A federal judge in Arizona has ruled that transgender people are no longer required to get gender-affirming surgeries in order to update their birth certificates to align with their gender identity. The Arizona Department of Health Services has 120 days to comply with the ruling.
“We are grateful that the Court ruled in Plaintiffs’ favor and found that this outdated requirement violated Plaintiffs’ constitutional rights,” said Rachel Berg, a staff attorney for the National Center for LGBTQ Rights (NCLR), which filed the case on behalf of four trans youths. “We are thrilled that the Arizona Department of Health Services will be permanently enjoined from enforcing this irrational and overly burdensome requirement, and Plaintiffs will be able to amend their birth certificates to reflect who they are.”
The ruling instructs the Arizona Department of Health Services to ignore the state’s law that requires proof of surgery to be able to amend gender markers on a birth certificate. A correction of one’s gender marker on the document still requires a doctor to attest that the patient is living as a different gender from the one assigned at birth.
The Arizona Attorney General’s Office represented the state health department. The office told the Arizona Daily Star that they are studying the ruling while deciding whether to launch an appeal on the matter.
In August last year, the same federal judge, James Soto (who was appointed by former President Barack Obama), made a similar ruling recommending that the Department of Health Services reconsider the surgical requirement for amending a birth certificate.
Soto highlighted that the requirement risked forcing trans people into unnecessary surgeries in order to live authentically or risk outing themselves in potentially dangerous situations. After a failure to act from the Department of Health Services, this week’s ruling from Judge Soto takes the matter out of their hands.
Earlier this year, Arizona Republicans tried to pass legislation to ban gender marker changes on trans people’s birth certificates entirely. While that bill passed both the state’s House and Senate, it was vetoed by Democratic Gov. Katie Hobbs.
If the Arizona ruling withstands an appeal, it’ll leave only 10 states that require proof of surgery for trans people to correct their birth certificate gender markers. However, several states still refuse to allow trans people to update their gender markers in any way.
The requirement for trans people to receive surgery to update their gender markers is discriminatory, can force people to have surgeries they don’t want, and can cause particular issues for minors who cannot access gender-affirming care.
As Soto noted in his 2024 ruling, “Not every transgender person needs surgery to complete a gender transition. Starting social transitioning and other recommended therapy may eliminate the need for any potential surgical intervention.”
These requirements can mean that minors, regardless of whether they wish to pursue gender-affirming surgeries later in life, are stuck for many years with documentation that includes an incorrect marker. That can lead to situations where a trans person is forced to out themselves, which — aside from being mentally damaging — can also put them at risk for physical harm, given the current climate towards trans people.
In a statement, NCLR noted, “For young people, their birth certificate impacts everything from school records to camp registration. ”
Finally, in most cases the surgeries required for a trans person to update their birth certificate in these states result in sterilization. That forces them to either give up on having biological kids one day, go through expensive processes to preserve their sperm or eggs, or requires them to put off updating their documents until after having children.
California lawmakers passed legislation this week to prevent health providers from releasing transgender patients’ confidential medical records in investigations of gender-affirming care in states that ban treatment for minors.
Senate Bill 497, introduced in February by Sen. Scott Wiener, a Democrat representing San Francisco, builds upon a 2022 state law that established California as a state of refuge for transgender people. That law, also authored by Wiener, prevents states that have banned gender-affirming care for minors from taking legal action against trans youth, their families and their doctors over treatment administered in California.
The latest bill would require law enforcement requesting health information about transgender people in California to provide a warrant, according to Wiener’s office. It would also bar medical providers from complying with out-of-state requests, including subpoenas, for information related to gender-affirming care.
“California must do everything in our power to protect the transgender community, and I’m confident that the Governor will continue his longstanding leadership on trans issues,” Wiener said in a statement on Thursday after the bill passed.
The California Senate voted 30-10 on Wednesday to pass Wiener’s bill, which the state Assembly passed earlier this week. A spokesperson for California Gov. Gavin Newsom (D) declined to comment, saying the governor’s office does not typically remark on pending legislation.
