Second-parent adoption laws permit a parent in a relationship to adopt their partner's child and become a legal parent of that child, giving the child two legal parents and giving both parents legal rights. LGBTQ people often create families in diverse ways, including outside of legal marriage, so these laws help protect LGBTQ parents’ rights without requiring legal marriage.

Only parents in legally recognized relationships can petition to adopt their partner’s child.

These laws permit adoption of a child by a second parent who is not married to the child’s parent, irrespective of one’s gender identity. Therefore, enumerating gender identity is outside of the scope of these laws.

Parents can petition for second-parent or stepparent adoption statewide irrespective of parents' marital status or legal recognition of their relationship.

A confirmatory adoption is a streamlined process established by law to confirm a parent’s existing legal relationship to a child. The parent may have established parentage through other means, but completing the confirmatory adoption process results in a formal adoption decree. Other means of establishing parentage can include the marital presumption (the presumption that married parents are the parents of a child born during their marriage), the holding out presumption (the presumption that if a person acted as a parent to a child, such as by providing a home and raising them, then they are a parent), or as someone who intended to parent a child born through assisted reproduction. In the streamlined confirmatory adoption process, the home study or background check requirements associated with other types of adoptions are not required.

Confirmatory adoption is not available.

Confirmatory adoption is available.

As a result of the 2015 U.S. Supreme Court decision in Obergefell, same-sex couples can marry nationwide and states must extend all the rights and benefits of marriage to same-sex couples. As a result, the following benefits are available to all married same-sex couples on the same basis they are available to married different-sex couples:

For most children born to unmarried parents, legal recognition of parentage is established through the “voluntary acknowledgment of parentage” (VAP), a legal document typically completed at the hospital at the time of the child’s birth. There are no costs associated with it, and once it takes effect, it is the legal equivalent of a court decree of parentage and, under federal law, must be respected across state lines and in all jurisdictions. However, in many states, only men who are believed to be the genetic father of the child in question are permitted to sign VAPs. As a result, many LGBTQ families face obstacles to this pathway to parental recognition. Now, a growing number of states are updating their parenting laws to ensure that any parent—regardless of their gender, sexual orientation, or genetic relationship to the child—can sign a VAP and have their parental relationship legally recognized and protected.

State has not yet expanded access of Voluntary Acknowledgment of Parentage (VAP)

State has Voluntary Acknowledgment of Parentage (VAP) that is explicitly available to non-genetic and LGBTQ parents

Adoption nondiscrimination policies protect LGBTQ parents from discrimination by adoption agencies and officials.

In combination with foster care nondiscrimination, this creates a full point for family services nondiscrimination policy.

Adoption nondiscrimination protections do not enumerate sexual orientation.

Adoption nondiscrimination protections do not enumerate gender identity.

State law, regulation, or agency policy prohibits discrimination in adoption based on sexual orientation of parent(s).

State law, regulation, or agency policy prohibits discrimination in adoption based on gender identity of parent(s).

Foster care nondiscrimination policies protect LGBTQ foster parents from discrimination by foster care agencies and officials.

In combination with adoption nondiscrimination, this creates a full point for family services nondiscrimination policy.

Foster care nondiscrimination protections do not enumerate sexual orientation.

Foster care nondiscrimination protections do not enumerate gender identity.

State law, regulation, or agency policy prohibits discrimination in foster care based on sexual orientation of parent(s).

State law, regulation, or agency policy prohibits discrimination in foster care based on gender identity of parent(s).

These laws apply when a child is conceived through donor insemination and other forms of assisted reproduction. These laws grant legal parenting rights to the non-gestational, non-genetic parent (just as a woman’s husband would be a legal parent of a child they have using donor insemination even though he is not the biological father). In some states, being a married is not a legal requirement for parental recognition of a non-gestational, non-genetic parent. The process of “consenting to inseminate” allows parents in some states a way to establish a legal relationship to the child irrespective of the parents’ marital status.

State lacks clear mechanisms to create legal ties between a non-gestational, non-genetic parent and a child born via donor insemination.

