Youth Gender Affirming Care Policy Tracker
- An update on the legal landscape surrounding access to gender-affirming care in the United States, following the Supreme Court's decision in United States v.
- State laws restricting access to gender-affirming care, particularly for minors, have increased considerably in recent years. Arkansas was the first state to enact such legislation in 2021.By January...
- Not all trans people seek the same types of gender affirming care or services and some people choose not to use medical services as a part of their...
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U.S. Supreme Court Ruling on Gender-Affirming Care: A Current Overview (August 30, 2025)
Table of Contents
An update on the legal landscape surrounding access to gender-affirming care in the United States, following the Supreme Court’s decision in United States v. Skrmetti.
Background: The Rise of Restrictions
State laws restricting access to gender-affirming care, particularly for minors, have increased considerably in recent years. Arkansas was the first state to enact such legislation in 2021.By January 2024, the number of states with similar laws or policies had increased more than fivefold, with most facing legal challenges (American Civil Liberties Union).
Gender affirmation is highly individualized. Not all trans people seek the same types of gender affirming care or services and some people choose not to use medical services as a part of their transition.
the Supreme Court Decision: United States v. Skrmetti
On June 18, 2025, the U.S. Supreme Court issued its ruling in United States v.Skrmetti. This case centered on a challenge to Tennessee’s Senate Bill 1 (SB1), which broadly bans gender-affirming care.
The Court found that SB1 did not constitute sex-based discrimination and did not violate the Equal Protection Clause of the Fourteenth Amendment to the U.S. Constitution. This decision effectively upheld the Tennessee law and has meaningful implications for similar bans across the country.
Current Status of Bans (August 30, 2025)
As a direct result of the Supreme Court’s ruling, approximately 25 state bans on gender-affirming care remain in effect. However, the legal landscape is still evolving.
Currently, bans in Montana and Arkansas are permanently enjoined by court order, meaning they are blocked from being enforced (reuters). Further legal challenges are expected in other states.
| State | Ban Status (August 30, 2025) | Legal Challenges |
|---|---|---|
| Tennessee | In Effect | Upheld by Supreme Court |
| Arkansas | enjoined | Permanently blocked by court order |
| Montana | Enjoined | Permanently blocked by court order |
| [Other State 1] | In Effect | Ongoing legal challenge |
| [Other State 2] | In Effect | Pending court decision |
Note: This table is not exhaustive and the status of bans is subject to change.
What This Means for Transgender Youth and Their Families
The Supreme Court’s decision creates a patchwork of access to gender-affirming care across the United States.Families in states with bans may need to travel to other states to access care, creating significant financial and logistical burdens. the ruling also raises concerns about the well-being of transgender youth who might potentially be denied medically necessary care.
It’s important to note that gender-affirming care encompasses a wide range of services, including social transition, mental health support, and medical interventions like puberty blockers and hormone therapy.The specific types of care available and accessible vary greatly depending on location and individual needs.