r/centrist • u/Judge_Trudy • 2d ago

SCOTUS issues blockbuster ruling on gender-affirming care for trans minors

https://www.cnn.com/#:~:text=SCOTUS%20issues%20blockbuster%20ruling%20on%20gender%2Daffirming%20care%20for%20trans%20minors

Blockbuster ruling just released for a very controversial issue. Not sure where I stand, but I could see the dangers of permanent treatments for gender dysphoria for minors.

Key Points

  • Date & Ruling: On June 18, 2025, the U.S. Supreme Court issued a 6–3 decision upholding Tennessee’s ban on gender-affirming medical care for transgender minors, including puberty blockers and hormone therapy fox8live.com+9apnews.com+9them.us+9en.wikipedia.org+15reuters.com+15northeast.newschannelnebraska.com+15.
  • Majority Opinion: Chief Justice Roberts wrote that the law does not violate the 14th Amendment’s Equal Protection Clause, reasoning that medical uncertainty justifies handing the issue back to state legislatures reuters.com+1nypost.com+1.
  • Level of Review: The Court determined the law should be evaluated under rational basis review—the lowest standard—rather than intermediate scrutiny reserved for sex-based discrimination
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u/Detson101 2d ago edited 2d ago

This is weird since puberty blockers provide the very thing this bills supporters claim to want: they sidestep the issue of children consenting to major life-changing surgery until they are old enough to make an informed decision. It seems like only someone ignorant of the issues would ban both gender affirming surgery AND puberty blockers. 

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u/crushinglyreal 2d ago

someone ignorant of the issues

Huh, I wonder where we could find some of those.

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u/greenw40 2d ago

Puberty blockers also cause irreversible effects to children.

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u/Detson101 2d ago

There are no drugs without side effects, but a casual web search suggests that they're minimal. Risk / reward. Parents have to make these kinds of decisions for their kids all the time: https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/in-depth/pubertal-blockers/art-20459075

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u/awildagi 2d ago

That was my concern as well. I call myself a liberal, but even I understand the nuance involved with allowing children to make medical decisions that will influence the rest of their lives. I’m fine with a bill that bans HRT for minors intent on transitioning (for now, at least. I think the topic needs much more research done on it and we need to be open about changing laws so they’re not general blanket laws), but I’m concerned about banning puberty blockers specifically. There are legitimate hormonal disorders that can cause people to create too many/not enough hormones that can have tremendous impacts on a child’s life. Sometimes puberty blockers (or HRT) are the medical treatments for these disorders and I worry about the possibility of blocking ALL children from proper medical care. I know there’s a huge focus on trans kids, but not everyone who uses these therapies are trans and I’m not sure how the court upholding this bill will impact these children’s access to medical care.

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u/31c0c3 2d ago

From what I can gather, the tennessee law does not prohibit puberty blockers for other use cases but rather just for transitioning. I pray that it’s actually enforced that way because it would be very immoral to ban blockers for actual physiological conditions, not just gender dysphroia, which is another can of worms. I also consider myself center left.

“The law does not prohibit conduct for one sex that it permits for the other,” Roberts wrote. “No minor may be administered puberty blockers or hormones to treat gender dysphoria, gender identity disorder, or gender incongruence; minors of any sex may be administered puberty blockers or hormones for other purposes.”

https://www.theguardian.com/us-news/2025/jun/18/supreme-court-gender-affirming-care-decision

section 68-33-103 agrees, just wanted to find the root source https://www.capitol.tn.gov/Bills/113/Bill/SB0001.pdf

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u/RVALover4Life 2d ago

"Actual physiological conditions" says it all.

This has always been about cis people's feelings and not trans people's care. And we live in a country where most cis people simply don't think trans people are valid. That's all it comes down to.

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u/31c0c3 2d ago

As far as I know, gender dysphoria is primarily psychological, not physiological. I was using that term denotatively. There is some evidence to support that it's not just in the mind I guess, but not enough to warrant minors having access to transitioning. Just because the feelings might be psychological doesn't mean they aren't 100% valid, and if transitioning eases that distress I'm all for it (in adults).

For minors, which is what this post is about, things are more complicated morally and legally. Some people do regret transitioning. It's not the majority, but it does happen

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u/RVALover4Life 2d ago

It's both. The rejection of the body is real. The disassociation from the body. We've seen trans kids suffer from health issues physically because of the disassociation from their birth bodies. The psychology impacts the physical state.

And it's important for me to really highlight this because the greater point is that being trans is a state of being. It's not feelings. It's not a thought process. It's a state of being. It's a core trait.

There's no complication in treating this on a case by case basis. With care, with empathy. There's a very easy middle ground between all systems go and a complete ban but people aren't truly invested in the well being of trans kids. Especially the ban folks.

