Introduction

On June 18, 2025, the Supreme Court of the United States released its opinion in the case of United States of America v. Jonathan Skrmetti, determining the constitutionality of Tennessee Senate Bill 1 (SB1). SB1 bans the prescription of puberty blockers, hormone treatments, and surgeries for minors seeking gender-affirming care. It was argued that SB1 violated the Fourteenth Amendment of the United States Constitution, which provides equal protection from discriminatory laws. In September 2024, the National Association of Social workers (NASW) partnered with the American Psychological Association (APA) and Kentucky Psychological Association (KPA) to submit an amicus brief for this case. Our brief showcased the positive findings of current gender-affirming care research and emphasized its importance for the mental and physical wellbeing of transgender people, regardless of age. Despite these efforts, the Supreme Court found through a six-to-three majority that SB1 did not violate the Fourteenth Amendment and could be enforced in the state of Tennessee.

The Amicus Brief Background

Our amicus brief was created in response to the lower court ruling in this case. Their opinion centered on a distorted and misleading view of gender-affirming care. We asked the Supreme Court to reject this line of thinking, and to view gender-affirming care through the research-based lens we presented. The care banned under SB1 represents the medical and mental health treatment standards for individuals with issues related to gender identity. Gender-affirming care has produced substantial positive effects in practice, especially for youth mental health and quality of life. NASW joined in this amicus brief in order to advocate for policies and practices that protect transgender youth and provide them with culturally appropriate, comprehensive health and mental health services.

Opinion of the Supreme Court

The majority believed that SB1 outlawed treatment based on patient age and the label of “gender-affirming care,” not based on the biological sex of the patient. Because of this viewpoint, SB1 only had to hold up under the most basic form of review used by the Supreme Court instead of the heightened level of scrutiny that laws pertaining to biological sex usually require. The majority found the wording of the law to be sufficient to rule that SB1 is constitutional, as the law states that it acts to further a public interest.

NASW’s Continued Commitment

Regardless of this ruling,  NASW is committed to advancing and advocating for policies and practices that benefit and empower transgender, gender diverse, and nonbinary people across the country. NASW will continue to fight for legislation and court decisions that enable the trans community to receive culturally appropriate, comprehensive health and mental health services. Advocacy for the protection of trans youth, and against regulations that can bring them harm, will continue to be an important goal of NASW.