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.