The Supreme Court has issued a major decision upholding Tennessee’s ban on so-called gender-affirming care, such as puberty blockers and cross-sex hormones, for minors. Its decision on June 18 will likely influence how states craft legislation and how other gender-related cases unfold in the legal system.

In the case United States v. Skrmetti, a majority of the justices disagreed with the Biden administration’s argument that Tennessee’s law should undergo more rigorous scrutiny in the courts. Instead, Chief Justice John Roberts said in his majority opinion that courts should apply a less rigorous standard known as rational basis, under which states have to show that their law is rationally related to a state interest.