It was a blustery December day in Washington, D.C., as hundreds of pro-LGBTQ protesters and conservative activists opposed to medical gender transitions for minors clashed outside the Supreme Court. Both sides showed up Wednesday to try to influence the high court’s decision-making in a landmark case that will determine whether states can ban puberty-blocking drugs, hormone treatments, and gender surgeries for minors.

The case landed in the high court after the American Civil Liberties Union sued the state of Tennessee over its spring 2023 passage of a measure banning medically assisted gender transitions for minors. The Biden administration intervened on the ACLU’s behalf, claiming the law violates the Constitution. The case began as L.W. v. Skrmetti, with parents Samantha and Brian Williams and their trans teen, known as L.W., and two other children squaring off against the state of Tennessee, represented by its attorney general, Jonathan Skrmetti.

Inside the court room Wednesday, Chief Justice John Roberts and Justice Samuel Alito cited several European countries that have placed restrictions on medically induced gender transitions for minors and calmly dissected the common argument from advocates of the practice that the drugs and surgeries help prevent suicides of children and teens with gender dysphoria.

Alito asked about the Cass Review of England’s gender services for children and young people, which called for more caution in providing medically assisted gender transitions and was used as the basis to restrict the prescribing of puberty blockers to children under 18 years old in the U.K.

“On page 195 of the Cass report, it says there is no evidence that gender affirmative treatments reduce suicide,” Alito stated.

ACLU attorney Chase Strangio conceded that there are no studies showing a reduction in “completed suicides,” which he said are thankfully rare, but argued that other studies do show a reduction in suicidal ideation, which he described as a “positive outcome to this treatment.” 

The obvious skepticism by the court’s conservative majority spurred headlines that the high court would likely uphold the Tennessee ban, meaning similar restrictions in 25 other states also would remain protected from legal challenges.

Alliance Defending Freedom CEO, president and general counsel Kristen Waggoner was in the room for the oral arguments and afterward appeared buoyed by the direction the decision appeared to be headed.

“We felt good about it,” Waggoner told CNN. “We’ve had a number of constitutional cases before the court, and you never want to speculate about what it will do. But in listening to the questions, I think what was very clear was that the U.S., the Department of Justice, was quickly walking back any allegation or suggestion that there’s overwhelming scientific support for this, because there’s not.”

The Alliance, or ADF, describes itself as the “world’s largest legal organization” fighting for parental rights and against abortion, censorship, trans individuals participating in women’s sports, and legal challenges to religious liberty. ADF filed an amicus brief in support of the Tennessee law, and the group also is serving as co-counsel in defending similar laws in Alabama and Idaho against the Biden administration’s challenges.

Waggoner, perhaps best known for serving on........

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