The Supreme Court upheld a Tennessee law that banned gender-affirming treatments for minors on Wednesday, giving states a free hand to restrict access to puberty blockers and hormone therapies for young transgender Americans.

Chief Justice John Roberts, who wrote for the court, rejected a Fourteenth Amendment challenge that had been brought against the law. “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,” he wrote. “The voices in these debates raise sincere concerns; the implications for all are profound. The Equal Protection Clause does not resolve these disagreements.”

It is fitting that Roberts wrote the majority opinion in United States v. Skrmetti because it is representative of his court’s slipshod approach to major, high-profile cases. The Supreme Court’s conservative majority effectively engineered a landmark case on transgender rights in which no transgender person is a named litigant, reducing them and their interests to an easily ignored abstraction. The result is tortured reasoning, misapplied precedents, and a transparently outcome-oriented ruling.

Skrmetti was expected to be a landmark ruling on whether transgender Americans, as a group, could receive a heightened level of judicial protection under the equal protection clause. Instead, the justices upheld the statute on narrower grounds by holding that it did not discriminate on the basis of sex or gender identity at all.

The ruling, on its own terms, drew sharp criticism from the court’s three liberal justices. In her dissent, Justice Sonia Sotomayor castigated the majority for what she saw as a blow to sex-based discrimination protections in general—and for the impact it would have on transgender Americans across the country. “By retreating from meaningful judicial review exactly where it matters most, the Court abandons transgender children and their families to political whims,” she wrote. “In sadness, I dissent.”

The dispute centered on Tennessee Senate Bill 1, which was enacted in 2023 as part of a Republican-led legislative pushback against transgender Americans in general. The law bans doctors in Tennessee from approving prescriptions or surgeries that “[enable] a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex” or “[treat] purported discomfort or distress from a discordance between the minor’s sex and asserted identity.” Puberty blockers and hormones are specifically targeted by the statute.

Major medical associations, including the American Medical Association and the American Academy of Pediatrics, have endorsed gender-affirming treatments for young people for transgender youth, citing high rates of suicidial ideation, self-harm, and other destructive behaviors if left untreated. To that end, a group of transgender children, their families, and their medical providers sued the state shortly after the law was passed, arguing among other things that it violated the Fourteenth Amendment’s equal protection clause. (The Biden administration also sued Tennessee over S.B. 1, giving the combined case its current title.)

The constitutional argument took two forms. On one hand, the plaintiffs........

© New Republic