Authorized Statements from the American Civil Liberties Union (ACLU) and its Puerto Rico Chapter Regarding the Ruling in U.S. v. Skrmetti:

The Supreme Court issued its ruling on Wednesday in U.S. v. Skrmetti, a challenge brought by three transgender teenagers, their families, and a Memphis medical provider against a Tennessee law banning gender-affirming hormone therapies for transgender people under 18.

The Court agreed with parts of the Sixth Circuit's opinion that allowed the law to take effect, holding that Tennessee's Senate Bill 1 does not draw a distinction based on sex (or trans status) and therefore only needs deferential review by the courts. This means the law can remain in force. It is important to note, however, that the decision is based on the record and context of the Tennessee case and thus does not extend to other cases related to discrimination based on transgender status.

"The ruling is a devastating loss for transgender people, our families, and everyone who cares about the Constitution," said Chase Strangio, Co-Director of the ACLU’s LGBTQ & HIV Project. "While this is a painful setback, it does not mean that transgender people and our allies are out of options to defend our freedom, our health care, or our lives. The Court left intact Supreme Court and lower court precedents establishing that other examples of discrimination against transgender people are unlawful. We are more determined than ever to fight for the dignity and equality of every transgender person and will continue to do so with defiant strength, relentless determination, and an enduring commitment to our families, our communities, and the freedom we all deserve," he clarified.

"Make no mistake, gender-affirming care is often life-saving care, and every major medical association has determined that it is safe, appropriate, and effective. This is a sad day, and the implications will reverberate for years and across the country, but it does not undermine our resolve to keep fighting," added Sasha Buchert, attorney and Director of the Transgender and Non-Binary Rights Project at Lambda Legal.

The U.S. v. Skrmetti case began when the ACLU, Lambda Legal, and Akin Gump Strauss Hauer & Feld LLP filed a lawsuit on behalf of Samantha and Brian Williams of Nashville and their 16-year-old transgender daughter, as well as two other plaintiff families who filed anonymously, and Dr. Susan Lacy, a Memphis-based physician. The plaintiff families and Lacy argued that the law violates the transgender adolescents' Equal Protection rights. Under President Joe Biden, the U.S. intervened to also argue that the Tennessee law violates the Equal Protection Clause of the 14th Amendment. After President Trump's inauguration, the U.S. reversed its position.

Since 2021, 25 states have enacted categorical bans on gender-affirming medical care, such as hormone therapy and puberty-suppressing drugs, to treat gender dysphoria in transgender youth, yet they readily permit those same medications for other similar purposes in cisgender youth. Over 100,000 transgender people under the age of 18 now live in a state with a ban on their medical care. In Puerto Rico, Senate Bill 350 pursues the same objective, with the aggravating factor that it extends the prohibition up to age 21. The ACLU of Puerto Rico has rejected this measure.

In January 2025, the Trump administration issued an executive order instructing federal agencies to withhold funding from medical providers and institutions that provide gender-affirming medical treatments, such as puberty blockers and hormone therapies, to any trans person under the age of 19. That order was challenged shortly thereafter on behalf of families, medical providers, and advocates by the ACLU and Lambda Legal, and its enforcement is currently blocked by a preliminary injunction.