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Map: Attacks on Gender Affirming Care by State
Produced by the
HRC Foundation
Last updated: 9/5/2023
In a coordinated push led by national anti-LGBTQ+ groups, legislators across the country have overridden the recommendations of the American medical establishment and introduced hundreds of bills that target transgender and non-binary youth’s access to age-appropriate, medically-necessary care.
The attack on gender affirming care is relentless and changing every day. Here, the Human Rights Campaign provides a real-time snapshot of the assault against trans youth’s access to age-appropriate and medically necessary gender affirming care in the United States.
. . .
35.1%
of transgender youth live in states that have passed bans on gender affirming care
As reported by The Williams Institute (in “How Many Adults and Youth Identify as Transgender in the United States?”), there are more than 300,000 high school-aged (ages 13-17) transgender youth in the United States today, many who need gender affirming care. Many trans youth (45.4%, or 136,300) live in states in which transgender youth have lost access to, or are at risk of losing access to, gender-affirming care, because of discriminatory laws and policies (more information on methodology below).
Three in ten (35.1% or 105,200 total) trans youth aged 13-17 live in states that have passed bans on gender affirming care
While our map focuses solely on high school aged youth (age 13-17), some states, such as Oklahoma, Texas, and South Carolina, have considered banning care for transgender people up to 26 years of age. The William’s Institute’s annual reporting provides additional detail about the number of trans adults and youth people impacted of these types of laws and policies, accounting for the full range of people potentially impacted.
States that have not passed a gender-affirming care ban and are out of their legislative session are no longer labeled as "considering" a gender-affirming care ban. However, the legislative session ending does not prohibit an administrative or executive form of a ban or restriction on gender affirming care.
Gender-affirming care is age-appropriate care that is medically necessary for the wellbeing of many transgender and non-binary people who experience symptoms of gender dysphoria, or distress that results from having one’s gender identity not match their sex assigned at birth.
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.
Tallies are computed by summing, for each of the two legislation categories tracked, the estimated number of high school aged transgender youth (age 13-17) living in each state, as reported by The Williams Institute (“How Many Adults and Youth Identify as Transgender in the United States?”), and then dividing each sum--and the sum total of youth in both categories--by the total estimated number of transgender youth nationwide (300,100, as reported in the same report). Williams Institute estimates were derived from the 2017 and 2019 Youth Risk Behavior Surveillance Survey, as described further in the linked report.
To determine the status of law/policy in each state, HRC Foundation utilized its own internal tracking of bills, laws and policies. States were categorized as either no legislation, “considering a ban” (bills have been introduced and/or passed one or both chambers, but not yet signed into law), and “ban has passed” (bans signed into law or implemented via administrative actions). States with an asterisk reflect those where court injunctions are currently halting implementation of an existing ban, ensuring continued access to care. The status of state legislation and litigation is current as of the date listed under the map.
Estimates reflect the total number of transgender youth living in each state (all of whom are assumed to be at risk of losing care), rather than the number of youth receiving gender-affirming care in each state (and thus may /have lost access), as the latter numbers are unavailable.
These bills have real world impact.
Nearly 1 in 5 of any type of hate crime is now motivated by anti-LGBTQ+ bias.
Over 310 transgender and gender non-conforming people have lost their lives to fatal violence in the past decade, a third of whom were killed in the last three years; Texas and Florida, two of the states leading the current wave of anti-transgender legislation, collectively were home to almost 20% of all victims.
Reports of violence and intimidation against LGBTQ+ people, such as the Club Q shooting that cost the lives of five people, have been making news across the country – with white nationalists targeting a Pride event in Idaho and Proud Boys crashing Drag Queen story hours at local libraries to shout homophobic and transphobic slurs.
Anti-LGBTQ+ stigma also drives alarmingly high rates of depression, anxiety and suicide. One survey from The Trevor Project found that almost nine in ten transgender and non-binary youth experienced worsening mental health as a result of the wave of anti-transgender legislation, and almost half had been cyberbullied as a result of discussions of these bills.
We must stop these harmful bills, laws and policies before we lose more lives.
Stories and Facts on Gender Affirming Care
Trans Kids are Just Kids
"You shouldn't be telling kids like me that they shouldn't live their life as their authentic self." Every kid deserves to be the person they were always meant to be.
Watch Video
HRC Explains Gender Affirming Care
What is gender-affirming care? HRC staff break down what it is, what it’s not and why it saves lives.
Read and Watch
Resources for Caregivers of Trans and Non-binary youth
Check out our resources for parents, family members and caregivers of transgender, non-binary and gender-expansive youth!
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