The U.S. Supreme Court on Wednesday upheld Tennessee’s ban on transgender surgeries and medical treatments for minors, affirming conservative arguments that the judgment of medical professionals should take precedence over the preferences of parents and families.

In a 6-3 ruling, the Court indicated that states across the country may now enact similar bans on gender-affirming care for minors—a highly controversial policy that has mobilized progressive activists during the 2024 election cycle. Already, 26 other states have enacted laws comparable to Tennessee’s.

“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,” Chief Justice John Roberts wrote for the majority. “The Equal Protection Clause does not resolve these disagreements. Nor does it afford us license to decide them as we see best.”

The ruling comes as states navigate the challenges of balancing the needs of transgender residents with the rights of parents and conservatives who oppose allowing minors to undergo life-altering medical treatments. The debate has extended to issues such as bathroom access, women’s sports, and the allocation of federal funding.

The U.S. is increasingly isolated in its approach to transgender medical procedures for minors compared to global trends. Last month, the U.K.’s highest court ruled that transgender women—biological males—can be excluded from certain gender-exclusive spaces, such as locker rooms and homeless shelters. Transgender activists criticized the decision as a violation of their civil rights.

Also, President Donald Trump ran on addressing the “transgender lunacy” that he says has permeated American culture and society. Trump made good on his pledge with an early executive order barring transgenders from serving in the U.S. military, a policy that was upheld by the Supreme Court in the spring.