Newsom must sign or veto the measure by Oct. 13.
The vote on Wiener’s bill comes after the Justice Department announced in June that it had sent more than 20 subpoenas to doctors and clinics “involved in performing transgender medical procedures on children” in investigations of alleged health care fraud and false statements. A subpoena sent to the Children’s Hospital of Philadelphia that was made public in a court filing last month requested patients’ birth dates, Social Security numbers and home addresses, as well as “every writing or record of whatever type” from doctors related to the provision of gender-affirming care to adolescents younger than 19 years.
The subpoena requested information dating back to January 2020, more than a year before transition-related care was banned anywhere in the U.S.
On Tuesday, a federal judge blocked an effort by the Trump administration to subpoena medical records of transgender patients who received gender-affirming care at Boston Children’s Hospital, calling the Justice Department’s investigation improper and “motivated only by bad faith.”
In an email on Friday, a spokesperson for Wiener said Senate Bill 497, if signed, would “strengthen the case for any medical provider who wishes to fight Trump’s vicious assault on the transgender community.”
President Trump and administration officials have broadly sought to ban gender-affirming care for minors. A Jan. 28 executive order states that the U.S. “will rigorously enforce” laws that ban transition-related care for anyone younger than 19.
Laws adopted by more than half the nation since 2021 ban gender-affirming care for minors, which major professional medical groups say is medically necessary and often lifesaving for transgender youth and adults. In June, the Supreme Court ruled that states can ban treatment for minors, finding that Tennessee’s prohibition on puberty blockers, hormones and rare surgeries for adolescents does not constitute sex discrimination.
Texas Attorney General Ken Paxton withdrew the state’s lawsuit against pediatric endocrinologist Dr. Hector Granados on Thursday after finding no evidence that he violated the state’s ban on gender affirming care for trans youth.
Paxton sued Granados in October 2024, accusing him of providing puberty blockers and hormones to patients as young as 12 in treatment for gender dysphoria. Paxton accused Granados of falsifying medical and billing records to mislead pharmacies and insurance providers into covering the care.
Paxton initially called Granados a “scofflaw who is harming the health and safety of Texas children,” and Granados wasn’t notified before the lawsuit’s filing, in worries that he might try to destroy relevant records, The Hill reported.
However, Granados said he stopped providing gender-affirming care in May 2023, after the state’s legislature passed the law. Now that Paxton’s office has dropped its charges against him, Paxton’s office will now “focus on other ongoing cases against doctors who illegally provided harmful ‘transition’ treatments and drugs to children,” an attorney general spokesperson said, according to The Hill.
The state has also sued May Lau and M. Brett Cooper, two medical providers from the University of Texas’ Southwestern Medical Center in Dallas. If found guilty, both could possibly lose their medical licenses and face hundreds of thousands of dollars in fines.
Despite Paxton’s claim about gender-affirming care being “harmful,” the medications used in such care have been used safely in children for decades for the purposes of gender transition and to treat other medical issues in cisgender children as well. In fact, Texas’ law stands in opposition to the best care practices for treating gender dysphoria recommended by every major American medical association. These associations agree that such care is safe, effective, and essential for the overall well-being of trans people.
At least 21 hospitals and health systems have suspended or reduced health services for transgender minors and young adults in 2025, according to an NBC News analysis. Many providers cited fears of federal investigations and the potential loss of government funding.
This rollback comes against a backdrop of escalating legal attacks on transgender health care. In recent years, 26 states have passed bans restricting gender-affirming care for minors, with six making it a felony to provide certain treatments. Roughly 40% of trans youth ages 13 to 17 now live in states where access to care is restricted, according to KFF. In June, the Supreme Court upheld Tennessee’s gender-affirming care ban, effectively green-lighting similar laws nationwide.
