The suit further claimed that SB 1 “infringes on the fundamental rights of parents guaranteed by the Due Process Clause of the Fourteenth Amendment by preventing parents from seeking appropriate medical care for their children.”
According to the suit, the law would not be able to withstand “heightened scrutiny or even rational basis review.”
The Equal Protection and Due Process Clauses are found in the following text of the Fourteenth Amendment:
All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.
The U.S. Department of Justice (DOJ) under the Biden administration got involved in the lawsuit, opposing SB 1. In a press release issued April 26, 2023, titled, “Justice Department Challenges Tennessee Law that Bans Critical, Medically Necessary Care for Transgender Youth,” the DOJ announced it had filed a complaint alleging that SB 1 violated the Equal Protection Clause of the Fourteenth Amendment.
“The department is also asking the court to issue an immediate order to prevent the law from going into effect on July 1, 2023,” said the DOJ.
According to JURISTnews, a district court responded favorably to the lawsuit, granting the plaintiffs’ requests for preliminary injunctions that would stop SB 1 from going into effect. After the state appealed, the U.S. Court of Appeals for the Sixth Circuit stayed the injunctions. The Biden administration and the original plaintiffs then requested the case be heard by the Supreme Court, a request the Court granted in July 2024.
However, with the incoming Trump administration came a change in the DOJ’s position on this matter. On Feb. 7, 2025, Deputy Solicitor General Curtis E. Gannon sent a letter to the Hon. Scott S. Harris, clerk of the Supreme Court, saying, “Following the change in Administration, the Department of Justice has reconsidered the United States’ position in this case.”
“The purpose of this letter is to notify the Court that the government’s previously stated views no longer represent the United States’ position,” he said.
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“The Department has now determined that SB1 does not deny equal protection on account of sex or any other characteristic,” said Gannon.
A crucial aspect of the Supreme Court’s ruling in United States v. Skrmetti was deciding what “tier of scrutiny” to apply. The plaintiffs’ lawsuit mentioned “heightened scrutiny” and “rational basis review.” Per JURIST, “The least intensive level of scrutiny, rational basis review, applies when a law does not classify based on a protected class, such as sex or race.”
“More heightened levels of scrutiny, such as intermediate or strict scrutiny, apply when a law classifies based on a protected class, such as sex or race, or infringes on a fundamental right,” said JURIST.
In the majority opinion of the Court upholding SB 1, Chief Justice John Roberts wrote, “We are asked to decide whether SB1 is subject to heightened scrutiny under the Equal Protection Clause. We hold it is not. SB1 does not classify on any bases that warrant heightened review.”
Roberts rejected the argument that SB 1 discriminates on the basis of sex because “the law does not prohibit conduct for one sex that it permits for the other.”
“Rather, SB1 prohibits healthcare providers from administering puberty blockers and hormones to minors for certain medical uses, regardless of a minor’s sex,” he said. Roberts also stated, “Classifications that turn on age or medical use are subject to only rational basis review.”
“SB1 includes only two classifications: healthcare providers may not administer puberty blockers or hormones to minors (a classification based on age),” said Roberts, “to treat gender dysphoria, gender identity disorder, or gender incongruence (a classification based on medical use).”
“The plaintiffs do not argue that the first classification turns on transgender status,” he said, “and our case law forecloses any such argument as to the second.”
Roberts further stated that “there is a rational basis for SB1’s classifications.”
“Tennessee concluded that there is an ongoing debate among medical experts,” he said, “regarding the risks and benefits associated with administering puberty blockers and hormones to treat gender dysphoria, gender identity disorder, and gender incongruence.”
“SB1’s ban on such treatments responds directly to that uncertainty,” said Roberts.
“Our role is not ‘to judge the wisdom, fairness, or logic’ of the law before us,” Roberts said as he concluded, “but only to ensure that it does not violate the equal protection guarantee of the Fourteenth Amendment.”
“Having concluded it does not,” said the chief justice, “we leave questions regarding its policy to the people, their elected representatives, and the democratic process.”
Joining Roberts in all or part of the majority opinion were Justices Clarence Thomas, Amy Coney Barrett, Samuel Alito, Neil Gorsuch, and Brett Kavanaugh. Dissenting were Justices Ketanji Brown Jackson, Elena Kagan, and Sonia Sotomayor.
