KY Senate Bill 150: Medical Ban, School Rules, and Court Status

Kentucky Senate Bill 150 is a 2023 state law that bans gender-affirming medical care for minors and sets new rules for public schools covering bathrooms, pronouns, sex education, and parental notification. The General Assembly overrode Governor Andy Beshear’s veto to enact it on March 29, 2023. The school provisions took effect immediately; the medical care ban took effect on June 29, 2023.¹

What the Law Prohibits and Requires

Gender-Affirming Medical Care for Minors

SB 150 prohibits health care providers from performing surgeries, administering puberty-blocking drugs, or prescribing cross-sex hormones for the purpose of altering a minor’s appearance or perception of sex when it is inconsistent with their biological sex. Providers who violate the ban face revocation of their medical license or certification. The law includes a narrow exception allowing treatment to taper minors off medications they were already receiving.² A minor who is injured by a violation may sue until age 30 or within three years of discovering damages, whichever comes later.³

Bathrooms, Locker Rooms, and Showers in Public Schools

Local school boards must adopt policies reserving restrooms, locker rooms, and shower rooms for students of the same biological sex. Transgender students whose parents provide written consent may receive alternative accommodations, such as a single-stall or faculty restroom, but they may not use facilities designated for the opposite biological sex when other students are present.²

Pronoun Use

School districts cannot require teachers, staff, or other students to use pronouns that do not conform to a student’s biological sex as indicated on the original birth certificate. The Kentucky Board of Education and Department of Education are also barred from recommending or requiring such pronoun usage.²

Sex Education and Curriculum

Instruction on human sexuality or sexually transmitted diseases is prohibited for students in grade five and below. At every grade level, the law bars instruction or presentations whose purpose is to explore gender identity, gender expression, or sexual orientation.²

For grades six and above, schools must notify parents at least two weeks before any instruction on human sexuality or sexually transmitted diseases and obtain written parental consent. That flips the traditional opt-out model, in which students are enrolled by default, into an opt-in model where no instruction occurs without affirmative permission. Schools must offer an alternative course to students whose parents do not consent, with no penalty to grade or standing.⁴ Parents must also be allowed to inspect curriculum materials and lesson plans.⁵

Parental Notification and Student Confidentiality

Schools must notify parents about any health or mental health services related to human sexuality, contraception, or family planning that are available to students, and must obtain parental consent before providing those services or referring students to outside providers. Consent is also required for any well-being questionnaire, assessment, or health screening given for research purposes.²

Districts cannot adopt policies designed to keep student information confidential from parents. There is one exception: information may be withheld if a reasonably prudent person would believe that disclosure would result in the child being abused, neglected, or becoming a dependent child.²

How Schools Are Applying the Law

The Kentucky Department of Education released guidance directing districts to comply while flagging that the requirement to share student information with parents “could conflict with federal privacy law,” a reference to the Family Educational Rights and Privacy Act. Then-Commissioner Jason Glass said many implementation questions “may ultimately have to be resolved by the courts.”⁶ On pronouns, the KDE said it was “no longer able to provide guidance to schools or districts related to the use of requested pronouns” and told districts to consult their own counsel.⁷ The department also identified the state’s fifth-grade health benchmark on reproductive body parts and puberty as out of compliance and told districts to omit that standard pending a broader review.⁴

Districts have taken different approaches within those constraints. Jefferson County Public Schools, the state’s largest district, adopted the mandated restrictions but allows a student with gender dysphoria to request, through a formal 504 disability-accommodation process with a parent, access to a bathroom aligned with their gender identity. JCPS attorney Kevin Brown called the approach “legal” but “bold.”⁸ JCPS also continued teaching puberty-related content to fifth graders by classifying it as personal hygiene and health rather than sex education.⁴

Reporting from The Hechinger Report described broader effects: districts revising health, psychology, and Advanced Placement courses; student-led gay-straight alliances moving “underground” or disbanding; some schools removing Pride flags and “safe space” stickers; and teachers reporting canceled discussions of the Holocaust or Shakespeare over concern that depicted themes could run afoul of the law. Former Kentucky Teacher of the Year Willie Carver said the law “legitimizes and legalizes harassment.”⁹ Sara Choate, a University of Louisville professor of public health and health equity, called the opt-in consent model “an unnecessary barrier for a high percentage of parents in Kentucky who do want their children to receive medically accurate information.”⁴

