In a 6-3 decision, the Supreme Court justices asserted that states generally have the authority to set medical care standards, especially when medical experts disagree.

According to Chief Justice John G. Roberts, who wrote the court’s opinion, states are responsible for establishing medical regulations. He stated, “We leave questions regarding its policy to the people, their elected representatives, and the democratic process.”

Dissenting, Justice Sonia Sotomayor argued that the law “plainly discriminates on the basis of sex… By retreating from meaningful judicial review exactly where it matters most, the Court abandons transgender children and their families to political whims. In sadness,I dissent.” Justices Elena Kagan and Ketanji brown Jackson concurred with the dissent.

The ruling upholds laws in Tennessee and 23 other Republican-led states, all enacted within the last four years.

Tennessee legislators have stated that diagnoses of gender dysphoria among minors have “exploded” recently,leading to a “surge in unproven and risky medical interventions for these underage patients.”

California, along with other Democratic-led states, permits doctors to prescribe puberty blockers or hormones to individuals under 18 diagnosed with gender dysphoria.

While the Supreme court’s decision in the Tennessee case isn’t expected to directly impact california’s laws, the Trump administration is seeking to block federal funding for gender-affirming care.

This could affect patients relying on Medicaid and perhaps restrict hospitals and medical clinics from providing hormone treatments and other medical care to minors.

The recent ruling underscores a meaningful shift in the past year concerning trans rights and “gender affirming” care.

Solicitor Gen.Elizabeth Prelogar, representing the Biden administration, appealed to the Supreme Court in November 2023, urging the justices to overturn the state laws.

She argued for a broad consensus supporting gender-affirming care, asserting that state bans on “evidence-based treatments supported by the overwhelming consensus of the medical community” were unconstitutional.

However, Republican lawmakers have expressed concerns regarding the long-term effects of hormone treatments on adolescents.

Their concerns were bolstered by the Cass Report from Britain,which indicated a lack of long-term studies or reliable evidence supporting these treatments.

Advocates for trans rights have contended that the court should have prioritized the decisions of parents and doctors over those of state lawmakers.

“The court today failed to do its job,” said Jennifer Levi, GLAD Law senior director of transgender and queer rights. “When the political system breaks down and legislatures bow to popular hostility, the judiciary must be the Constitution’s backbone. Instead, it chose to look away, abandoning both vulnerable children and the parents who love them.”