The Sixth U.S. Circuit Court of Appeals upheld a Tennessee statute that prohibits transgender individuals from changing the sex listed on their birth certificates. The ruling, delivered on Friday, dismissed constitutional challenges based on equal protection and due process grounds.

A group of transgender women born in Tennessee brought the lawsuit in 2023, arguing that the law unfairly targets transgender people by preventing them from amending their birth certificates to reflect their gender identity. Under the statute, amendments to the sex designation on birth certificates are only permitted with proof of an error.

The plaintiffs, represented by LGBTQ+ rights organization Lambda Legal, contended that this restriction forces transgender individuals to disclose their transgender status when obtaining other identification documents. At oral arguments in May, attorney Omar Gonzalez-Pagan emphasized that the plaintiffs were not seeking to interfere with the state’s collection of vital records or statistics.

The three-judge panel upheld the statute by a 2-1 vote. U.S. Circuit Chief Judge Jeffrey Sutton, writing for the majority, found that the collection of accurate vital statistics justified the requirement for birth certificates to reflect biological sex at birth. Sutton argued that the statute does not discriminate against transgender individuals because it treats all amendments to the sex designation uniformly.

“The law simply clarifies Tennessee’s use of ‘sex’ as speech about a biological and historical fact of birth and ensures a uniform practice across Tennessee birth certificates,” Sutton wrote. He added that the plaintiffs’ argument would lead to inconsistent standards where birth certificates reflect biological sex for some and gender identity for others.

Sutton noted that the policy predates medical diagnoses of gender dysphoria and that the plaintiffs could not show they belonged to a “suspect class” that would warrant heightened scrutiny under the Constitution. He suggested that transgender individuals should seek legislative solutions rather than constitutional mandates.

“For the fleeting present, eleven states provide individuals with this option, and all of them embraced these innovations through the democratic process in just the last seven years,” Sutton wrote. “The Equal Protection and Due Process Clauses of the United States Constitution do not suddenly require the remaining thirty-nine states, including Tennessee, to do the same.”

Sutton’s opinion was joined by U.S. Circuit Judge Amul Thapar, also appointed by former President Donald Trump.

U.S. Circuit Judge Helene White, appointed by former President George W. Bush, dissented from the majority’s opinion. White argued that the policy is inherently discriminatory because it classifies individuals based on sex in determining eligibility for amended birth certificates.