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a dead daughter or a live transgender son, I wasn’t suicidal. I was a happy child who struggled because she was different. However, at 16, after my (mastectomy) surgery, I did become suicidal.” As I write this column, I see that the Biden administration’s Depart ment of Justice (DOJ) was arguing against SB1. The DOJ sued Ten nessee officials, including Attorney General, Jonathan Skrmetti, who argued in defense of SB1. The debate surrounding Tennes see’s SB1 involves two main legal arguments: 1. Child Welfare. Tennessee argued that the state has a compelling interest in protecting minors from irreversible medical procedures. Just as states restrict minors from buying alcohol and tobacco, they have a duty to protect children from experimental medical interventions. 2. Equal Protection Clause. The DOJ argued that SB1 discriminates based on sex and transgender status. However, Tennessee contends that the law applies equally to all minors. Under SB1, no minor—regardless of gender—can access puberty blockers or cross-sex hormones. This makes the law facially neutral and not a vio lation of the Equal Protection Clause. It is well recognized that children and adolescents are not equipped to make fully informed decisions about medical matters. Govern ments must be very cautious when it comes to life-altering decisions such as gender transition. Medical evidence suggests that the human brain continues to develop well into the early 20s, particularly in areas related to judgment, risk assessment, and long-term planning. 4 The use of puberty blockers, cross-sex hormones, and gender-affirming surgeries has profound—and in some cases irreversible—effects on the body, including infertility, reduced bone

embolden other states to pass similar legislation. Conversely, if the Court strikes down SB1, it could under mine states’ authority to protect minors from dangerous gender transi tioning procedures. At stake is not only the legality of gender transitioning procedures but also broader questions, including the role of Christian counselors in providing medically safe and ethi cally based guidance to children and families. If the Court rules against Tennessee, it may limit Christian counselors’ right to conscientiously object to providing referrals or ser vices related to gender-transitioning procedures.

density, and loss of sexual function. 5 Others argue that “gender affirming care” is “lifesaving” for transgender youth, claiming it reduces depression and suicidality. However, evidence on this point is contested. For example, a study in Sweden—the first country to broadly adopt gender-affirming care—found that individuals who underwent gender reassignment surgeries con tinued to experience high rates of depression, anxiety, and suicidal ideation. 6 The Supreme Court’s review of United States v. Skrmetti will have national implications. If the Court upholds Tennessee’s law, it could

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