Cheering Justice Thomas’ Important Defense of Children From ‘Trans’ Procedures

by Zachary Mettler | June 18, 2025 | Government Updates

The U.S. Supreme Court on Wednesday handed down a monumental ruling, allowing states to protect children from harmful and damaging “transgender” medical interventions.

In a 6-3 decision, the Court held that the 14th Amendment’s Equal Protection Clause does not prohibit states from enacting laws restricting minors’ access to puberty blocking drugs, opposite-sex hormones and transgender surgeries.

“Tennessee’s law prohibiting certain medical treatments for transgender minors is not subject to heightened scrutiny under the Equal Protection Clause of the Fourteenth Amendment and satisfies rational basis review,” the Court held.

The ruling allows Tennessee to maintain its law (SB 1) protecting children from transgender interventions, and will help protect 26 similar state Help Not Harm laws.

Photo Credit: Family Policy Alliance

Supreme Court Justice Clarence Thomas authored a concurring opinion, writing “separately to address some additional arguments made in defense of Tennessee’s law.”

In his opinion, Justice Thomas highlighted the numerous harms that transgender medical interventions have on kids.

This is an important consideration, since many media outlets, in reporting on the Court’s decision, have published false and misleading headlines. Consider just a few examples:

  • The Guardian: “US Supreme Court upholds Tennessee ban on youth gender-affirming care. … Ruling is devastating loss for trans rights supporters.”
  • NPR: “Supreme Court upholds Tennessee law that bars gender-affirming care for minors.”
  • Politico: “Supreme Court upholds Tennessee’s ban on gender-affirming care for minors.”
  • PBS News: “Supreme Court delivers major blow to transgender rights, upholding Tennessee ban on gender-affirming care for minors. … [The ruling is] a stunning setback to transgender rights.”
  • CNN: “Supreme Court upholds Tennessee’s ban on gender-affirming care for trans youth. … [The] ruling … will bolster efforts by conservative state lawmakers to pass and preserve other divisive laws targeting transgender Americans.”

But the Court’s ruling – and Tennessee SB 1 – does no such thing. It protects children from harmful and damaging transgender medical interventions.

This is very much in line with carefully documented medical conclusions. In fact, the editor-in-chief of the British Medical Journal wrote just last year that “The evidence base for interventions in gender medicine is threadbare, whichever research question you wish to consider — from social transition to hormone treatment.”

Media outlets and transgender activists commonly use the phrase “gender-affirming care” to refer to puberty blocking drugs, opposite-sex hormones and surgeries. But these interventions do not “affirm” a person’s gender; they harm and mutilate healthy body parts to make a person appear more like the opposite sex.

Transgender activists often claim that individuals struggling with sexual identity confusion are “born in the wrong body,” and therefore need drugs, hormones and surgeries to “affirm” their “gender identity” and bring their bodily appearance in alignment with their new “identity.” Gender identity is not a real thing, but an ideological concept.

But no matter how many drugs, hormones or surgeries a person has, it is impossible for a person to change their sex. Such interventions also have serious, lifelong side effects and consequences.

Justice Thomas noted this exact thing.

“SB1 prohibits puberty blockers, cross-sex hormones, and surgery for the purpose of treating gender dysphoria in children,” Justice Thomas wrote. “The United States and the dissent have described these medications and procedures as ‘gender-affirming care.’”

“But, that ‘sanitized description’ obscures the nature of the medical interventions at issue,” he pointed out.

Puberty blocking drugs. Justice Thomas wrote, “It is undisputed … that [puberty blocking drugs] carry risks,” adding,

Research suggests that, aside from interrupting a child’s normal pubertal development, puberty blockers may lead to decreased bone density and impacts on brain development. And … it is unclear whether “patients ever develop normal levels of fertility if puberty blockers are terminated after a ‘prolonged delay of puberty.’”

Opposite-sex hormones. Justice Thomas laid out several side effects of opposite-sex hormones:

Prescribing such high doses of testosterone to girls induces “hyperandrogenism,” which can cause increased cardiovascular risk, “irreversible changes to the vocal cords,” “clitoromegaly and atrophy of the lining of the uterus and vagina,” as well as “ovarian and breast cancer.”
Giving high doses of estrogen to boys induces “hyperestrogenemia,” which can produce similarly severe side effects including, among other things, increased cardiovascular risk, breast cancer, and sexual dysfunction.
And, for girls and boys alike, “it is generally accepted, even by advocates of transgender hormone therapy, that hormonal treatment impairs fertility, which may be irreversible.”

Surgeries. In graphic detail, Justice Thomas described the surgeries involved in making minors appear more like the opposite sex. While explicit, this is important to know – especially since transgender activists use warm, soft words like “gender affirming care” to describe such surgeries.

Warning, the following content is graphic.

The justice wrote,

Sex-transitioning surgeries for girls include “the surgical removal of the breasts” and “phalloplasty,” that is, an “attemp[t] to create a pseudo-penis” by transplanting “a roll of skin and subcutaneous tissue” from another area of the body “to the pelvis.” …
For boys, surgical interventions include “removal of the testicles alone to permanently lower testosterone levels,” as well as an “attempt to create a pseudo-vagina” by “surgically open[ing]” the boy’s penis, removing “erectile tissue,” and then “clos[ing] and invert[ing the penis] into a newly created cavity in order to simulate a vagina.”
These surgical interventions are irreversible, entail significant complications, and, in some cases, result in permanent infertility.

All of this led Justice Thomas to pen a scorching conclusion, blasting “expert” organizations like the World Professional Association for Transgender Health (WPATH) and the American Medical Association (AMA), both of which have long endorsed transgender medical interventions.

“This case carries a simple lesson: In politically contentious debates over matters shrouded in scientific uncertainty, courts should not assume that self-described experts are correct,” Justice Thomas wrote, adding,

Deference to legislatures, not experts, is particularly critical here. Many prominent medical professionals have declared a consensus around the efficacy of treating children’s gender dysphoria with puberty blockers, cross-sex hormones, and surgical interventions, despite mounting evidence to the contrary.
They have dismissed grave problems undercutting the assumption that young children can consent to irreversible treatments that may deprive them of their ability to eventually produce children of their own. They have built their medical determinations on concededly weak evidence. And, they have surreptitiously compromised their medical recommendations to achieve political ends.
The Court today reserves “to the people, their elected representatives, and the democratic process” the power to decide how best to address an area of medical uncertainty and extraordinary importance. That sovereign prerogative does now bow to “major medical organizations.”

We are grateful the U.S. Supreme Court has concluded that states can protect children from such harmful and experimental drugs, hormones and surgeries. We also appreciate Justice Thomas’ courage in exposing the dark underbelly of transgender medicine.

Because of the Court’s ruling, thousands of children per year will now be protected from life altering and damaging procedures. We encourage more states to follow Tennessee’s example.

The case is U.S. v. Skrmetti.

Related articles and resources:

Counseling Consultation & Referrals

Transgender Resources

God’s Amazing Grace in a Transgendered Person’s Life

Chloe Cole: Gender Reassignment Surgery Regret

Addressing Gender Identity with Honesty and Compassion

HHS Releases Report on Harms of ‘Transgender’ Medical Interventions for Minors

American College of Pediatricians: No Benefits From ‘Gender-Affirming’ Interventions

Tennessee and Mississippi Pass Bills to Protect Children from Harmful ‘Sex Change’ Procedures

Photo from Getty Images.