Hearing a high-profile culture-war clash, a majority of the Supreme Court seemed reluctant Wednesday to block Tennessee’s ban on gender-affirming care for minors.

The justices’ decision, not expected for several months, could affect similar laws enacted by another 25 states and a range of other efforts to regulate the lives of transgender people, including which sports competitions they can join and which bathrooms they can use.

The case is coming before a conservative-dominated court after a presidential election in which Donald Trump and his allies promised to roll back protections for transgender people.

In arguments that passed the two-hour mark Wednesday, five conservative justices voiced varying degrees of skepticism of arguments made by the Biden administration and lawyers for Tennessee families challenging the ban.

Chief Justice John Roberts, who voted in the majority in a 2020 case in favor of transgender rights, questioned whether judges, rather than lawmakers, should be weighing in on a question of regulating medical procedures, an area usually left to the states.

”The Constitution leaves that question to the people’s representatives, rather than to nine people, none of whom is a doctor,” Roberts said in an exchange with ACLU lawyer Chase Strangio.

The court’s three liberal justices seem firmly on the side of the challengers. But it’s not clear that any of the court’s six conservatives will go along. Justice Neil Gorsuch, who wrote the majority opinion in 2020, has yet to say anything.

Four years ago, the court ruled in favor of Aimee Stephens, who was fired by a Michigan funeral home after she informed its owner that she was a transgender woman. The court held that transgender people, as well as gay and lesbian people, are protected by a landmark federal civil rights law that prohibits sex discrimination in the workplace.

The Biden administration and the families and health care providers who challenged the Tennessee law are urging the justices to apply the same sort of analysis that the majority, made up of liberal and conservative justices, embraced in the case four years ago when it found that “sex plays an unmistakable role” in employers’ decisions to punish transgender people for traits and behavior they otherwise tolerate.

The issue in the Tennessee case is whether the law violates the equal protection clause of the 14th Amendment, which requires the government to treat similarly situated people the same.

Tennessee’s law bans puberty blockers and hormone treatments for transgender minors, but not “across the board,” lawyers for the families wrote in their Supreme Court brief. The lead lawyer, Chase Strangio of the American Civil Liberties Union, is the first openly transgender person to argue in front of the justices.

Advocates for transgender rights are turning to a conservative-dominated Supreme Court after a presidential election in which Donald Trump and his allies promised to roll back protections for transgender people.

The justices on Wednesday are taking up the issue of gender-affirming care for transgender minors, which has been banned by Tennessee and 25 other Republican-led states.

The fight over whether transgender adolescents can access puberty blockers and hormonal treatments is part of a broader effort to regulate the lives of transgender people, including which sports competitions they can join and which bathrooms they can use.

Trump backed a national ban on such care as part of his 2024 campaign in which he demeaned and mocked transgender people.

In its waning days, the Biden administration, along with families of transgender adolescents, will appeal to the justices to strike down the Tennessee ban as unlawful sex discrimination and protect the constitutional rights of vulnerable Americans.

“The stakes are high, of course, for transgender adolescents, but also for the parents who are watching their children suffer, who are just trying to do right by their kids,” Chase Strangio, who represents the families at the Supreme Court, said in an interview. Strangio, a lawyer for the American Civil Liberties Union, will be the first openly transgender person to argue before the high court.

A lawyer for Tennessee will argue that the “life-altering gender-transition procedures” are risky and unproven and that it’s the state’s role to protect children.

Trump nominated three justices in his first term who pushed the court in a more conservative direction that included the decision in 2022 overturning the landmark Roe v. Wade ruling, which had protected abortion rights for nearly 50 years.

Yet one of Trump’s appointees, Justice Neil Gorsuch, also authored a ruling in 2020 that protected LGBTQ people from discrimination in the workplace under federal civil rights law.

The administration and transgender families both rely on that decision to bolster their arguments.

After Trump takes office on Jan. 20, 2025, it’s possible the new administration could weigh in on the case, which is not expected to be decided until the spring.

There are about 300,000 people between age 13 and 17, and 1.3 million adults who identify as transgender in the United States, according to the Williams Institute at the UCLA School of Law. The Williams Institute is a think tank that researches sexual orientation and gender identity demographics to inform laws and public policy decisions.

Most Republican-controlled states have adopted a ban similar to the one in Tennessee, and those laws mostly are in effect, despite legal challenges. The Tennessee case is the first time the nation’s top court will consider the constitutionality of the bans.

Sivan Kotler-Berkowitz, a 20-year-old college student in Massachusetts who is transgender, said his life would have been very different if he were just a few years younger and living in one of the states.

“These bans are denying people the opportunity to live and excel,” he said in an interview. “There are thousands of transgender youth across the country that are thriving just like me because we’ve had the love and understanding of our families and because we’ve had access to proper care.”

The bans in Tennessee and elsewhere have put families in the position of deciding whether to travel for ongoing health care, go without or wait until their children turn 18.

