The US Supreme Court upheld Tennessee’s ban on “gender-affirming” care for minors in a 6-3 ruling on Tuesday. Justices Sotomayor, Jackson, and Kagan were in the minority who dissented from the ruling.

The case, titled United States v. Skrmetti, concerned the constitutionality of Tennessee’s Senate Bill 1 (SB 1). This law “prohibits a healthcare provider from performing on a minor or administering to a minor a medical procedure if the performance or administration of the procedure is for the purpose of enabling a minor to identify with, or live as, a purported identity.” The judges deliberated over whether SB1 violates the Equal Protection Clause in the 14th Amendment, ultimately finding it does not.

In his opinion for the majority, Chief Justice John Roberts wrote specifically about the Equal Protection Clause not applying to arguments against the ban:

“This case carries with it the weight of fierce scientific and policy debates about the safety, efficacy, and propriety of medical treatments in an evolving field. The voices in these debates raise sincere concerns; the implications for all are profound,” Roberts wrote toward the end of his opinion. “The Equal Protection Clause does not resolve these disagreements. Nor does it afford us license to decide them as we see best.”

In her dissenting opinion, Justice Sotomayor wrote oppositely, finding the majority’s decision a slight to the Equal Protection Clause:

“The Court’s willingness to [‘obfuscate a sex classification’] does irrevocable damage to the Equal Protection Clause and invites legislatures to engage in discrimination by hiding blatant sex classifications in plain sight,” Sotomayor concluded. “It also authorizes, without second thought, untold harm to transgender children and the parents and families who love them. Because there is no constitutional justification for that result, I dissent.

Sotomayor also defended the alleged benefits of hormone therapy and the consequences that ensue when trans-identifying individuals are unable to access it, including decline in mental health and self-harm.

Justice Kagan also issued a dissenting opinion, echoing everything argued in Sotomayor’s dissent.