What standard of review did the Supreme Court apply to Tennessee's gender-affirming care ban in Skrmetti?

In the case of *United States v. Skrmetti*, the Supreme Court applied rational basis review to Tennessee's ban on gender-affirming care for minors. This is the lowest and most deferential standard of judicial scrutiny, meaning a law will be upheld if there is any conceivable rational basis for it and it is rationally related to a legitimate government interest. The Court's majority concluded that the Tennessee law classified individuals based on age and specific medical diagnoses, such as gender dysphoria, rather than on sex or transgender status.

The plaintiffs in *Skrmetti* had argued that the law should be subjected to heightened scrutiny, a more rigorous standard typically applied to classifications based on sex, because they contended the ban effectively discriminated against transgender youth. However, the Court determined that the law prohibited certain medical treatments for minors for particular medical uses, regardless of the minor's sex. Tennessee successfully argued that its legitimate government interests included regulating medical care for minors and protecting them from what the state characterized as potentially risky or unproven treatments, satisfying the lenient requirements of rational basis review.

This decision has significant implications for similar laws across the country. By applying rational basis review, the Supreme Court avoided addressing the broader constitutional question of whether laws targeting transgender people or based on transgender status warrant a higher level of scrutiny. Justice Sotomayor, in a dissenting opinion, criticized the majority for sidestepping a direct sex classification and for abandoning transgender children and their families to political whims by applying such a low standard of review. The ruling effectively gives states more leeway to enact and enforce bans on gender-affirming care for minors.