Twenty-three other states have similar bans, but the Tennessee case is the first one to have made it to the nation’s highest court.

Behind the legal questions debated are medical questions that are in dispute.

A transgender girl identified as “L Williams” is at the center of the case brought by the American Civil Liberties Union and later supported by the Biden administration. In an article posted on the ACLU’s website, L said she was emotionally distressed as she began puberty.

“You’re at a point where not only are you going through puberty, but you’re also going through nightmare puberty,” L said. “I mean, obviously, nobody’s 100% comfortable with [the changes,] but you’re immensely uncomfortable with them.”

L’s parents sought puberty and hormone blockers in another state when Tennessee lawmakers passed its ban in 2023. They were on the steps of the U.S. Supreme Court when the case was argued.

Also on the steps was Dr. Jared Ross, a member of Do No Harm, a group of medical professionals who say their mission is to keep identity politics out of medical education, research, and clinical practice.

Ross has a story, too, about a blue-haired girl who came into an emergency room one night. She described herself as “gender-confused,” Ross said in an interview with The Center Square.

“She was cutting herself with a razor blade because voices were telling her to,” Ross said. “Can you imagine if I had affirmed these voices, affirming what she was hearing? That would have been malpractice, that would have been criminal. I didn’t affirm those voices. I also didn’t affirm her gender confusion.”

Do No Harm filed an amicus brief challenging the medical evidence presented by the ACLU and the Biden administration. It points to a study called the “Cass Review,” a multi-year project from the United Kingdom that said studies of the use of puberty blockers and cross-sex hormones were uncontrolled observational studies subject to bias.”

The ACLU says it also has medical evidence on its side. The American Medical Association and the American College of Pediatrics are among the groups that support gender dysphoria treatment for minors.

At least one medical organization is taking a second look at the treatments. The American Society of Plastic Surgeons said in April that it is reviewing the practice.

“ASPS currently understands that there is considerable uncertainty as to the long-term efficacy for the use of chest and genital surgical interventions for the treatment of adolescents with gender dysphoria, and the existing evidence base is viewed as low quality/low certainty. This patient population requires specific considerations,” the organization said in a statement.

Doctors who don’t support treatments for gender dysphoria for minors are accused of discrimination and not caring about the patients.

But that’s not the case, Ross said.

“The other side often plays this as we’re neglecting these kids or we’re minimizing their suffering that they’re going through,” Ross said. “I don’t doubt that they’re suffering. They’re suffering tremendously. They need love and compassion and good evidence-based mental health care.”

Until the Supreme Court rules in 2025, the Tennessee law and others like it will stay on the books.