At the federal level, restricting access to transition-related care has become a main policy objective of the administration. In January, the president signed an executive order directing federal agencies to cut off funding for gender-affirming care for minors and instructing the Department of Justice (DOJ) to investigate and criminalize providers and health centers that offer such care. In April, Attorney General Pam Bondi ordered the DOJ to investigate providers, hospitals, and clinics that provide gender-affirming care to trans youth.
The crackdown escalated earlier this summer when federal prosecutors issued subpoenas to more than 20 hospitals and clinics. In August, sixteen states and the District of Columbia filed suit in an attempt to block the administration’s investigations. However, several providers that received subpoenas chose to suspend offering gender-affirming care instead of waiting for the outcome of the lawsuit.
The chilling effect has extended even into Democratic-led “sanctuary” states, where lawmakers have promised protections for transgender people. While attorneys general in those states initially reminded hospitals that scaling back gender-affirming care could violate state anti-discrimination laws, none have pursued enforcement actions. In practice, this has allowed hospitals to quietly eliminate or reduce programs without consequence.
The presidential administration has quietly ended federal employees’ insurance coverage for gender-affirming care. An LGBTQ+ legal advocacy organization called the policy “not only cruel, [but] illegal.”
A letter sent last Friday from the U.S. Office of Personnel Management Healthcare and Insurance to insurance companies said that the Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) Programs will no longer cover “gender transition” services for people of all ages starting in 2026. The letter says that insurance companies can develop an exemption process for patients currently receiving gender-affirming care “on a case-by-case basis,” though it doesn’t specify how.
However, the programs will still cover “counseling services for possible or diagnosed gender dysphoria,” including “faith-based counseling,” which might be a euphemism for conversion therapy, a widely debunked pseudoscientific practice that purports to change a person’s gender identity or sexual orientation.
The letter also directs insurance companies not to “list or otherwise recognize” providers of gender-affirming care in directories of medical professionals and clinics covered by insurance, Them reported.
In a statement condemning the letter, the LGBTQ+ legal advocacy group Lambda Legal wrote that the “policy violates constitutional protections and multiple federal anti-discrimination laws.”
“This discriminatory policy… is not only cruel—it is illegal,” wrote Lambda Legal Counsel and Health Care Strategist Omar Gonzalez-Pagan.
“The federal government cannot simply strip away essential healthcare coverage from transgender employees while providing comprehensive medical care to all other federal workers,” Gonzalez-Pagan added. “Beyond the fundamental equal protection guarantees enshrined in our Constitution, which prohibit such animus-laden actions, multiple federal laws also prohibit this type of discrimination.”
Lambda Legal pledged to explore all options to respond to the discriminatory policy and asked federal employees harmed by the policy to contact their organization.
While the current presidential administration has sought to eradicate gender-affirming care for trans youth, something the administration calls “chemical or surgical mutilation,” this policy change is one of many that show the administration’s interest in ending gender-affirming care for trans people of all ages.
In January, the president issued an executive order (that has since been blocked by several courts) instructing the Department of Justice to use laws against false advertising to prosecute any entity that may be misleading the public about the long-term effects of gender-affirming care.
On February 7, the Department of Defense issued a memo halting gender-affirming medical procedures for adult military service members. In June, the administration finalized a rule modifying the Affordable Care Act to remove requirements that insurance providers cover gender-affirming care as an essential health benefit.
Gender-affirming care is supported by all major medical associations in the U.S., including the American Medical Association, the Endocrine Society, and the American Academy of Pediatrics, as safe and life-saving for young people with gender dysphoria.
The Department of Justice (DOJ) has issued subpoenas to medical providers who offer gender-affirming care to transgender youth, demanding that they provide private information on their young patients. The subpoenas demand “billing documents, communication with drug manufacturers, patient’s Social Security numbers, addresses, emails, Zoom recordings, voicemails, encrypted text messages, as well as every writing or record of whatever type” doctors have made from January 2020 to the current day, The Washington Post reported.
