In a major victory today, the Supreme Court issued a 6-3 decision upholding a Tennessee law that prohibits gender transition procedures for minors. The opinion, written by Chief Justice John Roberts, explains that Senate Bill 1 (SB1) does not violate the Equal Protection Clause and is not subject to heightened scrutiny.
The court found that the Tennessee law does not discriminate based on sex or transgender status; instead, SB1 is an exercise of the state’s constitutional responsibility to protect children from experimental and harmful medical procedures.
Southern Baptists have been unequivocally clear about the dangers of gender transition drugs and procedures on minors and the devastating effects they have on children. In October of 2024, the ERLC filed a brief before the Supreme Court alongside the Tennessee Baptist Mission Board, advocating for Tennessee’s law to be upheld and children to be protected from experimental gender transition procedures.
What is this “gender transition” case about?
The Tennessee State Legislature passed SB1 in 2023 to prevent healthcare providers from prescribing medications or performing procedures on minors to “transition” to an identity opposite of their biological sex. The bill prohibits any procedure for the purpose of:
- “Enabling a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex;
- Treating purported discomfort or distress from a discordance between the minor’s sex and asserted identity.”
The challengers in this case contend that SB1 violates sex discrimination protections in the Equal Protection Clause and asked the justices to examine the law under a heightened level of scrutiny. This means the law would have to satisfy more legal tests in order to survive. However, the justices declined to grant such a heightened review, ruling rational basis scrutiny was appropriate.
States have a constitutional responsibility to protect children from harm, and this ruling adds clear parameters to prevent harmful, potentially irreversible interventions.
Currently, 27 states have laws in effect that prohibit doctors from performing these dangerous surgeries and procedures on minors. Today’s decision from the court is vital to the favorable conclusion of legal challenges to many of these other laws. States have a constitutional responsibility to protect children from harm, and this ruling adds clear parameters to prevent harmful, potentially irreversible interventions.
What did the justices rule in this “gender transition” case?
Writing for the majority, Justice Roberts held that Tennessee’s law, SB1, does not rely on sex-based classifications, which may be subject to heightened scrutiny by the court. Instead, the court holds that SB1 classifies those subject to the statutory ban based on age and medical treatment. He writes:
“The plaintiffs argue that SB1 warrants heightened scrutiny because it relies on sex-based classifications. But neither of the above classifications turns on sex. Rather, SB1 prohibits healthcare providers from administering puberty blockers or hormones to minors for certain medical uses, regardless of a minor’s sex.” (10)
Justice Roberts continues:
“. . . SB1 does not exclude any individual from medical treatments on the basis of transgender status. Rather, it removes one set of diagnoses—gender dysphoria, gender identity disorder, and gender incongruence—from the range of treatable conditions. SB1 divides minors into two groups: those seeking puberty blockers or hormones to treat the excluded diagnoses, and those seeking puberty blockers or hormones to treat other conditions.” (3)
Justice Roberts makes clear that the law only prohibits puberty blockers and hormones from being administered to minors to treat gender dysphoria, gender identity, and gender incongruence but not other purposes when medically necessary.
Tennessee determined that administering puberty blockers or hormones to minors experiencing gender dysphoria often leads to irreversible, life-long consequences, and that minors were unable to understand and appreciate these risks. The court held that these determinations are sufficient to meet the rational basis level of scrutiny.
In its closing paragraph, the majority states that this “case carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field.” (24) Justice Roberts holds that the court’s role is “only to ensure that” the law “does not violate” the Equal Protection clause. “Having concluded that it does not, we leave questions regarding its policy to the people, their elected representatives, and the democratic process.” (24)
Thomas, Concurring:
Justice Thomas signed on to the majority opinion but also authored a separate concurrence, making it clear that he believes that nothing in the Constitution prevents States from restricting medical treatments for children, much less experimental ones like sex reassignment procedures.
Barrett, Concurring:
Justice Barrett also joined the majority opinion but added her own concurrence. She emphasized that transgenderism is not immutable or distinguishable, that the transgender population is not a “discrete group,” and that state legislatures, not courts, are best suited to make policy decisions regarding healthcare for individuals with gender dysphoria. She reasons “If laws that classify based on transgender status necessarily trigger heightened scrutiny, then the courts will inevitably be in the business of ‘closely scrutiniz[ing] legislative choices’ in all these domains.” (6)
Sotomayor, Dissenting:
Justice Sotomayor dissented from the majority, joined by Justice Jackson, and in part by Justice Kagan, arguing that SB1 plainly classifies on the basis of sex and transgender status, and thus warrants intermediate scrutiny not rational basis.
Sotomayor believes that the two classifications under SB1 (age, and medical treatments) exclude transgender individuals based on their sex and would subject the law to a higher level of scrutiny.
However, as Justice Roberts notes in his opinion, “the law does not prohibit conduct for one sex that it permits for the other.” Furthermore,“[t]his Court has never suggested that mere reference to sex is sufficient to trigger heightened scrutiny.” (13)
Why does this case matter to Southern Baptists?
This case directly confronts the harmful effects of gender ideology on children—an issue Southern Baptists have clearly and repeatedly spoken against. Southern Baptists desire to see children protected from the ideological agenda of the sexual revolution, which seeks to separate them from God’s good design for their lives as males and females. Southern Baptists have explicitly and frequently condemned the “harmful and often irreversible ‘gender transition’ experiments on vulnerable minors and young adults” (2023 resolution “On Opposing “Gender Transitions”, 2014 resolution “On Transgender Identity”).
Furthermore, as culture continues to cultivate an atmosphere that promotes gender confusion for children and adolescents, the ERLC has called upon state legislatures to enact laws like Tennessee’s SB1 to protect children from exploitation and safeguard parental rights (see State Policy Agendas from 2023, 2024, and 2025).
In response to today’s victory, ERLC President Brent Leatherwood said,
The protection of children from harmful transgender surgeries and interventions is not only an entirely appropriate action by the state, it is desperately needed in a culture that believes a person’s identity can be divorced from biological realities simply on a whim. Southern Baptists have been unequivocally clear about the dangers of ‘gender transition’ procedures and interventions on minors and the devastating effects they have on children.
The ERLC has opposed disastrous gender ideology legislation at every level of government—Congress, federal rulemaking, state government, and the courts—and will continue working to ensure that laws like SB1 are upheld and that children are not experimented on in the name of radical, unbiblical ideology.
