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Did you read the dissent? Heightened scrutiny applies when the state makes legal distinctions based on sex. Any reasonable reading of the Tennessee law does this. If a 13-year-old girl starts developing unwanted facial hair, a doctor can prescribe certain medications that he would be prohibited from prescribing if a 13-year-old boy had the same complaint. You can argue semantics and say that this technically wouldn't be a prescription to treat gender dysphoria, but I don't think the legislature's goal was to make sure doctors coded such prescriptions differently. You don't have to agree with this interpretation, but saying that it's so completely devoid of reasoning so as to question the intelligence of the person who expressed it doesn't make sense.
This is sophistry. The distinction in sex between a 13-year-old girl and a 13-year-old boy developing facial hair is not a legal one, it's a biological one -- one is abnormal and the other is normal. That the law recognizes there's a distinction does not mean it's making legal distinctions based on sex.
It's a 2-step analysis. First, you have to determine whether or not the law itself makes a distinction based on sex. This is a legal question, not a biological one. If you determine that it does, only then do you get to consider biology, since step two then asks if the distinction is "substantially related to an important government interest". The Tennessee law doesn't even pretend that this isn't a sex-based distinction. Hell, the law finds it necessary to define "sex" to eliminate all ambiguity. Yet the majority puzzlingly finds that it doesn't to avoid having to get to step 2.
Not really. If the law says "you can't change sex" to both sexes, it's not a sex-based legal distinction. It's a sex-based biological distinction, because how exactly you'd go about changing your sex is a biological matter.
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