In 2023, over 100 anti-trans health care bills were introduced in state legislatures across the United States. Though some have been rejected, others have been passed and signed into law.

Many of the bills aim to ban gender-affirming care services, including mental health therapy that accounts for trans experiences, the right for people to change their personal pronouns, access to puberty blockers—which have been used to hold off puberty in cisgender children for decades—and more. If enacted, the new laws could force trans individuals to detransition or incorrectly align their gender with the sex they were assigned at birth. 

Anti-trans bills are more than just socially harmful; they negate the rights of trans individuals to their bodily autonomy and well-being and put their health in danger. Research has shown that without gender-affirming care, trans people are at increased risk of depression and suicide

The following summary is a regional breakdown of some active anti-trans health care bills in the 2023 legislative sessions.

Western and Pacific U.S.

Montana and Oregon are driving anti-trans legislation efforts in the West and Pacific U.S.: 

Montana signed Senate Bill 99 (SB99) into law in April, prohibiting gender-affirming medical and surgical care for transgender minors as well as discouraging social transitions (like changing the pronouns they use or their style of dress).

Idaho, Arizona (which instituted a ban on gender-affirming surgeries for minors in 2022), and Utah have also signed bills into law that ban gender-affirming care for trans youth.

In Oregon, Senate Bill 897 (SB897) was introduced in February, aiming to prohibit gender-affirming care at correctional facilities, including hormone replacement therapy and gender-affirming surgeries. Specifically, it would prohibit the “Department of Corrections from paying for or providing, directly or indirectly, gender-affirming care to individuals in custody of” any correctional facilities in the state. The bill recently failed at the end of June.


Both Missouri and Ohio have passed so-called SAFE acts to ban gender-affirming care for minors. The acronym stands for Save Adolescents from Experimentation, a title that misleads the public into believing that transgender children are in danger of being used for or undergoing experimentation. 

North and South Dakota, Nebraska, and Iowa also passed bills that ban gender-affirming care for transgender youth. Wisconsin and Michigan are considering bills that would ban it as well. 

Indiana has also banned gender-affirming health care, and it has another anti-trans bill in progress. House Bill 1407 (HB1407) would make it illegal for child services agencies to consider a trans-affirming environment as a criteria when considering removing a child from a potentially abusive home. 


A few states in the Northeast have introduced bills against trans health care. Similar to other anti-trans health care bills in the 2023 legislative session, New Jersey’s Senate Bill 3076 aims to ban gender-affirming care and procedures for minors. 

In addition to banning gender-affirming care for minors, New Hampshire’s House Bill 619 would reinstate conversion therapy as an option for parents of children with gender dysphoria—or the feeling of unease when a person’s gender identity and biological sex do not match. If this bill passes, it would mean that transgender children could be subject to practices, like hypnosis and aversion therapy via electric shock, that are known to cause psychological harm

Both bills have yet to be passed.


The South has the most active anti-trans health care legislation in the country. All southern states—except Virginia and the Carolinas—have passed legislation to prevent trans minors from accessing gender-affirming care. However, the surge in anti-trans health care bills is fairly new. Only Alabama, Arkansas, and Texas had banned some form of gender-affirming care prior to 2023.

Currently, the two most notable states are Texas and Florida, which have both introduced multiple bills with measures that target the health and well-being of transgender individuals. 

Texas is moving to reinstate psychological evaluations before transgender people of any age can receive gender-affirming care. The state also introduced a bill in the House of Representatives (HB4754) that would criminalize providing or referring anyone under 26 to gender-affirming care. HB4754 has not been passed.

Florida’s House Bill 1421 was introduced in March in an effort to allow physicians and medical personnel to refuse those seeking gender-affirming care. The bill was not passed. However, the contents of House Bill 1421 were recently signed into law under another bill.

And most significantly, both states—Texas’s Senate Bill 1690 (SB1690) and Florida’s Senate Bill 254 (SB254)—have motioned to involve the state in the rights of parents and guardians who choose to support their children’s gender-affirming care. 

Florida’s SB254, which became law in May, allows the government to take jurisdiction over ongoing custody cases of parents seeking gender-affirming care for their children, even cases of those from out of state. In Texas, the bill would strip court-ordered custody rights of parents and guardians who attempt to leave the state to get gender-affirming care for their child elsewhere. 

Texas’s SB1690 has yet to be passed.

What this means for the future of transgender health

The 2023 legislative season was a threat to the health and well-being of trans individuals. It not only challenged the global increase in social acceptance of trans people since 1980 but also went against the opinion of medical professionals who agree that gender-affirming care is lifesaving. Whether it’s meant to galvanize conservative voters or is part of a larger effort to further conservative ideals, anti-trans legislation hurts individuals and isolates a growing community

To keep track of all current anti-trans legislation, visit For specific information regarding gender-affirming care legislation, visit the Human Rights Campaign’s map resource.


If you or anyone you know is affected by anti-trans health care legislation, help may be available. Check out the following resources:

The Trevor Project has championed LGBTQ+ youth’s mental health for nearly two decades. 

Transgender Law Center provides a legal help desk for transgender individuals in need.

The Human Rights Campaign Foundation has a legal team dedicated specifically to LGBTQ+ people and queer-specific issues.

The LGBT National Help Center has hotlines for LGBTQ+ youth, adults, and seniors, including a hotline dedicated to coming out.

Trans Lifeline is a trans-run and trans-specific 24/7 hotline for all questions and occasions.