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Bans on Best Practice Medical Care for Transgender Youth

Bans on best-practice medical care represent one of the most extreme and coordinated political attacks on transgender people in recent years. These bills target transgender youth by blocking their access to best-practice medical care, care that is backed by years of rigorous research and endorsed by the American Academy of Pediatrics, the American Medical Association, and other leading health authorities. These bills not only display a fundamental lack of understanding of transgender children, but they also ban access to medical care often by criminalizing either the doctors or even the parents of transgender youth seeking to provide best-practice medicine for children in their care. 

For more on these efforts, including how these attacks have become more extreme over time, read MAP's 2023 spotlight report.

United States Map
Washington New York U.S. Virgin Islands Puerto Rico Guam Commonwealth of the Northern Mariana Islands American Samoa New Hampshire Vermont Virginia Pennsylvania New York Maine West Virginia Ohio Kentucky Indiana Michigan Illinois Wisconsin North Carolina South Carolina Tennessee Georgia Florida Mississippi Missouri Arkansas Louisiana Iowa Minnesota Oklahoma Kansas Nebraska South Dakota North Dakota Texas 33 Colorado Wyoming Montana Idaho Arizona Utah Nevada Oregon California Hawaii Alaska Massachusetts Rhode Island Connecticut New Jersey Delaware Maryland Washington D.C. New Hampshire Vermont
  • State has "shield" law protecting access to transgender health care (see this map for more information) (10 states + D.C.)
  • State bans best practice medication and surgical care for transgender youth (18 states)
  • State bans best practice surgical care for transgender youth (1 state)
  • State does not ban best practice medical care for transgender youth (31 states , 5 territories + D.C.)
  • State ban makes it a felony crime to provide best practice medical care for transgender youth (5 states)
  • State has taken steps to ban or restrict best practice medical care for transgender youth, but state law does not ban this care (see note) (1 state)

*Notes (and see the "Citations" tab or click "Citations & More Information" below the map legend for more information about every state): 
-Yellow caution icons refer to other efforts attempting to limit or ban health care for transgender youth, such as non-legislative actions. This does not refer to bills introduced: as of April 1, 2023, nearly 4 out of 5 states have introduced these bills. See the "Citations" tab or click "Citations & More Information" below the map legend for more information about every state. (These each link to the same document.)
-Several states have "grandfather" clauses or limited exceptions for some transgender youth and/or for some types of medication. Click "Citations" to read more detail about each bill or to access the law's language directly.

Bans Temporarily Blocked (In Full or In Part)
The following laws are at least partially blocked from being enforced. This map will be updated as these cases progress. Transgender youth/people should still be able to access care to the extent each of these blocks allow.
-Alabama: In May 2022, a federal judge 
temporarily blocked the part of the state's law that bans medication for transgender youth, though the rest of the law remains in effect for now, including the felony punishment and provisions that require school staff to tell parents if a child expresses thoughts that they might be transgender. The state's law applies to individuals up to the age of 19. 
-Arkansas: In July 2021, a federal judge temporarily blocked Arkansas's 2021 ban from going into effect.  However, the state 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.
-Oklahoma: On May 18, 2023, the state's attorney general signed a binding agreement to not enforce the state's ban, pending further legal challenges.
-Missouri: On April 13, 2023, the state's attorney general issued an emergency rule intended to go into effect on April 27, 2023, with a planned expiration date of February 6, 2024. A lawsuit, Southampton Community Healthcare et al. v. Bailey, earned a temporary restraining order to block the rule until at least July 24, 2023, with the potential for a further block of the rule at that time. If the rule had gone into effect, it would have effectively banned, or at a minimum, extraordinarily restricted, medically necessary care for all transgender people, regardless of age.   On May 16, 2023, the state's attorney general filed to withdraw/terminate the rule. At the same time, the legislature has passed a bill that awaits the governor's signature, and he has indicated that he will sign it. 

