The question
Whether a state law banning certain medical treatments for transgender minors must face heightened constitutional scrutiny under the Equal Protection Clause.
United States v. Skrmetti
What the Court decided
The Court upheld Tennessee's ban on puberty blockers and hormone therapy for transgender minors. It held the law is not a sex classification that triggers heightened scrutiny under the Equal Protection Clause, so it needs only a rational basis, which the Court found the state met. The ruling leaves such bans in place in the states that have them.
How the justices split
6-3The Court's opinion
Roberts, joined by Thomas, Gorsuch, Kavanaugh, Barrett
The law draws lines based on age and medical diagnosis, not sex, so it is not a sex classification and does not trigger heightened equal-protection scrutiny. Under rational-basis review the state may regulate these treatments given ongoing debate about their risks and benefits for minors. The wisdom of the policy is for legislatures.
Concurring in the judgment
Alito, writing alone
Alito agreed the law should be upheld but wrote separately, and would have addressed whether transgender status is a suspect class more directly than the majority did.
Dissenting
Sotomayor, joined by Kagan, Jackson
The dissent argued the ban plainly turns on sex, because whether a treatment is allowed depends on the sex the patient was assigned at birth, so it should face heightened scrutiny. It argued the majority abandons transgender adolescents and their families to the political process.
How we know · 3 sourced claims
The Court held Tennessee's law is not subject to heightened scrutiny under the Equal Protection Clause and satisfies rational-basis review.
Source: syllabus, Held, at 23-477
The Court reasoned the law classifies by age and medical use, not sex.
Source: opinion of the Court (Roberts, C.J.)
Roberts, C.J., wrote for the Court; Sotomayor, J., dissented, joined by Kagan and Jackson, JJ.
Source: syllabus, lineup