Tennessee Gov. Bill Lee signed SB1, banning gender-affirming medical care for transgender minors

On March 22, 2023, Tennessee Governor Bill Lee signed Senate Bill 1 (SB0001/HB0001), enacted as Public Chapter 1 of the 113th General Assembly, into law. The statute prohibits healthcare providers from performing surgery or administering hormones or puberty blockers to a minor for the purpose of enabling the minor to identify with or live as a gender inconsistent with the sex assigned at birth, or to treat purported distress or discomfort arising from that discordance. Care available to other minors for other diagnoses remains permitted; the ban applies specifically to gender-transition treatment.

The law is enforced through multiple channels. It creates private civil causes of action, including wrongful-death claims, against providers and the parents who consent to prohibited care, and it authorizes the Tennessee attorney general to seek injunctions, disgorgement of proceeds, and civil penalties of up to $25,000 per violation. The Tennessee Senate passed the bill 26-6 and the House passed it 77-16 before Governor Lee signed it, with a July 1, 2023 effective date.

Updates

2025-06-18 — U.S. Supreme Court upheld the law in United States v. Skrmetti [3, 4]

On June 18, 2025, the U.S. Supreme Court ruled 6-3 in United States v. Skrmetti that SB1 does not violate the Fourteenth Amendment's Equal Protection Clause, holding that the statute's age- and diagnosis-based limits are subject only to rational-basis review rather than heightened scrutiny. The decision left the Tennessee ban in force and reversed the U.S. Court of Appeals for the Sixth Circuit's contrary reasoning.