最高法院以6比3维持田纳西州未成年人性别转换医疗禁令
2025年6月18日，美国最高法院以6比3裁定，维持田纳西州的未成年人性别转换医疗禁令，认定该法不违反宪法第十四修正案的平等保护条款。涉案法律是田纳西州议会2023年通过的 SB1，全名为《禁止对未成年人实施与性认同有关的医疗程序法》，州议会所在地位于田纳西州达维森县 Nashville。
SB1 禁止医疗提供者出于两类目的向未成年人开具、实施或提供青春期阻断剂与激素类药物：一是让未成年人认同或表现为与生理性别不一致的身份，二是治疗未成年人因性别与自我认同不一致而产生的所谓不适或痛苦。同类药物用于早熟等其他病症、或用于成年人，并不在禁止之列。
案件由三名跨性别未成年人及其家长与一名医生提起，美国政府一度介入支持原告。地区法院采用较严格的审查标准，初步叫停了该法；联邦第六巡回上诉法院随后推翻地区法院，认定该法不触发严格审查、且通过合理基础审查。
首席大法官 John Roberts 撰写的多数意见说，SB1 的区分是按年龄与按医疗用途划线，并不按性别分类，也不按跨性别身份分类，因此不适用较严格的审查。在合理基础审查下，多数意见认定，该法的年龄与诊断分类与州议会关于此类治疗风险的调查结论、以及保护未成年人健康与福祉的目标之间存在合理关联，法律成立。
多数意见由大法官 Clarence Thomas、Neil Gorsuch、Brett Kavanaugh、Amy Coney Barrett 全数加入，大法官 Samuel Alito 加入其中大部分；Thomas、Barrett 与 Alito 另有协同意见。大法官 Sonia Sotomayor 撰写异议意见，大法官 Ketanji Brown Jackson 全数加入、Elena Kagan 加入大部，她主张 SB1 按性别分类、本应接受较严格审查。
本案案号 23-477，判决书编号 605 U.S. 495，2024年12月4日进行口头辩论。田纳西是近年多个通过法律限制未成年人性别转换医疗的州之一，本判决意味着这类州法在平等保护条款下的挑战难以成立。
（来源：美国最高法院）
Supreme Court Upholds Tennessee's Ban on Gender Transition Medical Care for Minors, 6-3
On June 18, 2025, the U.S. Supreme Court ruled 6-3 to uphold Tennessee's ban on gender transition medical care for minors, holding that the law does not violate the Equal Protection Clause of the Fourteenth Amendment. The law at issue is Senate Bill 1, the Prohibition on Medical Procedures Performed on Minors Related to Sexual Identity, enacted in 2023 by the Tennessee legislature, which sits in Nashville, Davidson County, Tennessee.
SB1 prohibits healthcare providers from prescribing, administering, or dispensing puberty blockers or hormones to any minor for two purposes: enabling the minor to identify with, or live as, a purported identity inconsistent with the minor's biological sex, or treating purported discomfort or distress from a discordance between the minor's sex and asserted identity. The same medications remain available for other conditions, such as precocious puberty, and for adults.
Three transgender minors, their parents, and a physician challenged the law, and the United States intervened in support of the plaintiffs. A district court applied heightened scrutiny and preliminarily blocked the law; the U.S. Court of Appeals for the Sixth Circuit reversed, holding that the law did not trigger heightened scrutiny and satisfied rational basis review.
Writing for the majority, Chief Justice John Roberts said SB1 classifies on the basis of age and medical use, not on the basis of sex or transgender status, so heightened scrutiny does not apply. Under rational basis review, the majority held, the law's age- and diagnosis-based classifications are rationally related to the state legislature's findings about the risks of such treatments and to the state's objective of protecting minors' health and welfare.
Justices Clarence Thomas, Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett joined the majority in full, and Justice Samuel Alito joined in most of it; Thomas, Barrett, and Alito also wrote concurring opinions. Justice Sonia Sotomayor dissented, joined in full by Justice Ketanji Brown Jackson and in large part by Justice Elena Kagan, arguing that SB1 classifies on the basis of sex and should have faced heightened scrutiny.
The case is No. 23-477, cited as 605 U.S. 495, and was argued on December 4, 2024. Tennessee is one of a growing number of states that have restricted gender transition medical care for minors in recent years, and the ruling means such state laws are unlikely to fall to Equal Protection challenges.
(Source: Supreme Court of the United States)
来源：美国最高法院
发布：GSM·美国（发布链接）
图片来源：图：位于 Nashville 的田纳西州议会大厦，涉案法律 SB1 由田纳西州议会在此通过。w_lemay 摄，CC BY-SA 2.0，经 Wikimedia Commons。 / Photo: The Tennessee State Capitol in Nashville, where the Tennessee legislature passed SB1, the law at issue. Photo by w_lemay, CC BY-SA 2.0, via Wikimedia Commons.
GSM Global · 本篇英文版 English edition of this story
