States With Anti-Trans Laws In 2026: An Official Roundup

Between 2020 and 2026, state legislatures across the United States passed hundreds of bills targeting transgender individuals, reshaping the legal reality for millions of people in ways that would have been hard to predict even a decade ago. Whether you’re a trans person trying to figure out which states are safe to live in, a parent researching options for your child, or simply someone trying to understand the current political moment, having a clear, state-by-state reference matters. This article provides a comprehensive guide to all the states with anti-transgender laws on the books, covering healthcare restrictions, education policies, public space limitations, and the legal challenges working their way through the courts.

The Current Landscape of Transgender Rights Legislation

The period from 2020 to 2026 has seen the most concentrated wave of anti-transgender legislation in American history. What started as a handful of bills in a few states quickly became a coordinated national effort, with model legislation circulating among conservative lawmakers and advocacy groups. By mid-2026, more than half of U.S. states have enacted at least one law restricting transgender rights, and many have passed multiple overlapping measures.

The sheer volume of legislation can be disorienting. Some states have passed narrow, targeted bills (a single sports ban, for instance), while others have enacted sweeping packages that touch healthcare, education, identification documents, and public accommodations simultaneously. Understanding the full picture requires looking at both the breadth and depth of these laws.

Overview of Legislative Trends in 2023 and 2024

The year 2023 was a turning point. State legislatures introduced over 500 anti-transgender bills that year, and a significant portion became law. Arkansas had been an early mover in 2021 with its ban on gender-affirming care for minors, but by 2023, states like Florida, Texas, Missouri, and Montana were passing far more comprehensive packages.

Florida’s approach was particularly aggressive. Governor Ron DeSantis signed bills restricting healthcare for minors, banning transgender students from using bathrooms matching their gender identity, limiting pronoun usage in schools, and restricting what could be taught about gender identity in classrooms. The state also extended healthcare restrictions to adults by prohibiting Medicaid coverage for gender-affirming treatments and imposing new requirements on providers.

Texas took a different path to similar ends. Before the legislature passed its own healthcare ban in 2023, Attorney General Ken Paxton had already issued an opinion classifying certain gender-affirming treatments as child abuse, prompting investigations by the Department of Family and Protective Services into families of transgender children. The legislature formalized these restrictions with SB 14, which banned puberty blockers, hormone therapy, and surgical interventions for minors.

By 2024, the pace hadn’t slowed. States that had been considering bills in 2023 moved them across the finish line, and new states joined the effort. Idaho, Indiana, Iowa, Kentucky, Louisiana, and Nebraska all added or expanded restrictions. The legislative focus also broadened beyond healthcare for minors to include adult healthcare access, identification document policies, and restrictions on drag performances.

The 2025 and early 2026 sessions have continued this trajectory, with some states tightening existing laws and others passing new measures. A handful of states have also moved in the opposite direction, enacting shield laws to protect transgender individuals who travel to their jurisdictions for care, but these remain a minority.

Key Legal Definitions and Policy Terminology

Understanding these laws requires knowing the specific language legislators use, because the terminology itself is often contested and politically charged.

Gender-affirming care is the medical term for treatments that help align a person’s physical characteristics with their gender identity. For minors, this typically means puberty blockers (which pause the onset of puberty) and, for older adolescents, hormone therapy. Surgical interventions on minors are extremely rare and were uncommon even before any legislative bans. For adults, gender-affirming care can include hormone therapy, surgical procedures, and mental health support.

Many of the laws use the phrase “biological sex” to mean the sex assigned at birth, and they define gender as synonymous with this assignment. This framing rejects the distinction between sex and gender identity that medical and psychological organizations recognize. Some laws go further, defining “male” and “female” strictly by reproductive capacity or chromosomes, which can create complications for intersex individuals.

“Fairness in sports” acts typically prohibit transgender girls and women from competing on female sports teams at the K-12 or collegiate level. These laws generally require athletes to compete based on the sex listed on their original birth certificate, regardless of any medical transition.

