ACLU, Lambda Legal Respond to Supreme Court Ruling in U.S. v. Skrmetti

This morning, the Supreme Court issued its ruling in U.S. v. Skrmetti, a challenge brought by three transgender adolescents, their families, and a Memphis-based medical provider against a Tennessee law banning gender-affirming hormone therapies for transgender people under 18.

The Court agreed with parts of the Sixth Circuit’s opinion that allowed the law to take effect, holding that Tennessee’s SB1 does not draw a sex-based (or a trans status-based) line and thus only necessitates deferential review by the courts. That means SB1 can remain in effect. Notably, however, the decision is based on the record in and context of the Tennessee case and therefore does not extend to other cases concerning discrimination based on transgender status.

“Today’s ruling is a devastating loss for transgender people, our families, and everyone who cares about the Constitution,” said Chase Strangio, Co-Director of the ACLU’s LGBTQ & HIV Project. “Though this is a painful setback, it does not mean that transgender people and our allies are left with no options to defend our freedom, our health care, or our lives. The Court left undisturbed Supreme Court and lower court precedent that other examples of discrimination against transgender people are unlawful. We are as determined as ever to fight for the dignity and equality of every transgender person and we will continue to do so with defiant strength, a restless resolve, and a lasting commitment to our families, our communities, and the freedom we all deserve.”

“This is a heartbreaking ruling, making it more difficult for transgender youth to escape the danger and trauma of being denied their ability to live and thrive,” said Sasha Buchert, Counsel and Director of the Nonbinary and Transgender Rights Project at Lambda Legal. “But we will continue to fight fiercely to protect them. Make no mistake, gender-affirming care is often life-saving care, and all major medical associations have determined it to be safe, appropriate, and effective. This is a sad day, and the implications will reverberate for years and across the country, but it does not shake our resolve to continue fighting.”

“Today the Supreme Court told Tennessee transgender youth and their families that they cannot access healthcare that is vitally important for a successful life,” said Lucas Cameron-Vaughn, Senior Staff Attorney at the ACLU of Tennessee. “This ruling creates a class of people who politicians believe deserve healthcare, and a class of people who do not. We will continue to stand with transgender people in Tennessee and are committed to realizing a world where all people belong, are valued, and can access the necessary healthcare they need.”

U.S. v. Skrmetti began when a lawsuit was filed by the American Civil Liberties Union, the ACLU of Tennessee, Lambda Legal, and Akin Gump Strauss Hauer & Feld LLP on behalf of Samantha and Brian Williams of Nashville and their 16-year-old transgender daughter, as well as two other plaintiff families filing anonymously and Memphis-based physician Dr. Susan Lacy. The plaintiff families and Dr. Lacy argued that the law violates the Equal Protection rights of transgender adolescents. Under President Joe Biden, the United States intervened to also argue that the Tennessee law violates the Equal Protection Clause of the 14th Amendment. After President Trump’s inauguration, the U.S. reversed its position.

Since 2021, 25 states have enacted categorical bans on gender-affirming medical care, such as hormone therapy and puberty-suppressant medications, for treating gender dysphoria in transgender youth yet readily allow those same medications for other and similar purposes for cisgender youth. Over 100,000 transgender people under 18 now live in a state with a ban on their health care.

In January 2025, the Trump administration issued an executive order directing federal agencies to withhold funds from medical providers and institutions that provide gender-affirming medical treatments such as puberty suppressants and hormone therapies to any trans person under 19. That order was soon challenged on behalf of families, medical providers, and advocates by the ACLU and the Lambda Legal and is blocked from enforcement by a preliminary injunction.

This case is a part of the ACLU’s Joan and Irwin Jacobs Supreme Court Docket.