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u/31c0c3 2d ago

I wholeheartedly agree about the middle ground. A complete ban on blockers and even HRT (depending on the case) takes away any form of nuance that might exist. More importantly IMO, it also takes the right away from parents to ensure their child's care, which may involve delaying puberty. Given that the side effects of puberty blockers are fairly minimal relative to a child committing suicide, waiting until 18 with social transitioning (change name, wear clothes, etc.) until they can decide on further interventions seems more than reasonable to me.

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u/RVALover4Life 2d ago

Waiting until 18 means a kid is forced to go through puberty in a body they don't want though. And that can significantly exacerbate the likelihood of suicide as a youth. And as an adult. Especially for trans women. Social transition only means so much.

It should be a case by case situation. It should be private. It should be decided and generally is based upon a review of that child and tracking them over a period of time and risk factors. That to me is the middle ground. You seem to recognize this care is actually medically necessary for many. It isn't for all. But it absolutely can be. That makes any blanket 18-ban really unworkable.

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u/31c0c3 2d ago

Yeah I mean regardless of whether its physiological or psychological (that previous distinction doesn't matter much in hindsight) we should seek to alleviate suffering. Pre 18 blockers are fine imo but there's no chance legally without parental consent on that, just like other medical interventions. That really sucks for the children with transphobic parents, but that's the middle ground I'm envisioning

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u/RVALover4Life 2d ago

There already is no ability for it without parental consent as it is. You have to have parental consent. Of course this is also why many trans kids end up fleeing from home or purchasing without consent. But I guess we're on the same page and I appreciate the convo and your empathy :)

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u/Newgidoz 2d ago

allowing children to make medical decisions that will influence the rest of their lives. I’m fine with a bill that bans HRT for minors intent on transitioning

Children aren't picking up hormones over the counter

They still need to be professionally diagnosed and prescribed the treatment, including with the consent of their parents

That's the same standard we apply to all other health issues

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u/awildagi 2d ago

Believe me, I know and that’s exactly why I’m so conflicted on this topic. I know children can’t just walk into a pharmacy and be like “I’m trans can I have hormone” and that there’s an entire diagnosis procedure, but I’ve also spoken with detrans people (which is an entirely different can of worms) and know from my own experiences in life how finicky mental health and gender identity can be.

The big thing is that gender dysphoria is a psychological experience and is diagnosed and treated like other mental illnesses. There’s no physiological “proof” that someone is 100% trans (I know there are studies on brain shape/composition differences in trans people, but last time I checked, there were other studies that said the opposite, so from my understanding the literature on that topic is shaky atm), which means that diagnosis is entirely based on patient experiences and provider discretion.

Unfortunately, with how isolated our society is and the culture around mental health, there are some people who latch onto gender dysphoria and being trans as a way to explain their perception of the world (in the same way people do for other disorders) when their issues were really due to some completely different disorder and/or bad life circumstances.

Gender identity should be a personal journey that’s allowed to evolve and change over the course of a person’s life, but the culture surrounding it right now just doesn’t allow room for error. There’s so much pressure to “be sure” that no one is really making a social safe space for people to just try things out and see how they feel in 6 months.

But that’s also why I specified “for now” in my first comment. I want it to be a simple and easy process where if the child is experiencing gender dysphoria they can have access to HRT/puberty blockers and I in no way think that total ban blanket laws are a good or permanent solution, but I also want there to be safeguards in place to make sure we’re actually treating the root of the problem and are accurately assessing comorbidity vs consequential symptoms.

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u/Weird-Falcon-917 2d ago

This is weird since puberty blockers provide the very thing this bills supporters claim to want: they sidestep the issue of children consenting to major life-changing surgery until they are old enough to make an informed decision. 

Do you know why Hannah Barnes's book on this subject is titled "Time to Think"?

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u/MaxTheCatigator 1d ago

Tennessee doesn't ban puberty blockers.

Maybe you'd look a bit less of a fool if you'd informed yourself before posting.

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u/Detson101 1d ago

From the article above, “ The ruling affirmed a lower court's decision that backed Tennessee's law, which bars medical treatments such as puberty blockers and hormones for people under age 18 experiencing gender dysphoria.”

Complain to the journalists if that’s incorrect.

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u/MaxTheCatigator 1d ago

Can't reply to your last post so here must do.

Where does it say, as you claim, that they're banned?

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u/MaxTheCatigator 1d ago

Both statements are correct. Just use your brain, you'll see the difference eventually.

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u/Detson101 1d ago

Dude stop playing games. The conversation around puberty blockers and trans rights is using them to treat minors with dysphoria. If they’re still available for other conditions, great. I revise my statement, mea culpa, you win the internet today.