While Attorney General Pam Bondi admitted last month to sending 20 subpoenas to hold “medical professionals and organizations that mutilated children in the service of a warped ideology” accountable, she didn’t specify which organizations and individuals received the subpoenas. Anonymous informants told the aforementioned publication that some of the subpoena recipients (who got the subpoenas in June) operate in states with laws protecting gender-affirming care for youth. One trans civil rights activist called the incident an “unprecedented and disgusting violation of medical privacy.”
“[The government] is using its investigative powers to target medical providers based on a disagreement about medical treatment rather than violations of the law,” Jacob T. Elberg, a former federal prosecutor specializing in health care fraud, told The Washington Post. He added that the DOJ must show that the information it demanded is “relevant to a legitimate law enforcement probe.”
The publication contacted numerous clinics and professionals offering gender-affirming care for youth, but none would say whether they had received a subpoena, citing fears of violent threats or government retaliation. Other hospitals have been closing their trans youth clinics and erasing any mention of gender-affirming care from their web pages to avoid federal threats to cut funding or pursue prosecutorial charges.
“The subpoena is a breathtakingly invasive government overreach,” said Jennifer L. Levi, senior director of transgender and queer rights at the LGBTQ+ legal advocacy group GLAD Law. “It’s specifically and strategically designed to intimidate health care providers and health care institutions into abandoning their patients.”
Fewer than 3,000 teens nationwide receive puberty blockers or hormone replacement therapy, according to a 2025 JAMA analysis of private insurance data, The Post noted.
Responding to the news, transgender civil rights lawyer Alejandra Caraballo wrote via Bluesky, “This is an unprecedented and disgusting violation of medical privacy,” adding, “The fact that no lawsuit has been commenced challenging these subpoenas in court is ominous. My best guess is that many of the providers have complied and now DOJ is potentially sitting on the records of thousands of trans youth covering everything from therapy notes to pre- and post-op photos.”
Though there is no federal law banning gender-affirming care, the current presidential administration has sought to eradicate the practice through a January executive order (that has since been blocked by several courts). The order instructed the DOJ to extend the time that patients and parents can sue gender-affirming doctors and to use laws against false advertising to prosecute any entity that may be misleading the public about the long-term effects of gender-affirming care.
In April, Bondi issued a memo to DOJ employees, telling them to investigate and prosecute cases of minors accessing gender-affirming care as female genital mutilation (FGM); even though hospitals don’t conduct such female genital surgeries. The memo threatened to jail doctors for 10 years if they provide gender-affirming care to young people.
Gender-affirming care is supported by all major medical associations in the U.S., including the American Medical Association, the Endocrine Society, and the American Academy of Pediatrics, as safe and life-saving for young people with gender dysphoria.
One doctor interviewed by The Washington Post called the federal government’s crusade against gender-affirming care a “toxic plan” that will force some patients to detransition, potentially forcing them into adverse psychological and physical effects, including increased anxiety, depression, and the development of unwanted physical changes.
“This goes way beyond any degree of moral or ethical dilemma that any of us have ever experienced,” the doctor said. “It is completely scientifically and medically unfounded.”
Republican attorneys general in Texas and Tennessee have demanded similar patient information from providers of youth-centered gender-affirming care outside of their states, but they dropped their demands after courts blocked their efforts.
Atrium Health recently stopped providing gender-affirming medication for people 18 and younger, a move that transgender rights and other LGBTQ organizations around the Charlotte region immediately decried. They claimed that the Charlotte area’s largest health care provider buckled under political pressure.
Four LGBTQ rights groups issued a blistering statement on Facebook late last week condemning the move. The statement was on the page for Time Out Youth, a Charlotte nonprofit providing resources for LGBTQ+ people ages 13 to 24. The group was joined by Charlotte Trans Health, the Gender Education Network, and PFLAG Charlotte. The groups said Atrium and its parent company, Advocate Health, are making a decision “based on fear of retaliation by hostile federal agencies or funding cuts.”
