The Supreme Court threw out appellate rulings in favor of transgender people in four states, ordering judges to reexamine the cases in the wake of the justices’ decision to uphold a Tennessee ban on certain medical treatment for trans youths.
The four cases come from Idaho, North Carolina, Oklahoma, and West Virginia.
The action was unsurprising because the court had set the cases aside until after it decided the Tennessee case, as typically happens when the same legal issue is being considered.
The rulings all included findings that the restrictions on transgender people imposed by the states violate the U.S. Constitution’s Equal Protection Clause.
The earlier 6-3 Tennessee ruling on June 18 came along ideological lines in U.S. v. Skrmetti, and effectively protects from legal challenges many efforts by the Trump administration and state governments to roll back protections for transgender people.
The challenge was 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.
Transgender rights supporters rally outside the U.S. Supreme Court in Washington, D.C., on December 4, 2024.
Kevin Dietsch/Getty Images
Four Appeal Cases in Favor of Trans People
On Monday, the justices ordered the 4th U.S. Circuit Court of Appeals in Richmond, Virginia, to review its decision that West Virginia’s and North Carolina’s refusal to cover certain health care for transgender people with government-sponsored insurance is discriminatory.
The San Francisco-based 9th U.S. Circuit Court of Appeals will get back a case from Idaho stemming from the state’s ban on certain surgical procedures for Medicaid recipients.
The 10th U.S. Circuit Court of Appeals in Denver will review its ruling blocking an Oklahoma ban on people changing their gender on birth certificates.
In another case, from Kentucky, the justices rejected the appeal of transgender minors and their families challenging that state’s ban on gender-affirming care.
Tennessee Trans Case
Senate Bill 1, Tennessee legislation that bans gender-affirming care for transgender youth regardless of parental consent and medical recommendation, was signed into law in March 2023.
In April 2023, the American Civil Liberties Union, the ACLU of Tennessee, Lambda Legal and Akin Gump Strauss Hauer & Feld LLP sued the state on behalf of families and transgender youth to block the ban.
A district court judge later determined that the plaintiffs were likely to succeed on their constitutional claims and issued a preliminary injunction, which blocked the law from taking effect.
The district court decision was later appealed to the Sixth Circuit, which reversed the lower court’s decision.
The plaintiffs filed petitions with the U.S. Supreme Court, asking it to review the reversal. In June 2024, the Supreme Court agreed to take up the petition. Oral arguments were heard on December 4, 2024.
‘Law That Plainly Discriminates’
Writing for the court in its June 18, 2025, ruling, Chief Justice John Roberts said that Tennessee’s law falls within the bounds of legislative authority and does not discriminate against transgender individuals under federal constitutional standards.
His opinion says in part that this “case carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field. The voices in these debates raise sincere concerns; the implications for all are profound.”
Roberts added that the court’s role is “only to ensure” that the law “does not violate” the Equal Protection Clause, which he said “it does not.”
“Having concluded that it does not, we leave questions regarding its policy to the people, their elected representatives, and the democratic process,” he added.
Justice Sonia Sotomayor, writing in a dissent joined by the court’s other liberal justices, condemned the ruling, saying the majority “abandons transgender children and their families to political whims.”
“Thus, the majority subjects a law that plainly discriminates on the basis of sex to mere rational-basis review,” Sotomayor wrote.
“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.”
This article includes reporting by The Associated Press.
Update 6/30/25, 10:56 a.m. ET: This article was updated with additional information.