More specifically, the ruling doesn’t necessary rule out a heightened scrutiny for trans status, but it does rule out heightened scrutiny for gender dysphoria as a medical diagnosis. So, states and potentially even federal agencies like the FDA and CMS can just rule out gender dysphoria as a valid diagnosis for HRT or other procedures.

This is a terrible decision regardless, and more than lays the groundwork for gender affirming care bans across the country, and even at a federal level. It would also uphold the trans military ban and even a ban for trans federal employees.