Historically, parents using donor insemination are not denied legal recognition because they are transgender, but because they are part of (or perceived to be part of) a same-sex couple. Therefore, enumerating gender identity is outside of the scope of these laws.

State law recognizes the non-gestational parent as a legal parent, regardless of marital status, if the non-gestational parent consents to the process by which a child is conceived via donor insemination or other assisted reproduction.

State family leave laws allow a person to take leave from work to care for their family members, including a spouse or partner. Some laws allow the worker to take leave for a partner only if they are in a legally recognized relationship (i.e. marriage) to the person who needs care. Other family leave laws use broader definitions of spouse or partner that better reflect the varied ways that LGBTQ people create family, including outside of legal marriage.

State lacks a family leave law entirely.

Although transgender people may be (or be considered to be) in a same-sex relationship and benefit from family leave, historically these laws’ definitions of family have the effect of recognizing or not recognizing a same-sex partner or spouse because both parties are the same sex, not because one of the parties is transgender. Therefore, enumerating gender identity is outside of the scope of these laws.

State law grants workers leave to care for a partner, but only if the couple is in a legally recognized relationship.

State law grants workers leave to care for a partner, even if the couple is not in a legally recognized relationship.

State family leave laws allow a person to take leave from work to care for a child. Barriers to parental recognition for LGBTQ people raising children often mean that one parent lacks legal ties to the child or children they are raising. Additionally, LGBTQ people create families in many ways, and some LGBTQ workers may not have legal or biological relationships to their children. Parents who are not legal or biological parents may be denied this leave unless the state law uses broader definitions of children or parenting that recognizes these varied ways of family building.

State lacks a family leave law entirely.

In the domain of family leave laws, LGBTQ parents’ struggles to gain legal ties to the children they are raising, and thus be recognized under state family leave laws, stem from lack of recognition of parents who are part of a same-sex couple, rather than because a parent is transgender. Therefore, enumerating gender identity is outside the scope of these laws.

State law grants workers leave to care for a child for whom the worker is parenting, but only if the worker has a legal or biological relationship to the child.

State law grants workers leave to care for a child for whom the worker is parenting, even if the worker lacks a legal or biological relationship to the child.

Employment nondiscrimination laws protect LGBTQ people from being unfairly fired, not hired, or discriminated against in the workplace by private employers.

If state lacks a statewide law, this tally looks at local nondiscrimination ordinances and provides partial points based on the percent of the state's LGBTQ population covered by local laws that protect LGBTQ people from discrimination by private employers. No points are awarded for state policies or local laws that only protect government/public employees.

No state law prohibiting employment discrimination based on sexual orientation, and <25% of state population is protected from discrimination based on sexual orientation through local ordinances.

No state law prohibiting employment discrimination based on gender identity, and <25% of state population is protected from discrimination based on gender identity through local ordinances.

No state law prohibiting employment discrimination based on sexual orientation, but 25-49% of state population is protected from discrimination based on sexual orientation through local ordinances.

No state law prohibiting employment discrimination based on gender identity, but 25-49% of state population is protected from discrimination based on gender identity through local ordinances.

No state law prohibiting employment discrimination based on sexual orientation, but 50-99% of state population is protected from discrimination based on sexual orientation through local ordinances.

No state law prohibiting employment discrimination based on gender identity, but 50-99% of state population is protected from discrimination based on gender identity through local ordinances.

State employment nondiscrimination law does not explicitly enumerate sexual orientation, but state explicitly interprets existing state prohibition on sex discrimination to include sexual orientation.

State employment nondiscrimination law does not explicitly enumerate gender identity, but state explicitly interprets existing state prohibition on sex discrimination to include gender identity.

State law explicitly prohibits employment discrimination based on sexual orientation.

State law explicitly prohibits employment discrimination based on gender identity.

Housing nondiscrimination laws protect LGBTQ people from being unfairly evicted, denied housing, or refused the ability to rent or buy housing.

If state lacks a statewide law, this tally looks at local nondiscrimination ordinances and provides partial points based on the percent of the state's LGBTQ population covered by local laws that protect LGBTQ people from housing discrimination.

No state law prohibiting housing discrimination based on sexual orientation, and <25% of state population is protected from housing discrimination based on sexual orientation through local ordinances.

