U.S. v. Skrmetti Is a Profound Setback for Transgender Youth and Their Families

Today’s Supreme Court decision in U.S. v. Skrmetti is a profound setback for transgender youth and their families across the country. By allowing Tennessee’s categorical ban on gender-affirming care for minors to stand, the Court has opened the door for other states to continue denying medically necessary, evidence-based care—care that every major medical and mental health organization in the United States affirms as safe, effective, and often life-saving.

Chief Justice Roberts’s majority opinion downplayed the clear issue of sex-based discrimination, sidestepping the lived realities of transgender youth. This law permits certain medications for cisgender youth while banning them for transgender youth. This distinction is not rooted in science or safety, but in politics and ideology.

Justice Sotomayor’s dissent rightly calls out the danger of the Court’s retreat from its duty to protect marginalized communities. As she powerfully stated, “The Court abandons transgender children and their families to political whims.”

To be clear, this ruling does not ban gender-affirming care nationwide. In states where this care is legal, families should continue to consult trusted healthcare providers. But for families in the 26 states that have passed bans, today’s decision will increase uncertainty, fear, and suffering.

This is not the end of the fight. New legal strategies, particularly around parental rights and medical freedom, remain available. Communities will continue to challenge these unjust laws through both the courts and the democratic process.

At APLA Health, we affirm that transgender youth deserve access to care, the dignity of recognition, and the freedom to live full, authentic lives—free from political interference and stigma.