STATE OF DENIAL
States are racing to restrict the rights of transgender Americans, targeting everything from the healthcare they receive to how they engage in public life. While politicians see attacks on trans rights as an easy political win, these bills have very real consequences.
Fast Facts
Terminology
IN NUMBERS
AN AVALANCHE OF ANTI-TRANS BILLS
2023 stands to break records for the number of anti-LGBTQ bills introduced in state legislatures with the majority in 2023 targeting transgender individuals.
More bills targeting trans rights have been introduced this year than in the previous five years combined.
While it’s true that American attitudes towards the trans community are mixed, recent polling indicates that 80% of Americans acknowledge that transgender people face discrimination in this country, and 64% are in favor of laws that protect trans people.
As of this writing, Delaware remains the only state that has not introduced at least one piece of anti-trans legislation in 2023. Texas, Missouri, and Oklahoma alone have introduced a combined 150 pieces of legislation.
49
states have introduced laws targeting trans rights
31
pieces of federal legislation impacting trans rights have been introduced
130
bills banning or restricting gender-affirming care have been introduced in 2023, with more states considering such bills
THESE BILLS TARGET AN INCREDIBLY SMALL
PORTION OF THE POPULATION
State lawmakers are focusing time and resources on a tiny portion of their constituents. According to the UCLA Williams Institute, transgender Americans make up less than two percent of the U.S. population. More Republican lawmakers have been arrested for soliciting or performing sexual acts in a bathroom than trans people.
SIZE OF TRANSGENDER POPULATION IN STATES WITH THE HIGHEST NUMBER OF ANTI-TRANS BILLS
Source: translegislation.com (number of bills), UCLA Williams Institute, 2022 (population estimates)
"The end goal of anti-trans legislation is denying transgender people the words to describe our experience, the means to express it safely, and the community and support we all deserve."
- Gillian Branstetter,
American Civil Liberties Union
These bills target many aspects of how trangender people express themselves, the type of healthcare decisions they are able to make, and how they engage in public life. The types of legislation broadly fall into eight categories, hover over each type of bill to learn more.
PERSONAL
IDENTIFICATION
These bills attempt to limit the ability to update gender information on IDs and records, such as birth certificates and driver’s licenses. Trans, intersex, and nonbinary people need IDs that accurately reflect who they are to travel, apply for jobs, and enter public establishments without risk of harassment or harm.
EXAMPLE: North Dakota's HB1297 prohibits changing the sex indicated on a birth certificate for any reason other than error.
CIVIL
RIGHTS
These bills attempt to undermine and weaken nondiscrimination laws by allowing employers, businesses, and even hospitals to turn away LGBTQ people or refuse them equal treatment.
EXAMPLE: West Virginia is one of several states who have passed laws aimed at allowing businesses and individuals to deny service to LGBTQ individuals as a matter of religious freedom.
SPEECH AND
EXPRESSION
Politicians are fighting to restrict how and when LGBTQ people can be themselves. From book bans to banning or censoring performances like drag shows, these bills challenge First Amendment rights.
EXAMPLE: Montana's HB359 "prohibits minors from attending drag shows" - but is so broadly worded "drag shows" may include anything from a story hour at a library to a performance of a Shakespeare play.
SCHOOLS AND EDUCATION
State lawmakers are trying to prevent trans students from participating in school activities, force teachers to out students, cancel DEI initiatives, and censor any in-school discussions of LGBTQ people and issues.
EXAMPLE: Among other things, Indiana's HB 1608 requires schools to notify, in writing, "at least one parent of a student [...] of a request made by the student to change the student's name or pronoun." Several other states have introduced similar legislation aimed at "outing" transgender students.
PUBLIC ACCOMMODATION
So-called "bathroom bills", public accommodation bills seek to prohibit transgender people from using facilities like public bathrooms and locker rooms.
EXAMPLE: Arkansas's SB 270 makes it a criminal offense for a transgender individual to use a public changing facility that does not align with their assigned gender. If a person under the age of 18 is present in the changing room, the violation will constitute sexual indecency with a child.
SPORTS PARTICIPATION
These bills attempt to ban transgender athletes from participating in sports.
