Six of the nine Supreme Court justices reject challenge to Tennessee law designed to "protect" minors
The Sixth Circuit had found the statute constitutional and teh Supreme Court, by a vote of six to three and via an opinion written by Chief Justice Roberts, found the law at issue did not violate the Equal Protection clause of the 14th Amendment to the United States Constitution. The majority found that such a law did not require the sort of strict scrutiny analysis which is often, but not always, applied to laws that are said to discriminate against persons on the basis of race and sex. Such a strict scrutiny analysis is crucial because governmental distinctions between citizens that are subject to this standard are "inherently suspect."
Rather, the Tennessee law merely had to meet the rational basis test to pass equal protection muster, meaning the statute was constitutional as long as the legislature had a rational, even if arguably incorrect, basis for enacting the law.
Justice Thomas' concurs and notes that regulation of medical procedures routinely and properly distinguishes between the sexes
Justice Thomas aptly pointed out that the Fourteenth Amendment uses much different language from that of anti-discrimination laws such as Title VI, this amendment stating simply, "no State shall . . . deny to any person within its jurisdiction the equal protection of the laws." Justice Thomas further explained that courts have held that discrimination based upon "sexual orientation" is not equivalent to that based upon "sex" itself. However, even if one were to accept such analysis, this would not apply in the context of equal protection analysis given that, as noted above, the language in anti-discrimination statutes is different from that in the 14th Amendment.
Justice Thomas thus wrote that a finding that medical laws that supposedly "discriminate" against treatment for transgender minors is subject to "strict scrutiny" because such constitutes discrimination based upon "sex," would call into question much of our regulation of medical procedures, which does in fact distinguish among biological sexess:
Applying. . . such reasoning to the Equal Protection Clause would also invite sweeping consequences. Many statutes “regulate medical procedures defined by sex.” L. W. v. Skrmetti, 83 F. 4th 460, 482 (CA6 2023) (collecting examples, including laws referencing testicular and prostate cancer). If heightened scrutiny applied to such laws, then “[a]ny person with standing to challenge” such a decision could “haul the State into federal court and compel it to establish by evidence (presumably in the form of expert testimony) that there is an ‘exceedingly persuasive justification’ for the classification.” United States v. Virginia, 518 U. S. 515, 597 (1996) (Scalia, J., dissenting). Given the ensuing potential for “high-cost, high-risk lawsuit[s],” ibid., States might simply decline to adopt or enforce sex-based medical laws or regulations, even where such rules would be best medical practice. The burden of skeptical judicial review is therefore far from the “modest step” of requiring a State to “show its work” that the dissent posits. Post, at 31 (opinion of SOTOMAYOR, J.). (Skrmetti, J. Thomas concurring opinion, pp. 4-5; footnote omitted.)
In summary, the state law at issue more than survives the "rational basis" test, according to Justice Thomas. Echoing the majority opinion, Thomas wrote that not only is there no clear medical consensus on "gender-affirming treatment" for minors, but he went into detail regarding what this "medical treatment" entails, noting that it includes the excision of the breasts of minors too young to legally consent to such a procedure.
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