No state law prohibiting housing discrimination based on gender identity, and <25% of state population is protected from housing discrimination based on gender identity through local ordinances.

No state law prohibiting housing discrimination based on sexual orientation, but 25-49% of state population is protected from housing discrimination based on sexual orientation through local ordinances.

No state law prohibiting housing discrimination based on gender identity, but 25-49% of state population is protected from housing discrimination based on gender identity through local ordinances.

No state law prohibiting housing discrimination based on sexual orientation, but 50-99% of state population is protected from housing discrimination based on sexual orientation through local ordinances.

No state law prohibiting housing discrimination based on gender identity, but 50-99% of state population is protected from housing discrimination based on gender identity through local ordinances.

State housing nondiscrimination law does not explicitly enumerate sexual orientation, but state explicitly interprets existing state prohibition on sex discrimination to include sexual orientation.

State housing nondiscrimination law does not explicitly enumerate gender identity, but state explicitly interprets existing state prohibition on sex discrimination to include gender identity.

State law explicitly prohibits housing discrimination based on sexual orientation.

State law explicitly prohibits housing discrimination based on gender identity.

Public accommodation nondiscrimination laws protect LGBTQ people from being unfairly refused service from or entry to places accessible to the general public. Public accommodations laws generally cover anywhere someone is when they are not at home, work, or school, including retail stores, restaurants, parks, hotels, doctors' offices, and banks.

If state lacks a statewide law, this tally looks at local nondiscrimination ordinances and provides partial points based on the percent of the state's LGBTQ population covered by local laws that protect LGBTQ people from public accommodation discrimination.

No state law prohibiting public accommodation discrimination based on sexual orientation, and <25% of state population is protected from public accommodation discrimination based on sexual orientation through local ordinances.

No state law prohibiting public accommodation discrimination based on gender identity, and <25% of state population is protected from public accommodation discrimination based on gender identity through local ordinances.

No state law prohibiting public accommodation discrimination based on sexual orientation, but 25-49% of state population is protected from public accommodation discrimination based on sexual orientation through local ordinances.

No state law prohibiting public accommodation discrimination based on gender identity, but 25-49% of state population is protected from public accommodation discrimination based on gender identity through local ordinances.

No state law prohibiting public accommodation discrimination based on sexual orientation, but 50-99% of state population is protected from public accommodation discrimination based on sexual orientation through local ordinances.

No state law prohibiting public accommodation discrimination based on gender identity, but 50-99% of state population is protected from public accommodation discrimination based on gender identity through local ordinances.

State public accommodations nondiscrimination law does not explicitly enumerate sexual orientation, but state explicitly interprets existing state prohibition on sex discrimination to include sexual orientation.

State public accommodations nondiscrimination law does not explicitly enumerate gender identity, but state explicitly interprets existing state prohibition on sex discrimination to include gender identity.

State law explicitly prohibits public accommodation discrimination based on sexual orientation.

State law explicitly prohibits public accommodation discrimination based on gender identity.

Credit and lending nondiscrimination laws protect LGBTQ people from being unfairly denied credit and lending services.

Local nondiscrimination ordinances typically do not apply to credit and lending practices, so the 0.25 and 0.5 scoring options seen in the employment, housing, or public accommodations nondiscrimination policies are not applicable here.

No state law prohibiting credit and lending discrimination based on sexual orientation.

No state law prohibiting credit and lending discrimination based on gender identity.

State credit nondiscrimination law does not explicitly enumerate sexual orientation, but state explicitly interprets existing state prohibition on sex discrimination to include sexual orientation.

State credit nondiscrimination law does not explicitly enumerate gender identity, but state explicitly interprets existing state prohibition on sex discrimination to include gender identity.

State law explicitly prohibits credit and lending discrimination based on sexual orientation.

State law explicitly prohibits credit and lending discrimination based on gender identity.

Nondiscrimination policies for state employees prohibit discrimination against state employees on the basis of sexual orientation and/or gender identity.

No state policy prohibiting discrimination in public employment based on sexual orientation.

No state policy prohibiting discrimination in public employment based on gender identity.

