Conservative groups have for years sought to reduce the government’s sway over parents’ childrearing choices, particularly when it comes to decisions about school and health care.

Dr. Susan Lacy had been caring for transgender patients for several years in Tennessee when, in 2023, everything changed. In the span of a few months, the Republican-governed state banned healthcare providers from treating minors for gender dysphoria.

The logic of federalism, and judicial modesty, would seem to bolster the Volunteer State’s position in the transgender rights case to be heard at the Supreme Court next week. The dispute centers on whether Tennessee and 23 other states can ban sex changes and other so-called “gender affirming” medical treatments for children.