The term “SAFE Act” (or variations like “Save Adolescents from Experimentation”) appears frequently as the title of healthcare restriction bills. This framing positions gender-affirming care as experimental, despite the fact that major medical organizations, including the American Medical Association, the American Academy of Pediatrics, and the Endocrine Society, have recognized these treatments as evidence-based care.

“Shield laws” are the counterpart: laws passed in states like California, Minnesota, and Illinois that protect transgender individuals and their families from legal consequences in other states and ensure access to care within their borders.

States Restricting Gender-Affirming Healthcare

Healthcare restrictions represent the most consequential category of anti-transgender legislation, directly affecting the medical decisions of transgender individuals and their families. These laws vary in scope, from narrow bans on specific procedures for minors to broad restrictions that affect adults as well.

Bans on Medical Care for Minors

As of 2026, at least 24 states have enacted laws banning or severely restricting gender-affirming medical care for minors. The specifics vary, but most prohibit physicians from prescribing puberty blockers and cross-sex hormones to individuals under 18 for the purpose of gender transition. Many also ban surgical procedures, though these were already rarely performed on minors.

Here is a list of states that have enacted bans on gender-affirming healthcare for minors:

• Alabama (SB 184, signed 2022)
• Arizona (SB 1511, signed 2024)
• Arkansas (HB 1570/SAFE Act, signed 2021, the first state to do so)
• Florida (SB 254, signed 2023)
• Georgia (SB 140, signed 2023)
• Idaho (HB 71, signed 2023)
• Indiana (HB 1007, signed 2023)
• Iowa (SF 538, signed 2023)
• Kentucky (SB 150, signed 2023)
• Louisiana (HB 648, signed 2024)
• Mississippi (HB 1125, signed 2023)
• Missouri (SB 49, signed 2023)
• Montana (SB 99, signed 2023)
• Nebraska (LB 574, signed 2023)
• North Carolina (HB 808, signed 2023)
• North Dakota (HB 1254, signed 2023)
• Ohio (HB 68, enacted 2024 via veto override)
• Oklahoma (SB 613, signed 2023)
• South Carolina (H. 4624, signed 2024)
• South Dakota (HB 1080, signed 2023)
• Tennessee (SB 1, signed 2023)
• Texas (SB 14, signed 2023)
• Utah (SB 16, signed 2023)
• West Virginia (HB 2007, signed 2023)

Several of these laws include narrow exceptions, such as allowing minors who were already receiving treatment to continue under certain conditions. Tennessee’s law, for example, originally included a “wind-down” provision, though its implementation was contested in court. Others, like Arkansas’s SAFE Act, contained no grandfather clause, requiring minors to abruptly stop treatment.

The enforcement mechanisms also differ. Some states impose penalties on healthcare providers, including loss of medical licenses, civil liability, and even criminal charges. Alabama’s law, for instance, originally included felony penalties for providers, though parts of the law have faced legal challenges. Other states focus enforcement on licensing boards or insurance restrictions rather than criminal penalties.

Restrictions Affecting Adult Healthcare Access

While the initial wave of legislation focused on minors, a growing number of states have extended restrictions to adults. These measures take several forms.

Florida banned the use of Medicaid funds for gender-affirming care for adults and imposed strict new requirements on providers, including mandating that only physicians (not nurse practitioners or physician assistants) can prescribe hormones, that patients must receive in-person evaluations, and that informed consent processes include specific state-mandated disclosures. The practical effect has been to dramatically reduce the number of providers willing or able to offer care.

Missouri briefly attempted to restrict adult access through an emergency regulation issued by Attorney General Andrew Bailey in 2023, which would have required extensive mental health evaluations and imposed other barriers. The regulation was withdrawn before taking full effect but signaled the direction some policymakers want to move.

Several states have also restricted insurance coverage. Laws in states like Montana, West Virginia, and others have excluded gender-affirming procedures from state employee health plans or Medicaid coverage. While these don’t technically ban adults from seeking care, they make it financially inaccessible for many people.