Bans Not Yet In Effect
The following laws are not yet in effect, and youth should still be able to access care until the laws go into effect
-Idaho: HB71 (2023) does not go into effect until January 1, 2024.
-Indiana: SB480 (2023) does not go into effect until July 1, 2023.
-Georgia: SB140 (2023) does not go into effect until July 1, 2023. The law also contains some exceptions for youth who begin hormone-related medication before July 1, 2023, to continue receiving that treatment. See the ACLU of Georgia for more.
-Kentucky: According to the ACLU of Kentucky, the medical care ban portion of SB150 (2023) "will not go into effect until late June 2023 - 90 days after the legislature adjourns. Trans youth can still receive care until that portion of the bill takes effect." 
-Montana: SB99 (2023) does not go into effect until October 1, 2023.
-Nebraska: LB574 (2023), which applies to those under age 19, does not go into effect until October 1, 2023. The law also contains some exceptions for those who begin hormone-related medication before October 1, 2023, to continue receiving that treatment.
-South Dakota: HB1080 (2023) does not go into effect until July 1, 2023.
-Tennessee: HB1 (2023) does not go into effect until July 1, 2023.
-West VirginiaHB2007 (2023) does not go into effect until January 1, 2024. The law also contains some exceptions for hormone-related medication for youth under certain circumstances and requirements. Click "Citations" or go to the bill text directly to learn more.


Recommended citation:
Movement Advancement Project. "Equality Maps: Bans on Best Practice Medical Care for Transgender Youth." https://www.mapresearch.org/equality-maps/healthcare/youth_medical_care_bans. Accessed 05/30/2023.


Percent of Transgender Youth Covered by Laws

*Note: These percentages reflect estimates of the transgender youth (ages 13-17) population living in the 50 states and the District of Columbia. Estimates of transgender youth 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.

19%

19 % of transgender youth (ages 13-17) live in states that ban best practice medication and surgical care for transgender youth

2%

2 % of transgender youth (ages 13-17) live in states that ban best practice surgical care for transgender youth

79%

79 % of transgender youth (ages 13-17) live in states that do not ban best practice medical care for transgender youth

10%

10 % of transgender youth (ages 13-17) live in states that have taken steps to ban or restrict best practice medical care for transgender youth, but state law does not ban this care (see note beneath map)

Key
  • State does not have this lawBans best practice medical care for transgender youth
State Bans on Medical Care for Transgender Youth
  Citations
Alabama State does not have this law
Alaska
American Samoa
Arizona State does not have this law
Arkansas State does not have this law
California
Colorado
Connecticut
Delaware
District of Columbia
Florida State does not have this law
Georgia State does not have this law
Guam
Hawaii
Idaho State does not have this law
Illinois
Indiana State does not have this law
Iowa State does not have this law
Kansas
Kentucky State does not have this law
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi State does not have this law
Missouri State does not have this law
Montana State does not have this law
Nebraska State does not have this law
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota State does not have this law
Northern Mariana Islands
Ohio
Oklahoma State does not have this law
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota State does not have this law
Tennessee State does not have this law
Texas
U.S. Virgin Islands
Utah State does not have this law
Vermont
Virginia
Washington
West Virginia State does not have this law
Wisconsin
Wyoming


Data current as of 05/30/2023
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Sexual Orientation Policy Tally

The term “sexual orientation” is loosely defined as a person’s pattern of romantic or sexual attraction to people of the opposite sex or gender, the same sex or gender, or more than one sex or gender. Laws that explicitly mention sexual orientation primarily protect or harm lesbian, gay, and bisexual people. That said, transgender people who are lesbian, gay or bisexual can be affected by laws that explicitly mention sexual orientation.

Gender Identity Policy Tally

“Gender identity” is a person’s deeply-felt inner sense of being male, female, or something else or in-between. “Gender expression” refers to a person’s characteristics and behaviors such as appearance, dress, mannerisms and speech patterns that can be described as masculine, feminine, or something else. Gender identity and expression are independent of sexual orientation, and transgender people may identify as heterosexual, lesbian, gay or bisexual. Laws that explicitly mention “gender identity” or “gender identity and expression” primarily protect or harm transgender people. These laws also can apply to people who are not transgender, but whose sense of gender or manner of dress does not adhere to gender stereotypes.

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