Earlier this week, the Supreme Court of the United States (SCOTUS) issued an opinion on the case United States v. Skrmetti, upholding Tennessee’s law protecting minors from harmful drugs and surgeries. In addition to protecting Tennessee’s law, this ruling goes a long way toward protecting similar laws in 26 states, including North Carolina.
“No one has the right to harm a child. . . States are free to protect children from the greatest medical scandal in generations—and that’s exactly what states like Tennessee have done.” ~ Alliance Defending Freedom (ADF)CEO and President Kristen Waggoner
Background on the Skrmetti Case
In 2023, Tennessee passed a bipartisan law prohibiting health care providers from administering puberty blockers or cross-sex hormones or performing surgeries on children experiencing gender dysphoria. Shortly after, the U.S. Department of Justice (DOJ) and plaintiffs (three minors, their parents, and a doctor) sought and were granted an injunction in a federal district court to prevent the law from going into effect, arguing that the law violates the Equal Protection Clause of the 14th Amendment by discriminating based on sex and transgender status. However, the Sixth Circuit Court of Appeals stayed the injunction, allowing the law to go into effect. That decision was appealed, and the case was heard by the Supreme Court in December of 2024. Then on June 18th, 2025, SCOTUS released their ruling upholding Tennessee’s law.
Summarizing the opinion, ADF wrote: “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.’”
Future Impact
The same year that Tennessee passed their law, North Carolina passed Session Law 2023-111, a similar law that protected minors from dangerous and life-altering drugs and surgeries. Like in Tennessee, this law quickly faced a lawsuit. While the DOJ dropped federal interest in the case earlier this year, SCOTUS’ decision goes a long way to reinforce and protect North Carolina’s law for the foreseeable future.
In addition to this, the opinion sets a precedent for handling legal cases regarding politicized medicine and state legislative authority. In Justice Thomas’ concurrence, he wrote:
This case carries a simple lesson: in politically contentious debates over matters shrouded in scientific uncertainty, courts should not assume that self-described experts are correct. Deference to legislatures, not experts, is particularly critical here. Many prominent medical professionals have declared a consensus around the efficacy of treating children’s gender dysphoria with puberty blockers, cross-sex hormones, and surgical interventions, despite mounting evidence to the contrary. They have dismissed grave problems that undercut the assumption that young children can consent to irreversible treatments—treatments that may deprive them of the ability to eventually produce children of their own. These professionals have based their medical determinations on concededly weak evidence, and they have surreptitiously compromised their medical recommendations to achieve political ends.