- High Court sides with Tennessee law that regulates harmful drugs, surgeries attempting to “transition” children
- Ruling in United States v. Skrmetti will help protect 26 similar state laws

WASHINGTON (18 June 2025) – In a landmark victory for children’s health and science-based medicine, the U.S. Supreme Court Wednesday upheld Tennessee’s law protecting minors from harmful and life-altering drugs and surgeries. The ruling in United States v. Skrmetti will help protect 26 similar state laws and return common sense to America’s medical system.
The Court held that Tennessee’s Senate Bill 1, a bipartisan law passed in 2023, is constitutional. The law prohibits health care providers from providing puberty blockers or cross-sex hormones or potentially irreversible surgeries to encourage children to live as the opposite sex.
"States are free to protect children from the greatest medical scandal in generations—and that’s exactly what states like Tennessee have done."
- Kristen Waggoner, CEO and President, Alliance Defending Freedom
The ruling signals that American states have broad constitutional authority to ban dangerous so-called “gender transition” procedures and interventions for minors, and it aligns the U.S. with a growing international movement to protect youth from gender ideology.
“No one has the right to harm a child,” said Alliance Defending Freedom CEO and President Kristen Waggoner. “The Biden administration and ACLU asked the court to create a ‘constitutional right’ to give children harmful, experimental drugs and surgeries that turn them into patients for life. This would have forced states to base their laws on ideology, not evidence—to the immense harm of countless children. The court’s rejection of that request is a monumental victory for children, science, and common sense. States are free to protect children from the greatest medical scandal in generations—and that’s exactly what states like Tennessee have done.”
Tennessee’s law is “plainly rationally related” to the state’s findings that administering puberty blockers and cross-sex hormones to minors with gender dysphoria “can lead to the minor becoming irreversibly sterile, having increased risk of disease and illness, or suffering from adverse and sometimes fatal psychological consequences,” the court wrote in its opinion. The law is also rationally related to “the State’s objective of protecting minors’ health and welfare.”
Background
Currently, 26 states, in addition to Tennessee, have enacted comparable laws in the U.S to protect children from gender-ideology experiments. The High Court decided to review the case United States v. Skrmetti after the Biden administration appealed a decision by the U.S. Court of Appeals for the 6th Circuit that upheld Tennessee’s law. ADF filed a friend-of-the-court brief with the Supreme Court in October 2024, urging it to let state legislatures protect children from these experimental medical procedures.
The Court’s decision follows a global shift toward dismantling gender ideology. In the United Kingdom, the closure of London’s Tavistock Clinic and the publication of the Cass Review signaled a clear rejection of gender ideology experimentation on young people. As highlighted in an amicus brief to the Court from 17 international parental rights organisations, Sweden, Finland, Denmark, Norway, Italy, Hungary, and Slovakia are among the list of European countries that have taken legislative, judicial, or administrative steps to protect minors from gender ideology. In Latin America, Chile moved to ban gender “transition” for children in May, following bans in Argentina and Brazil.