Washington DC - The US Supreme Court on Wednesday hears a challenge to a Tennessee law banning gender-affirming medical treatments for transgender minors, a case with repercussions for similar state prohibitions across the country.

Two dozen Republican-led states have enacted laws restricting medical care for transgender people under the age of 18 such as puberty blockers or hormone therapy.

Chase Strangio, an attorney for the American Civil Liberties Union, which is representing three transgender adolescents, their parents, and a Memphis-based doctor challenging the Tennessee law, has described it as one of the most significant LGBTQ+ rights cases ever to reach the Supreme Court.

Strangio will be the first openly transgender lawyer to argue before the top court. In an essay published on Tuesday in The New York Times, he said he "will not just be presenting legal arguments to the justices, I will also be embodying them."

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"My presence at the Supreme Court as a transgender lawyer will have been possible because I have had access to the very medical treatment at the center of this case," he wrote. "Though some doubt the lifesaving properties of this care, I know them personally."

Strangio said the stakes are particularly high since President-elect Donald Trump has pledged to impose a federal ban on gender-affirming care for transgender minors and restrict it for transgender adults.

The Tennessee legislation known as Senate Bill 1, or SB1, was signed into law in March 2023 and purports to "protect the health and welfare of minors" by prohibiting medical procedures "that might encourage minors to become disdainful of their sex."

Tennessee Attorney General Jonathan Skrmetti, in a brief with the Supreme Court, said the state law is intended to "protect minors from the life-altering risks of uncertain gender-transition interventions."

The Justice Department of Democratic President Joe Biden has joined the families of transgender youth in opposing the law, arguing that SB1 violates the Constitution's Equal Protection Clause since it denies transgender people access to treatments otherwise permitted to others.

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In April, the Supreme Court allowed a similar ban – in Idaho – to take effect while legal challenges proceed.

Under the Idaho law, medical professionals who provide treatments to minors, including puberty blockers, hormone therapy, or surgery, can face up to 10 years in prison.

Advocates say gender-affirming care can be lifesaving for children and teens struggling with gender dysphoria.

Kelley Robinson, the president of Human Rights Campaign, which lobbies for LGBTQ+ rights, said the Tennessee law and similar legislation in other Republican-led states turn transgender youth into "political pawns."

"No politician should ever be able to interfere in the decisions best made by families and doctors – but that's exactly what these discriminatory bans allow," Robinson said.

"Nearly every major medical organization agrees: gender-affirming care isn't a political statement; it's healthcare that can prevent depression, reduce suicide risk, and help children thrive," she said. "This is about healthcare, plain and simple."

The Supreme Court hearing comes amid a rightwing assault on access to gender-affirming health care and participation in public life.

Advocates have warned that systemic discrimination against trans people – often exacerbated by poverty, racism, and sexism – creates the conditions for the continued epidemic of violence targeting transgender, gender-nonconforming, and nonbinary individuals.