Oklahoma and South Carolina have passed laws prohibiting the use of public funds for gender-affirming care at state universities and public hospitals, creating gaps in the healthcare infrastructure even for adults who can pay out of pocket.

The trend toward restricting adult access is newer and less widespread than the minor-focused bans, but it represents a significant escalation. Legal scholars have noted that restricting medical decisions for competent adults raises different constitutional questions than restricting care for minors, and several of these laws are expected to face court challenges.

Education and School-Based Legislation

Schools have become a primary battleground in the fight over transgender rights. Legislation in this area covers everything from which sports teams students can join to which bathrooms they can use, what pronouns teachers must use, and what information about gender identity can be included in curricula.

Sports Participation and Fairness Acts

Transgender athlete bans are the most widespread form of anti-transgender legislation. As of 2026, at least 25 states have enacted laws restricting transgender students from participating in school sports consistent with their gender identity. Most of these laws apply to K-12 athletics, and many extend to collegiate sports at public universities.

The common structure of these laws requires students to compete on teams that correspond to the sex listed on their original birth certificate. Some states, like Utah, initially attempted more nuanced approaches (Utah’s original bill created a commission to evaluate individual cases) before the legislature overrode the governor’s veto and enacted a blanket ban.

States with sports participation restrictions include Alabama, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, and Wyoming. A few additional states have enacted restrictions through executive orders or athletic association policies rather than legislation.

Idaho was one of the earliest states to pass such a law (the Fairness in Women’s Sports Act, signed in 2020), though it was immediately blocked by a federal court injunction. The legal status of Idaho’s law has shifted as court rulings and the federal political landscape have changed.

The practical impact of these laws falls disproportionately on transgender girls and women. While the laws technically apply to all transgender students, the legislative debate and public advocacy have centered almost exclusively on transgender female athletes. The number of transgender students affected is small relative to the total student population, but the personal consequences for those individuals are significant: loss of team membership, social isolation, and in some cases, being effectively outed as transgender.

Bathroom and Locker Room Access Policies

Bathroom bills have been a recurring feature of anti-transgender legislation since North Carolina’s HB2 in 2016, which was partially repealed after significant economic backlash. The current wave of bathroom legislation is broader and more durable.

At least 10 states have enacted laws requiring students in public schools to use bathrooms and locker rooms corresponding to their sex assigned at birth. Florida, Alabama, Arkansas, Idaho, Iowa, Kansas, Kentucky, North Carolina, North Dakota, Oklahoma, and Tennessee all have some form of school bathroom restriction on the books. Some of these are standalone bills; others are provisions embedded in larger education or healthcare packages.

Florida’s law (part of HB 1521, signed in 2023) extended beyond schools to any public facility, making it a misdemeanor trespass offense for a person to use a restroom that doesn’t correspond to their sex assigned at birth. This represents one of the most expansive bathroom restrictions in the country and has raised concerns about enforcement, since determining a person’s sex assigned at birth in a restroom setting is inherently invasive.

Several states have taken a softer approach, requiring schools to provide “reasonable accommodations” (typically a single-occupancy restroom) for transgender students rather than allowing them to use the facilities matching their gender identity. While framed as a compromise, transgender advocates argue that these policies single out transgender students and reinforce stigma.

The enforcement of bathroom laws is inconsistent and often depends on local school administrators. In some districts, the laws have led to strict policing of restroom use; in others, administrators have quietly continued allowing transgender students to use facilities consistent with their identity, particularly where doing so hasn’t generated complaints.

Pronoun Usage and Curriculum Restrictions

A newer category of legislation targets how schools address gender identity in the classroom. These laws generally fall into two categories: restrictions on pronoun usage and limits on what can be taught about gender identity and sexual orientation.

Pronoun laws typically prohibit school employees from using a student’s preferred pronouns without written parental consent, or they protect teachers who refuse to use a student’s preferred pronouns from disciplinary action. Florida, North Dakota, Tennessee, Iowa, and several other states have enacted versions of these policies. Some are embedded in broader “parental rights” bills rather than standalone pronoun legislation.