Where the Law Stands in Court

The Medical Care Ban: Doe v. Thornbury Through Skrmetti

The ACLU of Kentucky, the National Center for Lesbian Rights, and Morgan Lewis sued in the U.S. District Court for the Western District of Kentucky on May 3, 2023, on behalf of seven families with transgender children ages 9 to 16. The suit, Doe v. Thornbury, challenged the ban on puberty blockers and hormone therapy under the Fourteenth Amendment’s Equal Protection and Due Process Clauses. It did not challenge SB 150’s surgery, bathroom, or curriculum provisions.¹⁰

On June 28, 2023, Judge David J. Hale preliminarily enjoined the medical care ban. On July 14, 2023, a Sixth Circuit motions panel stayed that injunction, letting the ban take effect during the appeal.¹ The Sixth Circuit consolidated Kentucky’s case with Tennessee’s L.W. v. Skrmetti and, in a September 28, 2023 opinion by Chief Judge Jeffrey Sutton, reversed both preliminary injunctions. The panel held the laws did not infringe a fundamental right deeply rooted in American tradition and satisfied rational-basis review, citing “medical and scientific uncertainty” surrounding treatments for gender dysphoria in minors. Judge Helene White dissented.¹¹

The Tennessee case reached the U.S. Supreme Court as United States v. Skrmetti. On June 18, 2025, the Court issued a 6–3 decision upholding Tennessee’s ban. Chief Justice Roberts, writing for the majority joined by Justices Thomas, Gorsuch, Kavanaugh, and Barrett, held that the law classifies on the basis of age and medical use rather than sex, does not trigger heightened scrutiny under the Equal Protection Clause, and satisfies rational-basis review. The Court declined to extend Bostock v. Clayton County beyond Title VII employment discrimination. Justice Sotomayor dissented, joined by Justice Jackson in full and Justice Kagan in part; Justice Kagan also filed a separate dissent.¹²

Because the Sixth Circuit had consolidated Kentucky’s case with Tennessee’s and upheld both bans on the reasoning the Supreme Court then endorsed, the ruling effectively shields SB 150’s medical care ban from further equal-protection challenges.¹³

The School Provisions: State-Court Challenge in Fayette County

The federal case did not touch SB 150’s school rules. Those are the subject of a separate class-action lawsuit filed September 28, 2023, in Fayette County Circuit Court by families of five transgender and nonbinary students in Fayette County Public Schools. The plaintiffs, identified by pseudonyms, sued the Fayette County Board of Education and Attorney General Daniel Cameron, arguing the bathroom and pronoun provisions violate the Kentucky Constitution’s guarantees of the right to public education, privacy, free speech, and freedom of thought, as well as the state’s Sex Equity in Education Act.¹⁴ They seek to block enforcement of those provisions in Lexington schools.¹⁵

What Remains Open

Two things are still moving. The state-court challenge to the bathroom and pronoun rules turns on the Kentucky Constitution and a state statute, so the Supreme Court’s federal equal-protection ruling in Skrmetti does not decide it. And the KDE’s own guidance flagged that the parental-information requirements may collide with FERPA, a question Commissioner Glass said would likely land in court. If you are trying to work out how SB 150 applies to a particular school, service, or student, the answer will often depend on district-level policy choices within the law’s framework rather than on the statute alone.

1
ACLU of Kentucky. Doe v. Thornbury Challenge Trans Health Care Ban
2
Kentucky Legislative Research Commission. SB 150 Enrolled Bill Text
3
Kentucky Legislative Research Commission. SB 150
4
LPM News. What to Know About How Senate Bill 150 Affects Sex Education in Kentucky
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Kentucky Department of Education. 2023 Legislative Guidance Emergency Bills
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WUKY. Kentucky Education Department Cites Potential Conflicts With Federal Law in New Senate Bill 150 Guidance
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Lexington Herald-Leader. KDE Guidance on SB 150 Implementation
8
Spectrum News 1. JCPS Adopts Senate Bill 150 Policies Some Exceptions
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The Hechinger Report. School Clubs for Gay Students Move Underground After Kentucky’s Anti-LGBTQ Law Goes Into Effect
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Lexington Herald-Leader. ACLU Files Lawsuit Against SB 150
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U.S. Court of Appeals for the Sixth Circuit. L.W. v. Skrmetti and Doe v. Thornbury Opinion
12
Supreme Court of the United States. United States v. Skrmetti
13
WKYT. SCOTUS Ruling on Tennessee Law Protects Kentucky’s Controversial SB 150
14
Lexington Herald-Leader. Lexington Families Sue Over SB 150 School Provisions
15
LPM News. Lexington Families Sue Over Anti-LGBTQ Education Provisions of Senate Bill 150