Wednesday morning the Supreme Court heard argument in U.S. v. Skrmetti, a case challenging Tennessee’s ban on puberty blockers and cross-sex hormones for minors suffering gender dysphoria.

Prior to oral argument, I wrote a brief primer for the Register explaining the case that you can read here. While I am reluctant to predict how the Court will rule in any given case based on oral argument, it seems more likely than not that the Court will uphold the state law.

Below are some of the interesting exchanges the justices had with the advocates during Wednesday’s argument.

While the challengers of the law consumed the lion’s share of the more than two-hour argument, extra time was no substitute for a winning argument. With virtually indistinguishable arguments, the Biden administration, represented by U.S. Solicitor General Elizabeth Prelogar, partnered with American Civil Liberties Union’s Chase Strangio, arguing that Tennessee’s law violates the Equal Protection Clause of the 14th Amendment. They were not particularly convincing.

The law “restricts medical care only when provided to induce physical effects inconsistent with birth sex. Someone assigned female at birth can’t receive medication to live as a male, but someone assigned male can. If you change the individual sex, it changes the result. That’s a sex classification full stop, and a law like that can’t stand on bare rationality,” asserted Prelogar in her opening statement.

A host of very sensible questions were raised by the justices. For starters, Clarence Thomas asked Prelogar right off the bat whether the case was “simply a case about age classifications when it comes to these treatments?” Samuel Alito challenged the administration’s assertion that “overwhelming evidence establishes the proper gender-affirming treatment with puberty blockers and hormones directly and substantially improves the physical, psychological well-being of transgender adolescents with gender dysphoria.” Alito cited the Cass Review — a comprehensive and systemic review from the United Kingdom that he noted “found a complete lack of high-quality evidence showing that the benefits of the treatments in question here outweigh the risks.”

When Prelogar claimed that the “record evidence demonstrates that the rates of regret are very low because the population that has access to this treatment, so these are adolescents who have marked and sustained gender dysphoria that has worsened with the onset of puberty, they are likely to persist in their gender identity,” Brett Kavanaugh quickly followed up, getting her to acknowledge that there is, in fact, a “group of people who later change their mind and want to detransition.”

After Prelogar continued to argue that the Tennessee law discriminated based on sex, even though the ban falls equally on boys and girls, the ever-brilliant Amy Coney Barrett posed a hypothetical question: “What would your argument be if a new drug is developed within two or three years that just the only purpose of the drug — there is no precocious puberty purpose or anything like that — the only reason to give this drug is it targets minors who have gender dysphoria particularly. And a state passes the law, the FDA approves it so it’s available in some states, but no one has access to it.”

It was a genuine “the emperor has no clothes” moment for Biden’s top Supreme Court advocate, who could only turn to a weak retort that courts would then look to see if there was some sort of discriminatory intent.

One of the most surprising arguments to invalidate the Tennessee law was made from the bench as Justice Ketanji Brown Jackson equated the Tennessee law to a constitutional state ban on interracial marriage. Ed Whelan of the Ethics and Public Policy Center offered a helpful explainer on X: The Court in that case, ‘proscribes generally accepted conduct if engaged in by members of different races,’ and it states that there was ‘patently no legitimate overriding purpose independent of invidious racial discrimination.’”

Whelan added, “What’s the connection here? Biden administration sees none,” noting that it did not cite the case in its briefs.

Another baffling moment from the bench came from Justice Sonia Sotomayor, who likened the side-effects of transgender medical procedures to that of taking aspirin.

“There’s always going to be a percentage of the population under any medical treatment that’s going to suffer a harm. So, the question in my mind is not, do policymakers decide whether one person’s life is more valuable than the millions of others who get relief from this treatment?” she asked.

Courageous detransitioners like Do No Harm’s Chloe Cole would beg to differ.

The ACLU’s contribution was fairly predictable. In response to this question from the bench: “Is there any significant respect in which your position departs from the solicitor general?” Chase Strangio responded, “No, your honor. … The only argument we make before the court here that the solicitor general has not advanced, this is a law that falls under any standard of review. It is so discontinuous with the asserted interest in protecting children, and, therefore, fails under any standard.”

When pressed by Alito on whether transgenderism isn’t immutable — a characteristic typically referred to when speaking of suspect classes deserving of equal protection under the law — and he mentioned those who consider themselves “gender fluid,” Strangio offered up a word salad typical of today’s ideologues: “I think the distinguishing characteristic is to have a birth sex that does not align or a gender that does not align with one’s birth sex. So it may include people who have different understandings of their gender identity.”

Tennessee Solicitor General J. Matthew Rice’s defense of the ban was adept and admirable.

“Tennessee lawmakers enacted SB-1 to protect minors from risky, unproven medical interventions,” he said. “The law imposes an across-the-board rule that allows the use of drugs in some medical purposes and not others. The application turns entirely on medical purpose, not a patient’s sex. That is not sex discrimination.”

Rice added that half of the states in the nation, as well as Sweden, Finland and the U.K., restrict these interventions and “recognize the uncertainty surrounding their use.”

Tennessee was right in restricting experimental medications on minors with highly dubious purposes. Hopefully, the Supreme Court’s clear and unequivocal vindication of the state law will be forthcoming, sparing countless young people the injury of pursuing a medical “solution” for dysphoria and safeguarding our Constitution’s guarantee of equal protection under the law from the manipulation of gender ideology.

A decision by the Court is expected by summer.