The Supreme Court will dive headfirst into the politically fraught issue of transgender rights on Wednesday when it hears a challenge to Tennessee’s ban on gender-affirming care for minors in the highest-profile case of the fall.

The Supreme Court will consider if states can keep transgender adolescents from puberty blockers and hormone therapy, a major culture war flashpoint.

More than 20 states have moved to restrict gender-affirming care for youth. Now, the high court will weigh in on Tennessee’s law, and a decision could have wider implications.