In a much-anticipated decision, United States v. Skrmetti, the Supreme Court handed a win to states seeking to protect children from sex-rejecting hormonal and surgical procedures. The 6–3 decision, with Chief Justice Roberts writing for the majority, dealt a significant blow to the transgender juggernaut, curtailing the strategy of using courts to thwart legislative or executive action that protects children from the harms of “transition” procedures. But the Justices shied away from addressing more fundamental definitions of the human person, meaning we’ll likely see the transgender issue in court again before long.

The key question in Skrmetti was whether Tennessee’s 2023 law prohibiting sex “transition” treatments for minors—including puberty suppression, cross-sex hormones, and surgical interventions—is a sex-based classification requiring “heightened scrutiny” under the Equal Protection Clause. The majority held that the Tennessee law did not involve a sex-based classification but instead “prohibits healthcare providers from administering puberty blockers and hormones to minors for certain medical uses, regardless of a minor’s sex.” Classifications that “turn on age or medical use” (not sex) are subject to “rational basis review.” In this case, the Court found that the state has a “legitimate, substantial, and compelling interest in protecting minors from physical and emotional harm.” Policy questions, such as those raised by Tennessee’s law, are best left “to the people, their elected representatives, and the democratic process.” 

Read it all in First Things