According to the Williams Institute at UCLA School of Law, about 105,200 transgender youth aged 13 to 17 live in 22 states where gender-affirming medical care is banned. Nineteen of these bans—all except three—were enacted in 2023. An estimated 92,700 transgender youth reside in these states. About 26,000 transgender youth in five states with bans are currently able to access care due to court orders that prohibit enforcement of the laws.
Most gender-affirming care bans block access to a range of treatments, including puberty blockers, hormones, and surgical care, which are considered best-practice medical care for transgender youth by major medical associations in the U.S.
Approximately 300,000 youth ages 13 to 17 in the U.S. identify as transgender. Researchers estimate the number of transgender teenagers affected by five types of laws and policies from the 2023 legislative session—gender-affirming care bans, bans on sports participation, bathroom bans, gender-affirming care “shield” laws, and conversion therapy bans.
Results show that an estimated 96,800 transgender teenagers live in states that restricted their access to health care, sports, or school bathrooms in 2023. However, tens of thousands of transgender youth aged 13 to 17 in other states gained protections this year through laws that ensure access to gender-affirming care and prohibit conversion therapy.
“A record number of laws impacting transgender youth were introduced in state legislatures in 2023,” said lead author Christy Mallory, Legal Director at the Williams Institute. “While most of them did not pass, the ones that did significantly shifted the legal landscape for transgender youth.”
Additional Findings
Restrictive Legislation
Bans on sports participation
- 101,500 transgender youth—about one-third of transgender youth in the U.S.— live in 23 states that restrict access to school sports for transgender students.
- Five of these laws were passed in 2023. An estimated 14,200 transgender youth live in these states.
- 11,100 transgender youth live in four states with sports participation bans that cannot be enforced due to court orders.
School bathroom bans
- 32,700 transgender youth live in states that ban transgender students from using school bathrooms and other facilities that align with their gender identity.
- 23,600 transgender youth live in states that passed bathroom bans in 2023.
Protective Legislation
Gender-affirming care “shield” laws
- 146,700 transgender youth—about half of transgender youth in the U.S.—live in states with gender-affirming care “shield” laws that support access to care by protecting doctors and parents who prescribe or seek access to medical care for youth.
- 88,000 transgender youth live in states that passed these laws in 2023.
Conversion therapy bans
- 198,000 transgender youth—about two-thirds of transgender youth in the U.S.—live in states that ban conversion therapy, a practice intended to change a person’s sexual orientation, gender identity, or gender expression, for minors.
- 21,800 transgender youth live in states that passed bans in 2023.