Playing the long game

It wasn’t that long ago that social conservatives were understandably concerned that transgenderism was on the road to full normalization and perhaps even coerced celebration throughout American society. But the tide has been turning for a couple of years. The two major battles in this particular front in the culture war have been biological men competing in women’s sports and so-called “gender-affirming care” for minors. In the case of transgenderism and athletics, progressives have been losing in state legislatures, the courts, and, as Carl Trueman argues, the court of public opinion. The same can be said of transgenderism and teenagers.

On June 18, the United States Supreme Court announced its much-anticipated ruling in United States v. Skrmetti. In a landmark 6-3 decision that broke along conservative-progressive lines, the court upheld Tennessee’s ban on puberty blockers and hormone therapy for transgender minors. The stakes are nothing less than the health of children, the importance of science-based medicine, and the religious liberty of Americans who dissent from progressive views of gender and sexuality.

In 2023, the Tennessee General Assembly approved SB1, a bill that affirms biological sex and prohibits gender transition procedures for minors. The law provides numerous reasons for the ban. The known and suspected health risks for young people are simply too high. Minors aren’t mature enough to make such radical, irreversible, life-altering decisions. The moral objections (including those rooted in religious convictions) have been ignored and even threatened by the state. The profit motive has played far too important a role in the push for “gender-affirming care” for minors.

Under the Biden Administration, the federal government sided with three transgender teenagers and their families who argued that SB1 constitutes sex discrimination and violates the Equal Protection Clause of the 14th amendment. In February, however, the government reversed its position, noting it wouldn’t have challenged SB1 had Donald Trump been president at the time the law was passed.

Chief Justice John Roberts, writing for the majority in the Skrmetti ruling, argued that Tennessee lawmakers provided a rational basis that SB1 is rooted in a legitimate government interest. “Tennessee concluded that there is an ongoing debate among medical experts regarding the risks and benefits associated with administering puberty blockers and hormones to treat gender dysphoria, gender identity disorder, and gender incongruence. SB1’s ban on such treatments responds directly to that uncertainty.”

In a separate, concurring opinion, Justice Clarence Thomas more directly addressed some of the worldview concerns behind this debate. “This case carries a simple lesson: In politically contentious debates over matters shrouded in scientific uncertainty, courts should not assume that self-described experts are correct. … Many prominent medical professionals have declared a consensus around the efficacy of treating children’s gender dysphoria with puberty blockers, cross-sex hormones, and surgical interventions, despite mounting evidence to the contrary. They have dismissed grave problems undercutting the assumption that young children can consent to irreversible treatments that may deprive them of their ability to eventually produce children of their own. They have built their medical determinations on concededly weak evidence. And, they have surreptitiously compromised their medical recommendations to achieve political ends.”

The arguments advanced in SB1 and by Justice Thomas are neither new nor novel. In late 2024, the U.K. government banned puberty blockers for new patients under the age of 18 through at least 2027, citing similar rationale. In January 2025, President Trump issued an executive order titled “Protecting Children from Chemical and Surgical Mutilation.” The order called for the halting of transgender procedures for young people under the age of 19, citing concerns about the “maiming and sterilizing” of young people on the basis of “junk science” rooted in progressive worldview assumptions.

As I argued in an earlier column about the U.K. decision, conservative Christians should be encouraged by the growing consensus to ban transgender procedures for children. Governments are right to protect minors from transgender medical interventions, which are really a rejection of God’s design for gender rooted in a toxic combination of disordered sexual desires, hormonally driven pubescent confusion, mental illness, and progressive social engineering. At the same time, the wider transgender movement remains alive and well. For many, transgenderism is still considered perfectly reasonable for an adult, at least outside of athletic competition. But every victory matters, and social conservatives are playing the long game. The Lord changes hearts and minds in part through wise legislation and genuinely just judicial rulings that promote authentic human flourishing that is consistent with Scripture and reflects the Natural Law.

The Skrmetti ruling doesn’t settle the transgender debate. However, it paves the way for states to take legislative action to protect the wellbeing of minors. To date, 26 states have done so. Join me in praying that every state will follow suit—for the good of our children.