Missouri’s ban on providing cross-sex hormones and gender-affirming surgeries to transgender people under age 18 can remain in effect after the U.S. Supreme Court on Wednesday ruled states are allowed to prohibit such care to minors.
The 6-3 ruling upheld a similar law in Tennessee that prohibits such care for minors. Transgender children, their families and a doctor sued the state after it enacted the ban in 2023, arguing it violated the constitutional right to equal protection under the law and discriminated on the basis of sex and transgender status.
In the majority opinion, Chief Justice John Roberts said that because the law applied to transgender people of both genders, it did not immediately trigger the clause.
In a statement, representatives from the Missouri affiliate of the American Civil Liberties Union said the decision was crushing.
“Today's Supreme Court decision is devastating to transgender Missourians and their families,” said ACLU Missouri Communications Director Tom Bastian. “But [it] doesn't end our work against harmful laws in Missouri that target and discriminate against transgender individuals and deny them constitutional rights.”
The court’s decision split along conservative/liberal lines.
In a dissenting opinion, Justice Sonya Sotomayor said Wednesday’s decision “abandons transgender children and their families to political whims.”
Missouri in 2023 instituted its ban on gender-affirming care for transgender people under 18, one of the dozens of states to pass prohibitions in recent years.
Legislators passed the law after a former worker at the Washington University Transgender Center in St. Louis accused the organization of rushing minors into treatment without proper screening. That former employee, Jamie Reed, praised the court's decision Wednesday, saying in a written statement that "the ruling confirms what whistleblowers, parents, and detransitioners have been saying for years."
Reed, co-director of the LGB Courage Coalition, called for legislators nationwide to pass bans similar to Missouri's, which expires in 2027.
An upcoming ballot initiative that bans most abortions also contains language that would bar transgender care for minors permanently by placing restrictions in the state’s constitution.
A Missouri Circuit Court judge upheld the 2023 ban after patients, their families, providers and organizations, including the ACLU, sued to overturn it. The plaintiffs have appealed the decision.
Unlike the Supreme Court case decided Wednesday, the Missouri case is based on whether the state’s ban violates the state, not the federal, constitution, said Bastian of the ACLU.
“The Supreme Court decision does not change the reality of what we face in Missouri,” said Robert Fischer, a spokesman for the Missouri-based LGBTQ advocacy organization PROMO.
“However … this decision [doesn’t] mean that there are not other ways that the ACLU or [advocacy organization] Lambda Legal are going to try to overturn any of these bans,” he said, referring to the lawsuit over the state’s ban.
Fischer said that denying medical care for those who needed insulin or other medical treatments would be “outlandish and unthinkable.”
This story has been updated.
