On June 18, 2025, the U.S. Supreme Court issued a decision in United States v. Skrmetti, which challenged a Tennessee law (S.B. 1) that bans medically necessary gender-affirming health care for transgender youth. The Supreme Court affirmed a lower court’s decision to uphold Tennessee’s ban. The court found that Tennessee’s law is not subject to heightened scrutiny under the Fourteenth Amendment’s Equal Protection Clause.
This case made its way to the Supreme Court in 2023 after Tennessee Governor Bill Lee signed S. B. 1 into law, effectively banning gender-affirming medical care for transgender youth and ignoring well-established best practices in medicine. The law makes health care providers who violate these restrictions liable to civil lawsuits and risks the suspension of their licenses to practice medicine. Transgender youth, along with their parents and a doctor who treats transgender patients, filed a lawsuit challenging the constitutionality of S.B. 1 as a violation of the Equal Protection Clause of the Fourteenth Amendment because it discriminates on the basis of sex and transgender status. The Biden-Harris Administration – as well as a group of transgender youth, their parents, and a medical provider – asked the Supreme Court to intervene after a federal appeals court upheld the ban.
LDF, alongside co-counsel Weil, Gotshal & Manges LLP, filed an amicus brief in the case on September 3, 2024. The brief argues that the health care ban is rooted in animus and violates the Fourteenth Amendment. By placing the bill within the broader context of nationwide attacks against LGBTQ+ people, the brief makes clear that Tennessee’s ban is grounded in discrimination rather than concern for the health and well-being of transgender youth. This has specifically led to significant harms to Black transgender people.
Over the last few years, Tennessee and many other states have passed laws banning access to medically necessary health care for transgender youth. Over 500 anti-LGBTQ+ bills were introduced throughout the country in 2023 alone. S.B. 1 clearly singles out transgender people for unequal treatment, exacerbating the already-rampant discrimination they encounter.
The dramatic increase in such bills has been fueled by a rise in the political and social targeting of LGBTQ+ persons, and transgender people in particular, as immoral and dangerous. This hostility has resulted in grave harms to the mental health and physical safety of LGBTQ+ people, especially Black transgender people, who already endure rampant discrimination and violence.
LDF is committed to fighting attacks impacting the various communities in which we belong. Anti-transgender laws like Tennessee’s S. B. 1 harm Black youth and their families and create a less inclusive, fair, and equal society for us all.
