“Having concluded that it does not, we leave questions regarding its policy to the people, their elected representatives, and the democratic process,” wrote Chief Justice Roberts. During oral arguments in December 2024, many of the Justices questioned whether the Due Process Clause or the Equal Protection Clause prohibited a state from banning gender transition surgery on minors, especially due to the lack of international medical consensus on gender procedures.
The decision is likely to keep in effect the similar laws protecting children in 26 other states.
The Biden administration, along with three families with gender-confused children, took issue with the Sixth Circuit Court of Appeals ruling that found that banning “experimental” interventions for both sexes was not sex discrimination and that protecting children from these drugs and procedures is a legitimate state interest. Tennessee’s “Save Adolescents from Experimentation (SAFE) Act,” also known as SB 1, was enacted in 2023 and prohibited medical professionals from administering these procedures on any minor and allows children injured during violations of this law, or their parents, to sue those responsible.
In February 2025, the Trump administration had notified the U.S. Supreme Court that it considered Tennessee’s law banning child medical mutilation constitutional reversing the federal government’s previous position on the issue. The Trump administration urged the High Court, which had already heard oral arguments in the case, to still decide it on its merits as the decision would affect many other legal cases.