Last Updated on November 3, 2025 by Chicago Policy Review Staff
In June 2025, the Supreme Court quietly let a dangerous precedent take hold. By allowing Tennessee to enforce Senate Bill 1 (SB1), later referred to as Skrmetti, a law banning doctors from providing puberty blockers and hormone replacement therapy to transgender minors, the court did more than greenlight discrimination. It sent a chilling message: Trans children are fair game for political scapegoating, and the Constitution’s promise of equal protection is optional.
The majority brushed SB1 off as a “neutral regulation of medical practice.” Justice Sonia Sotomayor, in dissent, called it what it is: a sex-based classification rooted in animus, not evidence. She warned that the court had “abandoned” transgender children to the whims of state legislatures. Yet perhaps the most revealing opinion came from Justice Amy Coney Barrett.
Barrett’s concurrence, framed in lawyerly restraint, signaled that while the court wasn’t yet ready to say discrimination against transgender people is not sex discrimination, it was equally unwilling to treat laws like SB1 with constitutional suspicion. Barrett specified a deliberately narrow test for determining whether a group is entitled to heightened constitutional protection, acknowledging: “As far as I can tell, we have never embraced a new suspect class under this test.” In other words: The test was built to fail transgender Americans.
She went further. “Even vulnerable groups [fail] to satisfy it,” Barrett wrote, listing the mentally disabled, the elderly, and the poor as examples. Now, Barrett has added transgender people to that list, reducing their right to equal protection to a legislative bargaining chip. Her rationale rests on a faith that the “democratic process” will eventually sort things out. But while Barrett hands down a decision that does not impact cisgender women like her, trans youth are the ones paying the price in lives cut short and futures foreclosed.
Moreover, Barrett’s reasoning threatens to erode Bostock v. Clayton County, the 2020 decision that held that discrimination against LGBTQ+ employees is inherently sex-based under Title VII. Her insistence that “sex-based classifications require context-specific evaluation” opens the door to a future where courts can carve trans people out of civil rights protections entirely. This is not abstract legal theory. Bostock is the foundation of many protections trans people currently rely on — not just in employment, but in healthcare, education, and housing. If Barrett’s view prevails, states will argue that anti-trans laws are not sex discrimination at all, undoing one of the few meaningful victories for LGBTQ+ rights in recent history. Skrmetti does not overturn Bostock today, but Barrett’s concurrence plants the seeds for its demise tomorrow. The cracks are already starting to form, with Trump’s Executive Order 14168 prompting the Equal Employment Opportunity Commission to move to dismiss seven lawsuits from transgender federal employees asserting discrimination. While the rest of the nation enjoys the American Dream, complete with civil rights, trans people are left out in the cold.
The cost of this shift is devastating. SB1 and similar laws deny transgender youth evidence-based, life-saving care. A 2023 CDC report found that just over one quarter of transgender high school students had attempted suicide within the previous year. By contrast, research consistently shows that gender-affirming care reduces depression and suicidality. A ban on that care isn’t just harmful. It’s deadly.
For families, the choice is excruciating: watch their child deteriorate without treatment or uproot their lives and flee their home state. Over half of U.S. states have passed, or are considering, bans like SB1. More than 144,000 transgender youth now live where essential care is restricted, outright banned, or in jeopardy. Livable states for trans families are vanishing, one law at a time.
This fight, however, is bigger than healthcare. When a state can deny care because of a child’s identity — and the court shrugs, saying “let the states handle it” — we are not just debating medical policy. We are debating whether minority rights can be voted away. Today it’s puberty blockers. Tomorrow it could be restroom access, legal name changes, or even adult care. This is the blueprint for a two-tiered America: one where trans people can exist openly, and one where our existence is legislated out of public life.
We have seen this before. Dobbs v. Jackson Women’s Health Organization gutted Roe v. Wade and told women to fight for their lives state-by-state. Now, Skrmetti signals the same looming fate for trans people and protections —and perhaps for Bostock itself.
Democracy is not just majority rule. It is the promise that the rights of the marginalized will not depend on the whims of the powerful and the politicking. That is why the Fourteenth Amendment exists. If the court will not enforce it, we as Americans cannot accept injustice being handed down from on high. The rest of us must fight for our trans neighbors, loved ones, and fellow citizens.
If we abandon trans youth now, we don’t just fail them — we fail the Constitution itself. Protecting trans children is not a fringe issue. It’s a moral test for our democracy, and one we cannot afford to flinch from.
We must act where the court has failed. That means fighting for state and federal protections for trans people. It means showing up at school board meetings, state legislatures, and the ballot box. It means supporting the families forced to wage these battles alone, and recognizing that their fight is ours, too.
Now is the moment to act: to rise from our seats and stand for what is right. Not tomorrow. Not after the next election. Now.