The U.S. Supreme Court ruled Wednesday to uphold another state’s ban on gender-affirming health care for transgender youth — meaning Kentucky’s kids and teens who identify outside of their assigned sex at birth will not be able to access health care most major medical associations consider to be critical. 

The nation’s top court ruled 6-3 to allow Tennessee’s law banning access to care such as puberty blockers and hormone therapy treatments for transgender minors to remain in effect. 

“The Court’s ruling abandons transgender youth and their families to political attacks,” Shannon Minter, the National Center for LGBTQ Rights Legal Director, said in a press release. “It ignored clear discrimination and disregarded its own legal precedent by letting lawmakers target young people for being transgender. Healthcare decisions belong with families, not politicians. This decision will cause real harm. Today’s decision is a cruel blow to transgender youth and their families in Kentucky and other states, but we will continue to fight.”

Kentucky lawmakers passed a similar law in 2023’s Senate Bill 150, then considered the nation’s worst anti-trans piece of legislation in a year full of bills aimed at the LGBTQ+ community. Legal challenges over SB 150 got lumped into Tennessee’s Supreme Court fight since they were so similar and in the same court system. But, the ACLU of Kentucky noted Wednesday, the court ruling focused just on this topic and does not immediately impact other cases concerning transgender people’s rights. 

Trans youth in the Bluegrass State have been prohibited from accessing such care for two years, and Kentucky’s GOP-dominated legislature has since passed additional laws aimed at reducing LGBTQ+ rights and health care access. 

After SB 150 passed in the spring of 2023, groups including the NCLR and ACLU of Kentucky stepped in to challenge parts of the law in court. Their lawsuit, filed on behalf of multiple impacted Kentucky kids and teens and their families, focused just on the parts of the law aimed at non-surgical forms of gender-affirming care. Parts of SB 150 prohibiting gender-affirming surgeries weren’t contested.

A legal saga ensued. Initially, a judge ruled that trans youth should be able to access needed health care, reversing the law. But then the same judge reversed their thinking, allowing Kentucky’s ban on care to stay in effect.

And it has remained in effect as the lawsuit worked its way through the court system. It eventually got combined with a similar lawsuit coming out of Tennessee, which is the case that officially got tried in front of the Supreme Court last December and ruled on Wednesday.

Following the ruling, pro-LGBTQ+ rights advocates condemned the step, while some in the GOP — which dominates Kentucky’s legislature that passed SB 150 two years ago — celebrated. Senate Majority Floor Leader Max Wise, a Republican who sponsored SB 150, said the decision is “a victory for common sense and the safety of our children.”

Chris Hartman, who leads the Fairness Campaign, called the ruling “unconscionable and unacceptable,” adding more than two-dozen states still allow families to access these kinds of health care and the ruling won’t stop families from seeking it out.

“The Supreme Court has failed to protect families’ freedoms and allowed politicians to target transgender youth,” Corey Shapiro, the ACLU of Kentucky’s legal director, said. “This is a painful setback, and it is clear the Court will not protect these children. But it will not stop us from using all available legal tools to fight back against the political extremists targeting transgender people’s safety and dignity. What’s important to remember is that no matter what the Court or politicians say, transgender young people and their families are not alone in this fight.”

This story will be updated.