Montgomery, AL – On June 21, 2025, the U.S. Supreme Court issued a 6–3 decision in United States v. Skrmetti, upholding Tennessee’s law that imposes age-based restrictions on access to certain medical procedures for minors, including the use of puberty blockers, cross-sex hormones, and surgeries related to gender transition. The ruling, which rejected an Equal Protection Clause challenge brought by the Biden Administration and the ACLU, clears the way for similar laws in over 25 states, including Alabama, to be enforced.
Alabama Attorney General Steve Marshall, who supported Tennessee’s defense, issued a statement celebrating the decision. “Until a few years ago, the notion of providing sex-change procedures to children was practically unthinkable,” Marshall said, while also emphasizing the states’ authority to regulate medical practices. He argued that decisions regarding youth gender treatments should rest with state governments, not federal courts or medical interest groups.
Alabama passed its law restricting such procedures for minors in 2022. The legislation faced immediate legal challenges from the federal government and advocacy organizations, including the ACLU and Southern Poverty Law Center. In defending the law, Marshall’s office participated in court-ordered discovery and cited documents from the World Professional Association for Transgender Health (WPATH) that he claims raise concerns about the scientific basis and transparency of their Standards of Care.
Marshall submitted an amicus brief to the Supreme Court in the Skrmetti case, highlighting findings from Alabama’s litigation. His brief was cited by both Chief Justice John Roberts in the majority opinion and Justice Clarence Thomas in a concurring opinion. The brief alleged that the development of WPATH’s Standards was influenced by political and legal considerations rather than a rigorous, evidence-based approach.
Alabama’s involvement in the broader national debate over gender-related medical care for minors has been ongoing. In May 2025, the U.S. Department of Health and Human Services addressed some of the findings from Alabama’s legal proceedings in its review of pediatric gender dysphoria treatment practices.
Attorney General Marshall concluded his statement by reaffirming his stance on state oversight and voicing support for efforts to reevaluate medical policies related to gender identity in youth.
