Last week, the Supreme Court dealt a devastating blow to trans youth, their families and the communities that support them. In a 6-3 decision, the Supreme Court ruled in Skrmetti v. U.S. that SB1— Tennessee's ban on gender-affirming care for minors —does not illegally discriminate against individuals on the basis of sex or transgender status. This allows Tennessee, and any other states that may choose to follow its discriminatory lead, to ban medically-necessary health care for minors.
As one of the Tennessee parents challenging this ban put it, “the Supreme Court’s ruling on Wednesday will make it even harder for our daughter to get lifesaving health care. It will harm the lawsuit’s unnamed families and those that come after us, with younger kids just starting to understand and express themselves.”
This is a blow for trans youth who simply want to grow up healthy, supported, and seen. It is not, however, where the legal battle ends. Importantly, the Supreme Court limited its ruling to just Tennessee’s law. It did not decide on the broader questions about the legality of discrimination against transgender people in other areas.
Below, the American Civil Liberties Union breaks down what the court’s ruling means for trans youth across the nation, how we can all fight back, and how we can best support ourselves and our communities in this moment.
What Does the Court’s Ruling Mean For Trans Youth?
The Supreme Court’s ruling does not impact youth in states that have not passed gender-affirming care bans. For young people in Tennessee and Kentucky, however, this ruling means that access to medical care that has been deemed essential by every major medical organization will be denied. In states like Indiana, Alabama, and Florida, where courts have upheld similar bans, this ruling may embolden lawmakers and courts to let those bans stay in place.
Does Skrmetti Limit Care for Trans Adults?
No. This case was specifically about minors in two states – Kentucky and Tennessee.
The ruling didn’t address an equally powerful claim raised in Skrmetti and other cases: that these bans violate the rights of parents to direct their children’s medical care. In this case parents, who are legal adults, can challenge whether denying their minor child health care is a violation of their rights. That fight continues in lower courts, including a major case in Arkansas where four transgender youth and their families are challenging a similar ban.
What Can State Courts Do to Protect Trans Rights?
Though the Supreme Court did not provide federal-level security for trans individuals to seek care, at the state-level, bans can still be challenged under state constitutions and laws, which in some cases offer stronger protections than federal law.
This work is already happening in states like Montana, where state courts have blocked gender-affirming care bans under state law, and medical care is still accessible. Kansas and Ohio are also challenging bans on gender-affirming care in their court systems.
Does the Skrmetti Ruling Impact Any of Trump's Anti-Trans Executive Orders?
No. U.S. v. Skrmetti does not resolve challenges to anti-trans executive orders from the Trump administration. This case was about medical care for transgender minors in two states—it does not speak to broader attacks on transgender rights.
The ACLU, our nationwide affiliate network, and other LGBTQ rights organizations are challenging many of Trump’s attacks on transgender people’s rights and health care, including his orders restricting our ability to update passports and his order attempting to coerce doctors to drop their transgender patients.
How Can We Support the Trans Community Today?
Transgender youth deserve to be safe, loved, and respected—everywhere. You can help by taking action:
- Connect with your state ACLU affiliate, PFLAG, or local LGBTQ organizations.
- Support the Trans Youth Emergency Project, a nationwide effort by the Campaign for Southern Equality helping families access the care their children need.
- Contact your members of Congress and demand they stand with transgender people and families—rejecting laws that let politicians dictate our personal health care decisions.
Every action, every voice, every ally matters. The fight for trans lives isn’t over—and it needs you.
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