State law or policy explicitly prohibits discrimination against public employees based on sexual orientation.

State law or policy explicitly prohibits discrimination against public employees based on gender identity.

So-called "Commerce Protection Acts," or preemption laws, prohibit cities and counties from extending local nondiscrimination protections to classes not included in state law. They also render existing local nondiscrimination ordinances unenforceable if they extend protection to these classes. These laws have been used to prevent cities and counties from protecting LGBTQ people from discrimination, and to nullify local ordinances which extend these protections.

State does not ban cities and counties from passing nondiscrimination protections based on sexual orientation.

State does not ban cities and counties from passing nondiscrimination protections based on gender identity.

State law bans cities and counties from passing nondiscrimination protections based on sexual orientation.

State law bans cities and counties from passing nondiscrimination protections based on gender identity.

These laws prohibit transgender people from using bathrooms and facilities—such as locker rooms, shower rooms, changing rooms, and other sex-segregated spaces—according to their gender identity in certain circumstances or places. All of these policies apply to K-12 school settings, and some apply even more broadly to other government-owned buildings and spaces. This can include bathrooms and facilities in government buildings (e.g., city hall, courthouses, state legislative buildings, and more), colleges or universities, jails or prisons, and even in some cases airports, public parks, and much more.

Please note that these bans do not apply to, for example, private businesses or other non-government-owned spaces, though these spaces may have their own discriminatory policies.

No bathroom ban, or no bathroom ban applying beyond K-12 settings. Note that a K-12 bathroom ban may still apply; see LGBTQ youth category.

State bans transgender people from using bathrooms and facilities consistent with their gender identity in K-12 schools and at least some government-owned buildings (e.g., public colleges/universities, prisons or jails, etc).

State bans transgender people from using bathrooms and facilities consistent with their gender identity in all government-owned buildings and spaces, including K-12 schools, colleges, and more.

Broad religious exemption laws (also known as "RFRAs") permit people, churches, non-profit organizations, and sometimes corporations to seek exemptions from state laws if they argue the laws burden their religious beliefs.

State has no broad religious exemption law.

State has no broad religious exemption law.

State has broad religious exemption law.

State has broad religious exemption law.

Targeted religious exemptions for child welfare service providers permit state-licensed child welfare agencies to refuse to place and provide services to children and families, if doing so would conflict with their religious beliefs. These laws can harm many communities, as they can allow agencies to refuse to work with people from different or minority faith backgrounds, interracial or unmarried couples, single women, and LGBTQ people and same-sex couples, among others.

State has no targeted religious exemption law for child welfare providers.

State has no targeted religious exemption law for child welfare providers.

State has targeted religious exemption law that permits state-licensed child welfare agencies to refuse to place and provide services to children and families, including LGBTQ people and same-sex couples, if doing so conflicts with their religious beliefs.

State has targeted religious exemption law that permits state-licensed child welfare agencies to refuse to place and provide services to children and families, including LGBTQ people and same-sex couples, if doing so conflicts with their religious beliefs.

Targeted religious exemptions for medical professionals allow healthcare providers (such as doctors, nurses, pharmacists, and other medical professionals) to refuse to provide medical care to or otherwise serve LGBTQ clients.

State has no targeted religious exemption law for medical professionals.

State has no targeted religious exemption law for medical professionals.

State has targeted religious exemption law allowing medical professionals to refuse to serve LGBTQ clients.

State has targeted religious exemption law allowing medical professionals to refuse to serve LGBTQ clients.

Targeted religious exemptions for private wedding services permit private for-profit businesses to deny services to married same-sex couples.

State has no targeted religious exemption law for private wedding services.

Although transgender people may often be (or be considered to be) in a same-sex relationship and would be harmed by laws denying services to same-sex couples, these laws have the effect of recognizing or not recognizing a same-sex partner or spouse because both parties are the same sex, not because one of the parties is transgender. Therefore, enumerating “gender identity” is outside of the scope of these laws.

State permits services permits private for-profit businesses to deny wedding-related services to LGBTQ people/couples.

Targeted religious exemptions for public officials (i.e., state and local government employees) permit those officials to decline to marry couples of whose marriage they disapprove, including same-sex couples.