Erin Friday, a leader of Our Duty, an international group that supports the bans on gender-affirming care for minors, said the case is going to be as important as Roe v. Wade. She said upholding the Tennessee law would bolster the cases for the laws restricting sports participation and bathroom use.

An Illinois appellate court ruled Wednesday that a former deputy sheriff charged with the death of Sonya Massey, a 36-year-old Black woman shot in her home after she called police for help, should be released from jail pending his first-degree murder trial.

The 4th District Appellate Court’s unanimous decision found that a circuit court ruling in July that Sean Grayson should be detained was improper. It said prosecutors failed to supply sufficient evidence that there were no conditions the court could set that would lessen the danger Grayson posed to the community.

The case has drawn national attention as another example of police shooting Black people in their homes. Such are the tensions over the case that it was little surprise when Circuit Judge Ryan Cadagin ordered Grayson held, finding his actions were a “departure from the expectations of civil society.”

The case forced the premature retirement of Sangamon County Sheriff Jack Campbell, who hired Grayson, and prompted a Justice Department investigation.

In his opinion for the court, Justice Eugene Doherty found fault with prosecutors for basing their arguments against release on Grayson’s failures to meet expectations during the shooting.

“When the question before the court is whether defendant can be safely released prior to trial on appropriate conditions, it is inappropriate to dwell on whether he fell short of the high expectations society rightly has for its law enforcement officers,” Doherty wrote. “A defendant’s conduct may be reprehensible and deserving of punishment, but that is an inappropriate basis for imposing pretrial detention.”

The opinion ordered a court hearing for Grayson at which suitable conditions for his release be set.

Grayson’s next court hearing is scheduled for Monday. It’s unlikely he will be released immediately. There are actions the state can take, including appealing the appellate court’s ruling.

North Carolina Attorney General Josh Stein was elected governor on Tuesday, defeating Republican Lt. Gov. Mark Robinson and maintaining Democratic leadership of the chief executive’s office in a state where Republicans have recently controlled the legislature and appeals courts.

Stein, a Harvard-trained lawyer, former state senator and the state’s chief law enforcement officer since 2017, will succeed fellow Democrat Roy Cooper, who was term-limited from seeking reelection. He will be the state’s first Jewish governor. Robinson’s campaign was greatly hampered by a damning report in September that he had posted messages on an online pornography website, including that he was a “black NAZI.”

Democrats have held the governor’s mansion for all but four years since 1993, even as the GOP has held legislative majorities since 2011.

As with Cooper’s time in office, a key task for Stein likely will be to use his veto stamp to block what he considers extreme right-leaning policies. Cooper had mixed success on that front during his eight years as governor.

Otherwise, Stein’s campaign platform largely followed Cooper’s policy goals, including those to increase public school funding, promote clean energy and stop further abortion restrictions by Republicans.

Stein’s campaign dramatically outraised and outspent Robinson, who was seeking to become the state’s first Black governor.

For months Stein and his allies used television ads and social media to remind voters of previous inflammatory comments that Robinson had made about abortion, women and LGBTQ+ people that they said made him too extreme to lead a swing state.

“The people of North Carolina resoundingly embraced a vision that’s optimistic, forward-looking and welcoming, a vision that’s about creating opportunity for every North Carolinian,” Stein told supporters in his victory speech after Cooper introduced him. “We chose hope over hate, competence over chaos, decency over division. That’s who we are as North Carolinians.”

Robinson’s campaign descended into disarray in September when CNN reported that he made explicit racial and sexual posts on a pornography website’s message board more than a decade ago. In addition to the “black NAZI” comment, Robinson said he enjoyed transgender pornography and slammed the Rev. Martin Luther King Jr. as “worse than a maggot,” according to the report. Robinson denied writing the messages and sued CNN and an individual for defamation in October.

In the days following the report, most of Robinson’s top campaign staff quit, many fellow GOP elected officials and candidates — including presidential nominee Donald Trump — distanced themselves from his campaign and outside money supporting him on the airwaves dried up. The result: Stein spent millions on ads in the final weeks, while Robinson spent nothing.

Stein had a clear advantage among women, young and older voters, moderates and urban and suburban voters, according to AP VoteCast, an expansive survey of more than 3,600 voters in the state. White voters were about evenly divided between Stein and Robinson, while clear majorities of Black voters and Latino voters supported Stein.

Fifteen percent of those who voted for Trump also backed Stein for governor, while just 2% of those who cast ballots for Democratic presidential nominee and Vice President Kamala Harris backed Robinson.

Patrick Stemple, 33, a shipping coordinator attending a Trump rally last week in Greensboro, said he voted early for Trump but also chose Stein for governor.

Stemple mentioned both Stein’s ads talking about how he has fought illegal drug trafficking and his dislike for Robinson’s rhetoric. Stemple said the graphic language that CNN reported was used in Robinson’s posts reinforced his decision not to back Robinson.