EXAMPLE: South Carolina's "Save Women's Sports Act" requires any sports that are sponsored by a public elementary or secondary school or public postsecondary institution to maintain separate male and female designated leagues, and that all athletes participate only in the league which aligns with their sex assigned at birth.
BUSINESS AND COMMECE
These bills attempt to punish companies that engage in social issues.
EXAMPLE: Utah has joined other states in prohibiting "entering into a contract with a company that engages in certain boycott actions". The real aim of these laws are to punish companies who, for example, may choose not to operate in another state due to anti-LGBTQ policies.
HEALTHCARE
These bills target access to medically-necessary health care, like Medicaid, for transgender people. Many of these bills ban affirming care for trans youth, and can create criminal penalties for providing this care. Other bills block funding to medical centers that offer gender-affirming care, or block insurance coverage of health care for transgender people.
EXAMPLE: Florida's SB 254 bans access to gender-affirming care and allows the state to take custody of any children undergoing such treatment.
IN 21 STATES GENDER-AFFIRMING
CARE IS CONSIDERED CHILD ABUSE
In many of these states, parents seeking access to gender-affirming care, and doctors who provide care, can be charged with child abuse. Doctors can lose their licenses and parents, in states such as Florida, can lose custody of their children for seeking care.
Almost all of these bills are predicated upon prohibiting gender reassignment surgery for minors - even though this practice is exceedingly rare in this country.
While most of these bills apply to school-age children (ages 13-17), some states such as Oklahoma, Texas, and South Carolina, have considered banning care for transgender people up to 26 years of age.
By preventing doctors from providing this care, or threatening to take children away from parents who support their child in their transition, these bills prevent transgender youth from accessing medically necessary, safe health care backed by decades of research and supported by every major medical association representing over 1.3 million US doctors.
BILL EXPLORER
Use this chart to explore the number of bills introduced by state and target area. Click on any state to see that state's bills, or any target area to see which states have introduced legislation targeting that subject.
ASSESSING IMPACTS
A CHILLING EFFECT
Even though many of these bills fail to pass, are vetoed, or face legal challenges - the mere introduction and debate of these bills have serious consequences. They have a chilling effect on those who would otherwise seek care, create confusion among healthcare practitioners who may opt to deny care rather than face legal or financial repercussions, and restrict the actions of schools and businesses who may fear running afoul of the law.
Further, they send a message that it is ok to discriminate against a group of people based on their gender expression or physical appearance.
THESE BILLS HAVE ECONOMIC CONSEQUENCES
According to 2021 US government census data, the LGBTQ+ community is the fastest-growing minority segment in the U.S., with close to $1.4 Trillion in spending power - on par with Hispanic American, African American, and AAPI segments.
Some of the impacts these bills include:
1 IN 3 CHILDREN NOW LIVE IN A STATE WHERE GENDER-AFFIRMING CARE IS BANNED OR RESTRICTED, FORCING PARENTS TO MAKE TOUGH CHOICES
As of July, 2023, 21 states have passed statewide bans on best-practice medical care for transgender youth, forcing parents to make tough choices. An additional seven states are considering similar bans.
Court injunctions in five of these states - Alabama, Arkansas, Florida, Indiana, and Kentucky - have paused these laws from taking action.
Gender-affirming care is evidence-based, age-appropriate care that is medically necessary for the wellbeing of many transgender and non-binary people who experience symptoms of gender dysphoria, a medically recognized condition that results from having one’s gender identity not match their sex assigned at birth. This care typically includes non-permanent, reversible treatments such as hormone-related therapies that delay puberty or promote the development of masculine or feminine sex characteristics.
STATUS OF ACCESS TO GENDER-AFFIRMING CARE FOR MINORS BY STATE
Source: Human Rights Campaign. Last updated 7/25/23
THE MAJORITY OF BILLS INVOLVING TRANS HEALTHCARE HAVE BEEN WRITTEN WITHOUT ANY MEDICAL INPUT, PUTTING LIVES AT RISK
Ohio joins South and North Carolina, Wisconsin, Michigan, and Oregon in considering legislation banning or restricting gender-affirming care. In justifying the legislation, Ohio House Bill HB 454 claims, among other things, that trans children will "just grow out of it", that those experiencing gender non-conformity are psychopaths, and that those who undertake gender reassignment surgery are at a higher risk of suicide. No medical professionals were consulted in the drafting of the bill, and these assertions have not been validated by any major medical body.