State has no targeted religious exemption law for state and local officials providing marriage licenses.

Although transgender people may often be (or be considered to be) in a same-sex relationship and would be harmed by laws denying marriage licenses to same-sex couples, these laws have the effect of recognizing or not recognizing a same-sex partner or spouse because both parties are the same sex, not because one of the parties is transgender. Therefore, enumerating “gender identity” is outside of the scope of these laws.

State permits state and local officials to decline to marry couples of whose marriage they disapprove.

School nondiscrimination laws and statewide regulations protect LGBTQ students from discrimination in school, including being unfairly denied access to facilities, sports teams, or clubs.

No state law, regulation, or teacher code prohibits discrimination in schools based on sexual orientation.

No state law, regulation, or teacher code prohibits discrimination in schools based on gender identity.

Statewide regulation or teacher code prohibits discrimination in schools based on sexual orientation.

Statewide regulation or teacher code prohibits discrimination in schools based on gender identity.

State’s school nondiscrimination law does not explicitly enumerate sexual orientation, but state explicitly interprets existing prohibition on sex discrimination to include sexual orientation.

State’s school nondiscrimination law does not explicitly enumerate gender identity, but state explicitly interprets existing prohibition on sex discrimination to include gender identity.

State law explicitly prohibits discrimination in schools based on sexual orientation.

State law explicitly prohibits discrimination in schools based on gender identity.

Anti-bullying laws and statewide regulations protect LGBTQ students from bullying by other students, teachers, and school staff.

No state law or regulation prohibits bullying in schools based on sexual orientation.

No state law or regulation prohibits bullying in schools based on gender identity.

Statewide regulation or teacher code prohibits bullying in schools based on sexual orientation.

Statewide regulation or teacher code prohibits bullying in schools based on gender identity.

State law prohibits bullying in schools based on sexual orientation.

State law prohibits bullying in schools based on gender identity.

LGBTQ-inclusive curricular laws explicitly require the state’s curricular standards to include LGBTQ people and history, such as in subjects like history, civics, or social studies. Often, laws requiring LGBTQ-inclusive curricular standards also require inclusive representation of other communities like people of color, people with disabilities, and religious minorities.

No state law requiring state's curricular standards to be LGBTQ-inclusive.

No state law requiring state's curricular standards to be LGBTQ-inclusive.

State law requires state's curricular standards to be LGBTQ-inclusive.

State law requires state's curricular standards to be LGBTQ-inclusive.

Parental opt-out laws require parents to be notified in advance of LGBTQ-inclusive curricula, and allow parents to opt their children out of those classes. "LGBTQ-inclusive curricula" can refer to any curricula about sexual orientation, gender identity, and/or LGBTQ people in general. Some states' parental opt-out laws apply to sex education or human sexuality instruction, but they have defined these to inherently include anything about sexual orientation or gender identity.

State does not have this law.

State does not have this law.

State has law requiring parental notification of LGBTQ-inclusive curricula and allowing parents to opt children out.

State has law requiring parental notification of LGBTQ-inclusive curricula and allowing parents to opt children out.

“Don't Say Gay” laws restrict teachers and staff from talking about LGBTQ issues and people. Most of these laws are written to bar any discussion of same-sex relationships within sex education programming, but the laws are often vague and can be misapplied by schools to limit discussion and inclusion of LGBTQ people and issues in other parts of the curriculum, school events and programs, and even extracurricular activities (for example, by being seen as prohibiting Gay-Straight Alliances).

State does not prohibit or explicitly restrict teachers and staff from talking about LGBTQ issues and people.

State does not prohibit or explicitly restrict teachers and staff from talking about LGBTQ issues and people.

State has "Don't Say Gay" regulation prohibiting or explicitly restricting teachers and staff from talking about LGBTQ issues and people.

State has "Don't Say Gay" regulation prohibiting or explicitly restricting teachers and staff from talking about LGBTQ issues and people.

These anti-LGBTQ school laws prohibit schools and districts from adding sexual orientation or gender identity protections in the school/district's own anti-bullying and anti-discrimination policies.