Atrium refused to make anyone available for an interview with The Charlotte Observer. Instead, it emailed a statement from parent company Advocate Health confirming it no longer provides or prescribes gender-affirming care medications for patients younger than 19. That’s a departure from a 2023 state law, which restricted gender-affirming care for minors, defined as people younger than 18. In January, President Donald Trump issued an executive order limiting youth access to gender-affirming care nationwide. It defines individuals under 19 as “children” and directs federal agencies to take action to restrict care. Advocate Health said it has been closely following the evolving health care regulatory environment, and acknowledged a “changing federal environment.”
“We recognize that this is a deeply complex issue, and this decision was made after a multi-disciplinary team spent numerous hours carefully considering the options and outcomes,” Advocate Health stated. “This new policy allows our hospitals, clinics and pharmacies to continue caring for all patients’ health needs in the changing federal environment.” Advocate leaders announced the policy change to Atrium-affiliated clinicians and pharmacists during what they called a “difficult” Microsoft Teams meeting on July 31. A doctor associated with Atrium Health who was in that meeting provided an audio recording of it to The Charlotte Observer, and asked not to be named because they were not authorized to share the recording. “We understand the complexity of this, we understand the emotion, the real concern around it. We share it, which is why there has been so much time and so many people weighing in on this,” Dr. Scott Rissmiller, chief clinical officer of Advocate, said on the recording. “And at the end of the day, ultimately, it is to protect our clinicians, our patients and our organization as we move forward.” The Justice Department also issued a new policy memo that could have significant implications for healthcare professionals, Advocate leaders said during the meeting.
It suggested that doctors and other clinicians who provide specific types of gender-affirming care, both medical and surgical, to individuals under 19 may face criminal charges. The memo also includes provisions that encourage and protect whistleblowers who report violations within their healthcare organizations. Atrium Health had not previously provided surgical gender transition procedures for minors under age 18, the company told the Observer. About gender-affirming care Advocate Health defines gender-affirming care as services including social, psychological, behavioral or medical interventions (including hormonal treatment or surgery) designed to support and affirm an individual’s gender identity. That’s according to the draft of a policy shared with physicians in July and provided to the Observer by the doctor associated with Atrium Health. Advocate reviewed protocols for gender-affirming care and considered the potential impacts of federal actions on patients, clinics and employees before deciding to end the medications for people younger than 19, according to the draft policy. “Gender-affirming care is medical care,” the advocacy groups stated. “It is endorsed by every major medical and behavioral health association. It saves lives.”
Gender-affirming care is a supportive form of health care, according to the U.S. Department of Health and Human Services. That may include medical, surgical and mental health services as well as non-medical services for transgender and nonbinary people. Atrium’s policy change wasn’t just about Trump’s executive order, but also took into consideration actions coming from the Federal Trade Commission, the Centers for Medicaid and Medicare, and other “elements,” according to Advocate officials on the audio recording. While health care companies may face regulatory threats, executive actions and other risks, the LGBTQ groups said “the real harm will fall on young people who already face disproportionate rates of depression, anxiety and suicidality when affirming care is withheld.” Advocate Health physicians have been reaching out to patients affected by the policy change so they are aware of what it means for their care and to provide support, according to the company. In its statement to the Observer, Advocate said it recognized “that this will be difficult news” for patients affected by the policy change, and created a 24/7 hotline to assist them, focusing on providing personalized counseling that might be needed.
‘Operating out of fear’ Dr. Holly Savoy, executive director for Charlotte Trans Health, an advocacy group for transgender people, expressed concern and disappointment over Atrium’s decision.
“One of the biggest challenges for trans people is stigma and discrimination,” Savoy said. “(Atrium) is operating out of fear, rather than standing up for evidence-based care,” Savoy said. “It’s not standing behind the science of gender-affirming care and their values of being an organization that says that they support health care for all.” Advocate Health will focus on alternative, non-invasive care, such as behavioral health and peer support for patients, health care officials said at the July meeting. The company is the third-largest nonprofit health system in the U.S. It serves about 6 million patients. More than 155,000 employees work in 68 hospitals and more than 1,000 locations. Novant Health is the second largest health care provider in the Charlotte region. The Winston-Salem-based company did not respond to an Observer request about the status of gender-affirming care for youths.