“The criteria established in HB 454 creates intentionally impossible standards to meet, effectively eliminating the use of all medication. These were developed with zero medical input and with no studies or research to support those standards.”
- Nick Lashutka, President & CEO, Ohio Children's Hospital Association regarding Ohio's proposed ban on gender-affirming care
"If passed, HB 454 would make my job as a father much harder. This bill would take away my ability as a parent to make the best decisions I can for my child. Please leave decision-making in the hands of parents."
- Brendan Kelley, father of a trans teen regarding Ohio's proposed ban on gender-affirming care
MANY ARE ASKING THEMSELVES "WHERE CAN I BE SAFE"?
"Safe" may be a relative term, as transgender individuals face higher rates of violence and discrimination than the general population, however - some states are decisively better than others in terms of their political environment and the legal protections they offer to transgender individuals.
For families of transgender minors, 11 states plus Washington D.C. (indicated in white on the map below) have "shield laws" that protect the right to transgender healthcare.
Source: Movement Advancement Project,
ACLU, translegislation.com)
WE'RE ALL IN THIS TOGETHER
When states pass anti-LGBTQ laws they encourage discrimination, actively deter growth and opportunity, and upend lives.
They are a losing proposition for all Americans.
Many of these bills are broadly worded attacks on civil liberties we all enjoy, and encourage bigotry and hatred. Here are some resources for taking action, finding care, and learning more.
TAKE ACTION
DONATE TO THE ACLU
The ACLU works to ensure that lesbian, gay, bisexual, transgender and queer people can live openly without discrimination and enjoy equal rights, personal autonomy, and freedom of expression and association. The ACLU is currently mounting legal challenges against several of the bills that have been passed.
SHOW UP FOR TRANS PEOPLE
Accompany trans people to appointments or in social situations that may cause them anxiety or where they may face obstacles. For example, you can attend medical appointments as a patient advocate, or accompany them to court or county offices when petitioning for a name change.
VOTE AS IF YOUR LIFE DEPENDS ON IT
Yes, your vote really does matter. Vote in every election - not just the presidential years. Learn more about your voting rights, how to register, and where and when to vote.
GET HELP
FUND YOUR TRANSITION
The Campaign for Southern Equality provides a list of resources on grants, funds, and other resources to help pay for the cost of transitioning.
GET EMERGENCY HELP
The Human Rights Campaign is maintaining a list of resources and organizations that may provide emergency funding to individuals and families impacted by anti-LGBTQ+ legislation, to relocate or to access care or services outside of your current state of residence.
Rainbow Railroad is an international organization that helps LGBTQI+ individuals find safety through emergency relocation, crisis response, cash assistance, and other forms of assistance.
ACCESS CARE
Telehealth providers, such as Qmed, FOLX, and others, are working to assist those in states where trans healthcare may be limited or restricted. Another telehealth provider, Charlie Health, provides youth mental health support including treatment for gender dysphoria.
LEARN MORE
GENDER-AFFIRMING CARE
Gender-affirming care remains widely misunderstood by the general population. Politicians use this lack of understanding to pass bills using alarmist language such as "genital mutilation". Learn more about what gender-affirming care is - and what it is not - and educate others.
PRONOUNS
The second most commonly misunderstood trans issue is pronouns. For those that are not used to using them, collective pronouns such as "they" can feel awkward. Others worry about using the "wrong" pronouns and misgendering others. Here's what you need to know about the importance of pronouns and how you can make a best effort at being respectful.
GOING FURTHER
The first best thing you can do for the trans community is to be educated and educate others. Understand that the trans community is not a monolith. Don't assume someone is gay just because they are trans, that they wish to have surgery, or look a certain way. The National Center for Transgender Equality, the Movement Advancement Project, and Others offer a range of resources and practical tips for engaging with and supporting the trans community.
Note: the photographs used are from stock photography sources. No implication is being made regarding the gender identity or sexual orientation of those photographed.