The Supreme Court has upheld Tennessee’s ban on gender-affirming care for transgender minors, a stunning setback to transgender rights.

A U.S. Supreme Court ruling this week upholding a Tennessee ban on many gender-affirming treatments for minors could further strain Minnesota care providers. Minnesota’s protections for transgender youth remain in place under state law.

The U.S. Supreme Court delivered a blow to transgender rights by upholding a Tennessee ban on gender-affirming care for adolescents, but legal experts said the ruling was narrower than it could have been and left open the door for challenges to the rising number of government restrictions aimed at transgender people.