Concerns over resources LGBTQ advocates feared that Atrium’s decision could make it harder for patients to find new care in the area. “Our kids are now having to suffer because they are struggling now to find care that they’ve had at Atrium, some of them for a couple of years now,” said Joshua Jernigan, founder of the Gender Education Network, a nonprofit providing support and resources to transgender and gender-diverse children. “And it’s just very, very sad to us.”
The state law enacted in 2023, N.C. House Bill 808, prohibits puberty blockers and surgical gender transition procedures for minors who had not already started treatment as of Aug. 1, 2023. And it created penalties for doctors who perform those procedures or who prescribe, provide or dispense puberty-blocking drugs or cross-sex hormones to a minor. Atrium Health hasn’t provided surgical gender transition procedures for minors under 18 since the law passed and has followed the law, Advocate Health told The Charlotte Observer. Advocate’s medication changes went into effect Aug. 4, and also impacts patients previously grandfathered in to receive gender-affirming care services under the N.C. law, according to the draft policy. Gender-affirming care medications can still be prescribed for patients 19 and older, according to the policy. For patients under 19, these same medications can be prescribed for other medical reasons, such as post-chemotherapy needs, tumor removal surgery or to treat precocious puberty (when a child goes through puberty too early). Jernigan said transgender patients deserve access to care, regardless of age. “I would hope that major medical systems would treat their patients first and not act like the patient’s medical needs are not important,” Jernigan said.
Joshua Dumas, a board member of PFLAG Charlotte, said Advocate Health’s decision to cut gender-affirming care medication is a business decision based on the current political climate. The four advocacy groups want Atrium to rescind its decision. “To every trans and gender-diverse young person and their families: You are not alone,” they said. “We are fighting for you. And we will not stop.”
Democratic Gov. Maura Healey, the first out lesbian governor in the U.S., signed the Shield Act 2.0 into law Thursday. The bill further strengthens protections for patients and providers of reproductive healthcare, while explicitly mandating that abortions be performed when deemed medically necessary.
“Massachusetts will always be a state where patients can access high-quality health care and providers are able to do their jobs without government interference,” Healey said in a statement. “From the moment Roe was overturned, we stepped up to pass strong protections for patients and providers, and with President Trump and his allies continuing their assaults on health care, we’re taking those protections to the next level. No one is going to prevent the people of Massachusetts from getting the health care they need.”
The state’s original shield law, enacted by Democratic Gov. Charlie Baker in July, 2022, prohibits states that have banned the life-saving treatment from punishing those who travel to Massachusetts to receive it by preventing the release of information or the arrest and extradition of someone based on another state’s court orders.
The new law further prevents the disclosure of sensitive data, such as a physician’s name, and prohibits local law enforcement from cooperating with other jurisdictions in their investigations. It also directs the Department of Public Health to create an advisory group to help guide businesses as they implement privacy protections for storing or managing electronic medical records.
“Massachusetts is home to the best health care providers in the country, and we aren’t going to let them be intimidated or punished for providing lifesaving care,” said Lieutenant Governor Kim Driscoll. “Together with the Legislature, we are reminding the entire country yet again that Massachusetts is a place where everyone can safely access the health care they need and deserve.”
The island nation of Cuba will now allow transgender people to change the gender markers on their government-issued identity cards without having to undergo “bottom surgery,” a legal change long sought by the country’s trans and nonbinary communities.
On July 18, the country’s National Assembly of People’s Power (NAPP) approved a law allowing people to change their gender markers without first requiring a court-approved document proving that applicants had undergone genital affirming surgeries.