State does not ban schools and districts from passing nondiscrimination and/or anti-bullying protections that include sexual orientation.

State does not ban schools and districts from passing nondiscrimination and/or anti-bullying protections that include gender identity.

State law prohibits schools and districts from passing nondiscrimination and/or anti-bullying protections that include sexual orientation.

State law prohibits schools and districts from passing nondiscrimination and/or anti-bullying protections that include gender identity.

These laws explicitly prevent transgender student athletes from participating in sports according to their gender identity. Independent of state laws, state high school athletic associations may have developed their own policies, which also vary widely from state to state.

These laws explicitly target transgender youth only. While transgender people may be of any sexual orientation, these laws are focused on gender identity.

State has no law (though state high school athletic associations may have their own policies).

State has law banning transgender youth from participating in sports according to their gender identity.

These laws explicitly prevent transgender students from using school facilities, such as bathrooms or locker rooms, according to their gender identity.

These laws explicitly target transgender youth only. While transgender people may be of any sexual orientation, these laws are focused on gender identity.

State has no law banning transgender students from using school facilities according to their gender identity.

State law bans transgender students from using school facilities according to their gender identity.

Conversion therapy laws prohibit licensed mental health practitioners from subjecting LGBTQ minors to harmful conversion "therapy" practices that attempt to change their sexual orientation or gender identity.

No state law banning conversion therapy for minors, and <25% of state population is protected from conversion therapy through local ordinances.

No state law banning conversion therapy for minors, and <25% of state population is protected from conversion therapy through local ordinances.

No state law banning conversion therapy for minors, but 25-49% of state population is protected from conversion therapy through local ordinances.

No state law banning conversion therapy for minors, but 25-49% of state population is protected from conversion therapy through local ordinances.

No state law banning conversion therapy for minors, but 50-99% of state population is protected from conversion therapy through local ordinances.

No state law banning conversion therapy for minors, but 50-99% of state population is protected from conversion therapy through local ordinances.

State partially bans conversion therapy for minors.

State partially bans conversion therapy for minors.

State law bans conversion therapy for minors.

State law bans conversion therapy for minors.

Protections for LGBTQ youth in the child welfare system can stem from state laws, regulations, or agency policies that prohibit discrimination against youth based on sexual orientation and/or gender identity. Some states also require current and prospective foster parents and child welfare staff to receive training about LGBTQ youth in areas like cultural competency and legal requirements, and some states require that transgender youth be placed in accordance with their gender identity. These laws and regulations are designed to improve the safety of and outcomes for LGBTQ youth in the child welfare system.

No explicit state protections against discrimination based on sexual orientation for youth in the child welfare system, nor requirements of LGB cultural competency training.

No explicit state protections against discrimination based on gender identity for youth in the child welfare system, nor guidance about transgender youth being placed in accordance with their gender identity.

State law, regulation, or agency policy prohibits discrimination against youth in the child welfare system based on sexual orientation.

State law, regulation, or agency policy prohibits discrimination against youth in the child welfare system based on gender identity.

Insurance nondiscrimination laws protect LGBTQ people from being unfairly denied health insurance coverage or from being unfairly excluded from coverage for certain health care procedures.

No state law prohibiting private health insurance discrimination based on sexual orientation.

No state law prohibiting private health insurance discrimination based on gender identity.

State law prohibits private health insurance discrimination based on sexual orientation.

State law prohibits private health insurance discrimination based on gender identity.

The Behavioral Risk Factor Surveillance System (BRFSS) is the largest continuously conducted health survey in the world. It is run by the Centers for Disease Control and Prevention (CDC). States can opt to include a number of modules with added questions, including questions about sexual orientation and gender identity. We update our scores as each year's survey participation is publicly released.

State does not include sexual orientation module in its state-based BRFSS survey of adults, or does not participate in BRFSS.

State does not include gender identity module in its state-based BRFSS survey of adults, or does not participate in BRFSS.

State includes questions about sexual orientation in state-based BRFSS survey of adults.

State includes questions about gender identity in state-based BRFSS survey of adults.

