In 2023, the state legislature of Tennessee passed a law called SB 1, which explicitly banned minors who identified as transgender from receiving puberty blockers and hormone therapy. It was also later amended to ban “gender-affirming surgeries”.

The text of the bill prohibited health care providers from administering puberty blockers or hormones for the purpose of “enabling a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex [or] treating purported discomfort or distress from a discordance between the minor’s sex and asserted identity.”

This law applied to anyone in the state below the age of 18—even if that child had obtained their parents' consent.

However, the law did allow for some exceptions. Children who needed these treatments for medical reasons would still be allowed to have them. For instance, under the law as it was written, a child who experienced early onset puberty could still be given puberty blockers by their doctor. It’s just that these interventions could no longer be given to children simply because they identified as transgender.

Within days of passing, the law was challenged in court.

Civil rights groups sued the state, arguing that the law was a violation of the 14th Amendment’s equal protection clause. On the flip side, the state of Tennessee argued that this wasn’t discrimination; rather, it was simply the regulation of medical care for minors—something well within the purview of the state.

The case eventually made its way up to the U.S. Supreme Court where, after hearing both sides of the argument, there was a 6–3 split decision in favor of Tennessee—and in favor of the other 25 states that have similar laws on their books.

Let’s go through the details of this ruling together.