This new law is one of several recently approved by the NAPP to update the technology and policies of the nation’s record-keeping system. Cuba’s new Civil Registry code will now recognize unmarried couples’ emotional unions or cohabitation agreements, providing some legal recognition of various domestic partnerships.
In 2008, Cuba became the first Latin American country to provide comprehensive coverage for gender-affirming surgeries and related medical care. However, despite the country having the highest per capita population of medical doctors in the world, years-long U.S. trade embargo against the nation has prevented many doctors from accessing the hormone replacement medications and surgical supplies they need, according to a 2024 report from Teen Vogue.
Additionally, years worth of budget cuts by the Cuban government have forced many medical professionals to leave the island nation in search of higher-paying work abroad. As a result, trans Cubans must self-medicate using hormones purchased on the internet, something that can present risks since patients must then undergo the physical and psychological side effects without medical consultation.
CENESEX, the government-funded LGBTQ+ rights organization, ostensibly schedules trans-related healthcare for citizens. But one trans person told the aforementioned publication that the organization never contacted them back when they tried to schedule such care. CENESEX didn’t respond to the publication’s request for comment, and a security guard at the organization’s office said that CENESEX was closed and was only seeing patients “on an as-needed basis.”
Same-sex marriage is legal in Cuba. It was legalized on September 27, 2022, following a national referendum where a majority of Cubans voted in favor of a new family code that includes the legalization of same-sex marriage. The new family code also included provisions for same-sex adoption and surrogacy.
Although Cuban law currently prohibits “discrimination based on sexual orientation in employment, housing, statelessness, or access to education or health care,” the international LGBTQ rights site Alturi.com said, “Nonetheless, societal discrimination based on sexual orientation or gender identity persists.”
The US Supreme Court’s decision to uphold Tennessee’s ban on gender identity care for transgender minors earlier this summer has fueled ongoing polarization around LGBTQ issues and controversial policies across the nation. The high court has also agreed to take on more cases dealing with trans rights in its next session that begins in October.
Twenty-seven states have passed lawslimiting access to gender identity health care for transgender children and teenagers, according to KFF, a nonpartisan health policy think tank. An estimated 40% of trans youth ages 13 to 17 live in these states.
There have already been more anti-LGBTQ bills introduced in state legislatures so far this year than in any full year since at least 2020, a CNN analysis of American Civil Liberties Union data found. These bills span various aspects of everyday life, including bathroom access, school sports and identification documents.
CNN is tracking where these laws are being passed and where these bills are being introduced. This story will be updated.
Gender identity care includes medically necessary, evidence-based care that uses a multidisciplinary approach to help a person transition from their assigned sex— the one the person was designated at birth — to their affirmed gender, the gender by which one wants to be known.
Most of the states limiting gender identity care for trans minors adopted their bans in 2023, a record-breaking year for such laws. So far this year, one state — Kansas — has passed a ban, prohibiting the use of state funds to provide or subsidize health care for transgender youth.
Not all laws are currently being enforced, however. The ban in Arkansas has been permanently blocked by a federal court, though the state said it would appeal the ruling. Montana’s ban is also permanently blocked, according to KFF. Though Arizona has a 2022 law on the books banning surgical care for transgender minors, Democratic Gov. Katie Hobbs signed an executive order in 2023 ensuring access to gender identity health care.
Nearly 600 anti-LGBTQ bills have been introduced into state legislatures as of July 11, which is already more than any other year on record, according to the ACLU.
Education and health care continue to be key targets. There were more bills restricting student and educator rights — enforcing school sports bans and targeting students’ access to facilities consistent with their gender identities, for example — than any other category of bills, according to a CNN analysis of ACLU data.
Legislators in Texas have introduced 88 anti-LGBTQ bills so far this year, more than double the number of bills being considered in any other state. Four of those — including one that limits changes to gender markers on state medical records — have been passed into law.
Lawmakers in every state, except for Vermont, have filed at least one anti-LGBTQ bill in 2025, according to a CNN analysis. Twenty-two states have signed those bills into law.
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