Section 1557 of the Affordable Care Act (“ACA”) provides individuals shall not be subject to discrimination on the basis of sex under a health program or activity that receives federal financial assistance or is administered by an Executive Agency.  (42 USC 18116(a)).  As discussed in our blog post regarding United States v. Skrmetti, the contours of Section 1557’s prohibition of discrimination on the basis of sex remain a hotly litigated issue.

On June 18, 2025, the majority of the United States Supreme Court held Tennessee’s law prohibiting access to gender-affirming care for certain minors was permissible under rational basis review. The Tennessee law at issue, SB1, forbids healthcare providers from providing puberty blockers or hormones to minors.