The Supreme Court heard oral arguments Wednesday on a Tennessee law that bans the use of puberty blockers and hormone therapy for minors. The Tennessee law says there is a compelling interest to protect children.  

(full screen statement) 

“These procedures can lead to the minor becoming irreversibly sterile, having increased risk of disease and illness, or suffering from adverse and sometimes fatal psychological consequences.” 

James Mathew Rice, Office of Tennessee Attorney General 1:46:25

Its application turns entirely on medical purpose, not a patient’s sex. That is not sex discrimination. 1:46:44 Just as using morphine to manage pain differs from using it to assist suicide, using hormones and puberty blockers to address a physical condition is far different from using it to address psychological distress associated with ones body. 

The ACLU and Biden Administration argued against the law’s categorical ban for children who identify differently than their birth sex. 

Elizabeth Prelogar, US Solicitor General: “It doesn’t matter what parents decide is best for their children, it doesn’t matter what patients would choose for themselves, and it doesn’t matter if doctors believe this treatment is essential for individual patients.” 

This decision will impact transgender care nationwide because there are similar laws in 23 other states. 

Justice Alito asked the ACLU attorney, who is transgender, about minors who transition and then change their mind. 

Alito: Are there not such people?

Chase Strangio: There are such people I agree with that. 

Alito: So it’s not an immutable characteristic is it? 

Strangio: Well I think people’s understanding of it shifts. But the evidence shows there’s at least a strong underlying basis. I think the normative reason for that particular consideration is whether or not this is something that someone should or could change and whether they would have to change it in order to receive constitutional protections and I think transgender status clearly fits within that.  

That was one of Tennessee’s main points – the changes to the body are permanent, but the child may one day seek to reverse. 

James Mathew Rice, Office of Tennessee Attorney General Tc :28 They cannot eliminate the risk of detransitioners so it becomes a pure exercise of weighing benefits vs. risk. And the question od how many minors have to have their bodies irreparably harmed for unproven benefits is one that is best left to the legislature. 

Sotomayor: “I’m sorry counselor. Every medical treatment has a risk, even taking aspirin. There’s always going to be a percentage of the population under any medical treatment that’s going to suffer a harm.” 

Justice Sotomayor said the case is really about sex based differences. The law allows certain drugs to be used for children who have medical conditions like early puberty or delayed puberty, but not those who want to change gender. 

It could be months before the justices release a final decision, as they are still in the first half of their term which won’t end until approximately June 2025.