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.

A Times examination shows how a landmark case about gender-affirming care for minors was built on flawed politics and uncertain science.

The U.S. Supreme Court has upheld Tennessee’s ban on gender-affirming surgery for transgender youth in a ruling that’s likely to reverberate across the country. Most Republican-controlled states already have similar bans.