One mother in Tennessee, who spoke on the condition on anonymity to protect her transgender child’s identity, described a roller coaster of anger and sadness once the family heard the ruling. It was difficult, she said, to explain to her child why lawmakers and the court were opposed to treatment that felt so essential.

In United States v. Skrmetti, the Supreme Court ruled that Tennessee’s ban on gender-affirming care for minors was not unconstitutional—the first case of its kind on which the court has ruled.

The U.S. Supreme Court ruled in a case about puberty blockers and hormone treatments that holds implications for transgender students.