The Youth Risk Behavior Surveillance System (YRBSS) is a school-based survey of youth and young adults. The national survey is conducted by the Centers for Disease Control and Prevention (CDC) in schools across the country. States can opt to include a number of modules with added questions, including questions about sexual orientation and gender identity. We update our scores as each year's survey participation is publicly released. Note that YRBSS is conducted every other year, not annually.

State does not include sexual orientation module in its state-based YRBS survey of youth, or does not participate in YRBS.

State does not include gender identity module in its state-based YRBS survey of youth, or does not participate in YRBS.

State includes questions about sexual orientation in state-based YRBS survey of youth.

State includes questions about gender identity in state-based YRBS survey of youth.

Prohibitions on transgender exclusions in health insurance bar health insurance issuers from denying or limiting coverage based on gender identity and require the removal of “transgender exclusions” from health plans. They prevent insurers from explicitly refusing to cover medically necessary care for transgender people.

These laws are specific to “transgender exclusions” as insurance companies have not specifically banned care based on sexual orientation.

State policy is silent on transgender health insurance service coverage.

State policy prohibits transgender-specific exclusions in health insurance service coverage.

While federal healthcare regulations currently prohibit discrimination based on gender identity, state Medicaid policies reflect varying interpretations of those federal regulations. Some state Medicaid policies explicitly include medically necessary health care for transgender people, whereas other state policies explicitly exclude transgender health coverage and care. Still others have no explicit policy, often leading to inconsistent or difficult experiences in accessing health care for transgender people receiving Medicaid in that state.

These policies are specific to providing Medicaid coverage for medically necessary care for transgender people. Enumeration based on sexual orientation is outside the scope of these policies.

State Medicaid policy explicitly excludes transgender-related health care, despite medical necessity and federal regulations to the contrary.

State Medicaid policy has no explicit policy regarding transgender health coverage and care.

State Medicaid policy explicitly includes medically necessary transgender-related health care.

These state policies address whether the healthcare benefits provided to state employees explicitly include or exclude medically necessary health care for transgender state employees. Some states have no explicit policy either way, often leading to inconsistent or difficult experiences for transgender state employees attempting to access medically necessary care.

These policies are specific to providing healthcare for transgender people. Scoring based on sexual orientation is outside the scope of these policies.

State explicitly excludes transgender-related healthcare in their state employee health benefits.

State has no explicit policy regarding transgender-related healthcare in their state employee health benefits.

State explicitly includes transgender-related healthcare in their state employee health benefits.

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.

No state law bans or restricts best practice medical care for transgender youth.

State law bans or restricts best practice medical care for transgender youth.

Hate crime laws require law enforcement agencies to investigate and prosecute crimes committed with bias against LGBTQ people. Some state laws require collection of data on anti-LGBTQ hate crimes.

No state hate crime law, or existing state hate crime law does not enumerate sexual orientation.

No state hate crime law, or existing state hate crime law does not enumerate gender identity.

State hate crime law enumerates sexual orientation.

State hate crime law enumerates gender identity.

So-called “gay and trans panic defenses” allow defendants to claim a victim’s sexual orientation or gender identity provoked or caused the defendant’s actions. State bans prohibit the use of such defenses.

No state law prohibiting the use of so-called “gay panic” defense.

No state law prohibiting the use of so-called “trans panic” defense.

State law prohibits the use of so-called “gay panic” defense.

State law prohibits the use of so-called “trans panic” defense.

Jury service is an important civic responsibility, and the U.S. Constitution guarantees the right to a jury of one’s peers. Nondiscrimination protections are an important tool in ensuring that juries are representative of the broader community and to help ensure fairer and more equitable outcomes in the legal system. Currently, federal law prohibits discrimination against jurors based on their race, religion, sex, and other characteristics, but this law does not explicitly cover such discrimination based on sexual orientation or gender identity. This policy tracks whether state-level jury nondiscrimination protections across the country include sexual orientation and/or gender identity.

No state law or relevant court case that prohibits discrimination in jury service based on sexual orientation.

No state law or relevant court case that prohibits discrimination in jury service based on gender identity.

State law or relevant court case prohibits discrimination in jury service based on sexual orientation.

