The Supreme Court on Wednesday delivered a substantial blow to transgender-rights advocates in upholding a 2023 Tennessee law banning gender-affirming care for minors, a decision that could have far-reaching consequences for the future of transgender health in the U.S. but whose impact won’t be felt right away.

“The immediate outcome is that it doesn’t change anything,” said Kellan Baker, executive director of the Institute for Health Research and Policy at Whitman-Walker, a Washington-based nonprofit. “It doesn’t affect the availability or legality of care in states that do not have bans, and it simply says that states that have decided to ban this care can do so if they survive other challenges.”

Twenty-seven Republican-led states since 2021 have adopted laws that ban transition-related care, including puberty blockers, hormone therapy and rare surgeries for minors. Laws passed in Arizona and New Hampshire — the first Northeastern state to have restricted gender dysphoria treatments for youth — only prohibit minors from accessing surgeries, a provision that was not at issue before the Supreme Court.

In a 6-3 decision, the high court upheld a lower court ruling that found Tennessee’s restrictions do not violate the U.S. Constitution’s Equal Protection Clause. The state’s law, which allows cisgender children and teens to access medications that it bans for trans minors, makes distinctions based on age and diagnosis, the courts ruled, rather than sex and transgender status.

Three Tennessee families, a doctor and the Biden administration, along with attorneys at the American Civil Liberties Union (ACLU) and Lambda Legal, argued the measure amounts to illegal sex discrimination, warranting heightened review.

“Having concluded it does not,” Chief Justice John Roberts wrote for the majority on Wednesday, “we........

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