ advocates see a denial of transgender treatment for minors as an assault on their very identity and well-being, states like Tennessee and Kentucky are right to see such legislation as necessary.
Children are young and impressionable, not capable of making such weighty and life-altering decisions—decisions that often leave the patient distraught and confused. The most comprehensive long-term study of individuals who underwent sex-reassignment procedures found that, within 10 to 15 years after surgery, suicide rates were significantly higher compared to their peers. In some cases, the suicide rate was nearly 20 times greater. Notably, this study was conducted in Sweden—a country generally supportive of transgender people. These elevated mental health risks are tragic and underscore the depth of distress these youth experience and the failure of irreversible medical procedures to demonstrably resolve them.
While these results are tragic, they should come as no surprise, as these treatments cannot bend reality to the patient’s will. And if these procedures end so tragically for consenting adults, they certainly should not be allowed for children. What children need is not the ability to mutilate their body in search of identity, but support from family, friends, and community to work through their dysphoria and learn to embrace their biological sex. To allow minors—who cannot vote, drink, or get a tattoo—to choose to receive treatments that will irreversibly change their bodies is simply irresponsible.
Many protest that Tennessee’s bill is strictly ideological—nothing more than a knee-jerk reaction to any LGBTQ+ affirming legislation. But there are many nations with vastly different political makeups than Tennessee which have passed similar restrictions on transgender treatments. As Politico reports, nations like the United Kingdom, Sweden, Finland and Norway have been reexamining and reversing the legitimacy of such treatments in recent years. This emerging consensus in Europe suggests that conservatives’ motivations stem not from ideology, but from a genuine commitment to protecting vulnerable youth.
By contrast, the left’s insistence upon the supposed right of a child to undergo gender transition treatments underscores the danger of policy driven by ideology rather than by truth. The consequence of such ideology is the exploitation of the vulnerable. The U.S. Supreme Court was right to that affirm states have the authority to protect their children from dangerous gender transition treatments. But beyond legal rights, this moment reveals that protecting vulnerable youth is not only a moral right, but a moral responsibility—one that demands action.