State law or relevant court case prohibits discrimination in jury service based on gender identity.

HIV criminalization laws criminalize the transmission of, or perceived exposure to, HIV and other infectious diseases. The laws create a strong disincentive for being tested for HIV, and result in adverse public health outcomes. Some laws also criminalize behaviors, such as spitting, that have no risk of HIV transmission. Importantly, states may also have general STI or communicable disease laws that do not enumerate HIV but could still be used to prosecute people living with HIV. Additionally, there are no legal frameworks in place to prevent prosecutors in any state from prosecuting people living with HIV under general criminal codes.

State has no HIV-specific criminal law or policy.

State has no HIV-specific criminal law or policy.

State has no HIV criminalization law, but does have HIV-specific sentencing enhancements (i.e., additional penalties) for sex-related convictions.

State has no HIV criminalization law, but does have HIV-specific sentencing enhancements (i.e., additional penalties) for sex-related convictions.

State has HIV criminalization law only (including general STI laws that enumerate HIV).

State has HIV criminalization law only (including general STI laws that enumerate HIV).

State has HIV criminalization law and either HIV-specific sentencing enhancements or may require sex offender registration (or both).

State has HIV criminalization law and either HIV-specific sentencing enhancements or may require sex offender registration (or both).

Driver's license policies govern the process by which a state changes a gender marker on a person's driver's license. Many transgender people choose to update the gender marker on their identity documents so that it matches their gender identity, also reducing the likelihood they may experience harassment, discrimination, or violence when asked to show their ID.

State requires proof of surgery, court order, or amended birth certificate.

State has unclear, unknown or unwritten policy regarding gender marker changes.

State has no form. No court order or proof of surgery required, but burdensome process requirements and/or provider certification required from limited range of professionals.

State uses easy to understand form and requires provider certification (accepted only from limited range of professionals).

State uses easy to understand form and requires provider certification (accepted from wide range of professionals).

State uses easy to understand form and does not require provider certification.

Birth certificate laws govern the process by which a state changes a gender marker on a person's birth certificate. Many transgender people choose to update the gender marker on their identity documents so that it matches their gender identity, also reducing the likelihood they may experience harassment, discrimination, or violence when asked to show their ID.

State does not allow the gender marker on a birth certificate to be amended.

or

State requires proof of sex reassignment surgery in order to change gender marker.

State has unclear, unknown or unwritten policy regarding gender marker changes.

State is unclear regarding clinical requirements and/or may require a court order to change gender marker.

State accepts documentation from a broad range of licensed professionals and does not require sex reassignment surgery nor court order in order to change gender marker.

Name change laws govern the process by which a state changes the legal name on a person's identity documents. Many transgender people choose to legally change their name so that it better matches their gender identity, also reducing the likelihood they may experience harassment, discrimination, or violence when asked to show their ID or use their legal name. While state laws generally allow individuals to change their legal name for any non-criminal purpose, many states still have outdated and burdensome requirements that create substantial barriers to achieving a legal name change. One of the most common and problematic requirements is that a person must publicly post or publish their legal name change request, often in a local newspaper. This not only poses a financial obstacle (as the publication typically must be paid for), but also puts the person at risk of potential harm, harassment, or discrimination.

State law requires public announcement of name change, and/or includes only a narrow option to waive this requirement (e.g., only if in a witness protection program).

State law has unclear publication requirement, or requires publication but allows individual court discretion and/or broad option to waive requirement (e.g., "for good cause" or general safety).

State law explicitly states that there is no publication of name change required.

Some states provide the option for people to select a gender neutral or non-binary "X" on their driver's license, in addition to the typical options of male or female. The options available for gender markers are independent of the difficulty (or ease) of the process of changing the gender marker.

State only allows residents to identify as male or female on driver's licenses.

State allows residents to identify as male, female, or "X" on driver's licenses.

Some states provide the option for people to select a gender neutral or non-binary "X" on their birth certificate, in addition to the typical options of male or female. The options available for gender markers are independent of the difficulty (or ease) of the process of changing the gender marker.

State only allows residents to identify as male or female on birth certificates.

State allows residents to identify as male, female, or "X" on birth certificates.