The debate over transgender participation in sports and access to gender-affirming medical care for minors has reached a fever pitch in recent months, with landmark judicial decisions and high-profile public clashes drawing sharp lines in the sand. On June 18, 2025, the U.S. Supreme Court delivered a pivotal ruling that reverberated across the legal and cultural landscape, upholding state bans on gender-affirming care for transgender minors in Kentucky and Tennessee. This decision, along with subsequent federal appellate court rulings, has cast a long shadow over similar legal challenges nationwide, signaling that the battleground for these issues is now largely in the hands of individual states.
The Supreme Court’s ruling was laser-focused on the question of equal protection under the Fourteenth Amendment. According to the court, as reported by multiple legal sources, the Tennessee law in question did not constitute discrimination based on sex or gender identity. Instead, the court found that the law differentiated based on age and the intended purpose of medical treatment. The law did not ban all gender-affirming care outright; rather, it prohibited such care for minors seeking it for gender transition, while still permitting the same treatments for other medical conditions and for adults.
The court’s majority opinion reasoned that, since age and purpose of treatment are not considered “suspect classifications” under constitutional law, the state only needed to demonstrate a rational basis for its policy. And in the eyes of the justices, Tennessee had done just that. The state argued that it was rational to deny certain treatments to minors—treatments that were available to adults—on the grounds that the risks, in the state’s view, outweighed any potential benefits for children. The justices agreed that this rationale was sufficient for the law to stand, at least at the preliminary injunction stage. Notably, this decision was not based on a full trial record; instead, it stemmed from a preliminary injunction, where the standard is whether plaintiffs are likely to succeed, not whether they definitely will.
Other constitutional claims, such as due process for parents and free speech rights for doctors, were left unaddressed by the Supreme Court. These issues had been raised by plaintiffs in both Kentucky and Tennessee, but the high court only considered the equal protection claim presented by then-Solicitor General Elizabeth Prelogar. After the Supreme Court’s decision, the plaintiffs in both cases decided to withdraw their lawsuits, even though the only rulings on the books were about the appropriateness of preliminary injunctions, not the ultimate merits of the cases. As a result, many questions remain unresolved—particularly how the Supreme Court might handle due process and free speech arguments in future cases.
As the dust settled from the Supreme Court’s decision, lower federal courts quickly followed suit. On August 6, 2025, the U.S. Court of Appeals for the Tenth Circuit ruled in Poe v. Drummond, upholding Oklahoma’s ban on gender-affirming care for minors. Circuit Judge Joel Carson, writing for the panel, echoed the Supreme Court’s reasoning, dismissing claims that the Oklahoma law was intended to discriminate against transgender youth. Carson wrote, “Contemporary statements from a few legislators do not persuade us of discriminatory intent,” and he emphasized that the law’s focus on age was key: “If the law truly sought to discriminate against transgender persons, the prohibition would not distinguish based on age. Instead, the purpose becomes clear: children’s welfare.” The court also pointed to the lack of long-term data on such treatments for children, reinforcing the idea that legislative caution was not irrational.
The Tenth Circuit also rejected parents’ due process claims, referencing the long history of state regulation over medical practices. As the panel noted, there is ample precedent for governments limiting patient choice—especially for children—when legislatures deem certain procedures harmful or ineffective.
The Eighth Circuit Court of Appeals soon added its own voice to the chorus. On August 12, the court reversed a permanent injunction against Arkansas’s ban on gender-affirming care for minors, with a decisive 9-2 vote. The majority, led by Circuit Judge Duane Benton, once again leaned on the rational basis test established by the Supreme Court’s earlier ruling. However, the dissent, penned by Circuit Judge Jane Kelly, cited extensive evidence from the trial court that gender-affirming care is the only “evidence-based treatment” for adolescents with gender dysphoria and that requiring minors to detransition could impose severe health risks. Judge Kelly argued, “The record suggests that the state’s purported justifications for the act make no sense in light of how the state treats other groups similarly situated in relevant respects.”
Despite these dissenting voices, the overwhelming majority of federal appellate judges sided with the states. Notably, the Eighth Circuit is one of the most conservative in the country, with ten of its eleven judges appointed by Republican presidents. Legal analysts have pointed out that these decisions effectively close the door on further constitutional challenges to state bans on gender-affirming care for minors, leaving the issue to be fought out in state legislatures rather than federal courts.
Meanwhile, the debate over transgender participation in women’s sports has continued to spark controversy far beyond the courtroom. On August 18, 2025, Harry Potter author J.K. Rowling took to social media to criticize transgender handball player Hannah Mouncey, who had expressed doubts about being able to compete on Australia’s women’s Olympic team in 2028 and 2032 due to bans on biological males in women’s sports. Rowling wrote, “Man fears he won’t be allowed to cheat his way to the Olympics by playing against women. Man says anti-cheat sentiment is being ‘weaponized’ against men like him, who cheat. Read more here about why the cheating man is sad and why the women he might injure just don’t matter,” as reported by Fox News Digital.
Mouncey, a former Australian rules football player, responded on the “Sacked” podcast by pushing back against the notion that transgender athletes have an unfair advantage. “There’s this idea that trans athletes have an unfair advantage, but the results don’t show that,” Mouncey said. “I’ve always believed in fairness and restrictions where needed, but blanket bans are not the answer.”
The International Handball Federation’s policy, which took effect in 2022, requires transgender female athletes to maintain serum testosterone levels below 5 nmol/L for at least 12 months prior to competition and to keep those levels low throughout their participation. The policy also calls for medical documentation to confirm compliance. International Olympic Committee chief Kirsty Coventry stated in January 2025 that there was “overwhelming support” among IOC members to protect the women’s category, suggesting that the IOC might look to World Athletics’ restrictions as a model for future policy changes.
With both the courts and sports governing bodies drawing firmer lines, the landscape for transgender rights in the U.S. and abroad is rapidly shifting. The fate of gender-affirming care for minors and transgender athletes’ participation in women’s sports now hinges on state and organizational decisions, with the federal judiciary signaling a hands-off approach for the foreseeable future.
For advocates and opponents on both sides, these developments are a clear sign that the next chapter in this contentious debate will be written not just in courtrooms, but in statehouses, sports federations, and the broader public arena.
