Advocacy Alert

Urge Your Lawmakers to Support Essential Health System Designation

States Advance Transgender Health Legislation

Faridat Animashaun
March 7, 2023

Since 2021, state legislatures have focused steadily on access to health services for transgender patients, specifically youth. Currently, at least 24 bills in nine states focus on transgender patients, and four states in 2023 have legalized restrictions on gender-affirming care.

Legislation Targets Access to Transgender Health Care

Utah was the first state in 2023 to restrict transgender health care. Gov. Stephen Cox (R) signed a measure that prohibits gender-affirming surgery for youth and disallows hormone treatments for minors who have not yet been diagnosed with gender dysphoria. Governors in South Dakota, Mississippi, and Tennessee have signed bills that ban the prescription of puberty blockers, transgender hormone therapy, and gender-affirming surgery for minors.

A number of states proposed legislation that prohibits the use of public funds for gender-affirming care. For example:

  • A Virginia bill would prohibit the use of public funds and health benefit plans to cover gender-affirming care for those younger than age 18.
  • An Oklahoma bill prohibits any public institution or employee providing health care from providing gender-affirming care.

Further, several states specifically proposed to make it a criminal act for health care providers to provide gender-affirming care to youth:

  • An Idaho bill would make it a crime for a physician to perform gender reassignment surgery or hormone replacement therapy on those younger than age 18.
  • Bills in both Texas and Missouri would classify gender-affirming care for transgender youth as child abuse.

Legislation to Protect Transgender Health Care

Other states have enacted or proposed legislation to improve and protect health care for transgender populations at large. Twenty-four states and Washington, D.C. prohibit transgender exclusions in health insurance service coverage.

Additionally, pending legislation in New Mexico would ensure access for those seeking gender-affirming care in the state.

Contact Director of Policy Rob Nelb, MPH, at or 202.585.0127 with questions.

Keep up with the pulse of America's Essential Hospitals

Members: Sign up for email updates.