Transgender people’s access to best-practice health care—sometimes also called gender-affirming care—is increasingly under attack. In response, a growing number of states are taking action to protect access to this medically necessary health care. These “shield” or “refuge” laws can vary from one state to the next, but their primary goal is to protect transgender people, their families, and their medical providers against these ongoing attacks and to protect access to transgender-related health care. For example, if a person travels from a state where transgender healthcare is banned and receives that care in another state, a "shield" law can protect the recipient and/or provider of that healthcare against civil or criminal charges from the state where healthcare is banned.
Click the above tab "Shield Laws & Youth Care Bans" to see the landscape of shield laws relative to bans on medical care for transgender youth.
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State has "shield" law protecting access to transgender health care
(14 states + D.C.)
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State has "shield" executive order protecting access to transgender health care
(2 states)
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No "shield" law or policy protecting access to transgender health care
(34 states, 5 territories)
Note:
*Arizona banned surgical care for transgender minors in 2022, but in 2023 a new governor issued an executive order with "shield" style protections for transgender health care that is still legal in the state. *For more information about how these laws vary, click "Citations" to find more information and additional sources.Recommended citation:
Movement Advancement Project. "Equality Maps: Transgender Healthcare 'Shield' Laws." www.mapresearch.org/equality-maps/healthcare/trans_shield_laws.
Accessed 04/30/2025.
Percent of Transgender Population Covered by Laws
*Note: These percentages reflect estimates of the transgender population (ages 13+) living in the 50 states and the District of Columbia. Estimates of transgender people in the U.S. territories or under age 13 are not available, and so cannot be reflected here. Population estimates are from The Williams Institute.
38 % of transgender population (ages 13+) live in states that have "shield" law protecting access to transgender health care
6 % of transgender population (ages 13+) live in states that have "shield" executive order protecting access to transgender health care
56 % of transgender population (ages 13+) live in states that have no "shield" law or policy protecting access to transgender health care
Transgender people’s access to best-practice health care—sometimes also called gender-affirming care—is increasingly under attack. In response, a growing number of states are taking action to protect access to this medically necessary health care. These “shield” or “refuge” laws can vary from one state to the next, but their primary goal is to protect transgender people, their families, and their medical providers against these ongoing attacks and to protect access to transgender-related health care. For example, if a person travels from a state where transgender healthcare is banned and receives that care in another state, a "shield" law can protect the recipient and/or provider of that healthcare against civil or criminal charges from the state where healthcare is banned.
-
State has "shield" law protecting access to transgender health care
(14 states + D.C.)
-
State has "shield" executive order protecting access to transgender health care
(2 states)
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State neither bans nor has "shield" law for best practice medical care for transgender youth
(8 states, 5 territories)
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State ban makes it a felony crime to provide certain forms of best practice medical care for transgender youth
(6 states)
*Notes (and see the "Citations" tab or click "Citations & More Information" below the map legend for more information about every state):
-Arizona banned surgical care for transgender minors in 2022, but in 2023 a new governor issued an executive order with "shield" style protections for transgender health care that is still legal in the state. Go to the transgender healthcare "shield" Equality Map to learn more about these laws.
Bans Permanently Blocked
The following laws are permanently blocked from being enforced, though appeals may be ongoing. Transgender youth should still be able to access care legally.
-Arkansas: In June 2023, a federal judge permanently blocked the state's 2021 ban, ruling it unconstitutional. However, the state has said it will appeal the ruling, and the state also passed a new law in 2023 (effective 90 days after the legislature adjourns) that will allow individuals who receive gender-affirming care as minors (or the family members of those minors) to sue their medical providers for malpractice, among other provisions. The 2023 permanent block builds on an earlier temporary block issued in July 2021.
Bans Temporarily Blocked (In Full or In Part)
The following laws are at least partially blocked from being enforced, though these court cases are still ongoing. Transgender youth should still be able to access care legally to the extent each of these blocks allow.
-Montana, fully blocked: In Sept 2023, a state district court temporarily blocked the state's ban on youth's care from being enforced while the lawsuit continues.
Recommended citation:
Movement Advancement Project. [Year of access]. "Equality Maps: Transgender Healthcare 'Shield' Laws." www.mapresearch.org/equality-maps/healthcare/trans_shield_laws. Accessed [day of access].
Movement Advancement Project. [Year of access]. "Equality Maps: Bans on Best Practice Medical Care for Transgender Youth."
https://www.mapresearch.org/equality-maps/healthcare/youth_medical_care_bans. Accessed [day of access].
Percent of Transgender Population Covered by Laws
*Note: These percentages reflect estimates of the transgender population (ages 13+) living in the 50 states and the District of Columbia. Estimates of transgender people in the U.S. territories or under age 13 are not available, and so cannot be reflected here. Population estimates are from The Williams Institute.
38 % of transgender population (ages 13+) live in states that have "shield" law protecting access to transgender health care
6 % of transgender population (ages 13+) live in states that have "shield" executive order protecting access to transgender health care
56 % of transgender population (ages 13+) live in states that have no "shield" law or policy protecting access to transgender health care
3 % of transgender youth (ages 13-17) live in states that ban best practice surgical care for transgender youth
37 % of transgender youth (ages 13-17) live in states that ban best practice medication and surgical care for transgender youth
