Report

Prohibiting Gender-Affirming Medical Care for Youth

March 2023

As of March 2023, 30 states have restricted access to gender-affirming care or are currently considering laws that would do so. The bills carry severe penalties for health care providers, and sometimes families, who provide or seek out gender-affirming care for minors. This study estimates the number of transgender youth at risk of losing access to gender-affirming care under these bills.

Highlights
Nine states have enacted legislative bans on gender-affirming care for youth and young adults.
Several bans proposed in 2023 would limit access to care for older youth up to age 26.
Since 2020, 36 states have attempted to restrict access to gender-affirming care—primarily through legislative action.
Data Points
146,300
transgender youth have lost or are at risk of losing access to gender-affirming care
77,900
transgender youth live in 11 states that have enacted gender-affirming care bans or policies
18,700
live in six states that have enacted bans this year
68,400
trans youth in 19 states are at risk of losing access to care due to pending legislation
Report

Executive Summary

Gender-affirming care is considered safe, effective, and medically necessary by major professional health associations, including the American Medical Association, the American Academy of Pediatrics, and the Endocrine Society. Yet, a growing number of states have taken action to restrict access to this care for youth through enacted or proposed legislation or executive actions. Bills that limit access to gender-affirming health care for minors include criminal penalties against health professionals and parents who provide or enable access to such care.

The Williams Institute estimates that

  • 156,500 transgender youth live in 32 states where access to gender-affirming care has been restricted or was at risk of being banned due to legislation filed this legislative session.
    • 144,500 transgender youth in 30 states have lost access to care or are currently at risk of losing access to care due to pending legislation.
      • 77,900 transgender youth live in 11 states that passed bans or took other executive actions this year or in prior years to prohibit or limit their access to gender-affirming care.
        • 18,700 transgender youth impacted by legislative bans recently signed into law in Georgia, Iowa, Mississippi, South Dakota, Tennessee, and Utah and 59,200 transgender youth impacted by bans or executive action in prior years in Alabama, Arizona, Arkansas, Florida, and Texas.
      • 66,600 transgender youth in 19 states remain at risk of losing access to gender-affirming care due to pending legislation. These states are Hawaii, Idaho, Indiana, Kansas, Kentucky, Michigan, Missouri, Montana, Nebraska, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, South Carolina, Washington, and West Virginia.
    • 12,000 youth live in two states—Virginia and Wyoming—where bills were introduced this year but did not pass.

This report provides information about the current bans, which include over 126 bills filed this legislative session,1 and the impacts of these bans. It also reviews the larger landscape of state efforts to restrict care and provides an estimate of the number of transgender youth at-risk of losing access to gender-affirming health care due to these efforts.

Download the full report

Prohibiting Gender-Affirming Medical Care for Youth

See appendix for a full list of the bills considered in this report.