Curriculum restrictions, sometimes called “Don’t Say Gay” laws after Florida’s Parental Rights in Education Act (HB 1557, signed in 2022), prohibit or restrict classroom instruction on sexual orientation and gender identity. Florida’s original law applied to grades K-3 but was expanded in 2023 to cover all grades through 12. Other states with similar restrictions include Alabama, Arkansas, Indiana, Iowa, Kentucky, Louisiana, and North Carolina.

These laws vary in specificity. Some broadly prohibit “instruction” on gender identity, which can be interpreted to include anything from a planned lesson to answering a student’s question. Others focus on prohibiting the use of materials that depict or discuss transgender identities. The vagueness of many of these laws has created a chilling effect, with teachers self-censoring out of fear of violating provisions they don’t fully understand.

The impact on transgender students extends beyond the classroom. When schools are legally prohibited from acknowledging a student’s gender identity, it affects counseling services, communication with parents, and the overall school climate. Research from organizations like the Trevor Project has consistently shown that school environments that affirm transgender students’ identities are associated with lower rates of depression, anxiety, and suicidality among those students.

Public Space and Civil Rights Limitations

Beyond healthcare and education, a growing body of legislation affects transgender individuals’ ability to participate in public life, obtain accurate identification documents, and access public accommodations.

Legal Recognition and ID Document Changes

Several states have made it more difficult or impossible for transgender individuals to change the sex marker on their birth certificates, driver’s licenses, or other government-issued identification. This matters for practical reasons: an ID that doesn’t match a person’s gender presentation can create problems in employment, housing, travel, and interactions with law enforcement.

Montana passed SB 458 in 2023, which requires proof of surgical intervention before a birth certificate can be amended, a standard that excludes many transgender people who either cannot afford surgery, don’t want it, or are medically unable to undergo it. The law was briefly blocked by a court before being allowed to take effect.

Tennessee went further in 2023, enacting a law that prohibits any changes to the sex listed on a birth certificate, regardless of what medical steps a person has taken. This makes Tennessee one of the most restrictive states in the country for transgender individuals seeking accurate identification.

Kansas, Oklahoma, and West Virginia have also enacted or reinforced restrictions on amending birth certificates. Other states have taken administrative action rather than passing new legislation, with state agencies quietly changing policies to make the process more difficult.

On the driver’s license front, several states have tightened requirements for changing sex markers, often requiring documentation that wasn’t previously necessary. Florida, for example, changed its DMV policy to require a physician’s certification of completed surgical transition, a significant departure from its previous, more flexible approach.

The federal landscape adds another layer of complexity. The U.S. State Department began offering an “X” gender marker on passports in 2022, but federal identification policies don’t override state-level restrictions on birth certificates and driver’s licenses. A transgender person might have a passport with one sex marker and a state-issued ID with another, creating confusion and potential legal vulnerability.

Adult Performance and ‘Drag’ Restrictions

Starting in 2023, several states passed laws restricting drag performances, often framed as measures to protect children from “sexually explicit” content. While these laws don’t explicitly mention transgender individuals, advocates have raised concerns that their broad definitions could be used to target transgender people in public spaces.

Tennessee was the first state to pass such a law in 2023, making it a misdemeanor to perform in drag in a public space or in the presence of minors. The law was struck down by a federal judge as unconstitutionally vague and overbroad before it could be enforced. Despite this, similar bills were introduced and, in some cases, passed in other states.

Florida, Texas, Montana, and North Dakota have enacted laws that restrict performances involving “male or female impersonation” in the presence of minors. The definitions in these laws are often broad enough to potentially apply to any gender-nonconforming appearance, not just stage performances. This vagueness has been a central point of legal challenges.

The connection between drag restrictions and transgender rights is direct for many advocates. Drag performers and transgender individuals are distinct groups, but the laws often conflate gender nonconformity with sexual content, and their enforcement could affect anyone whose gender presentation doesn’t match societal expectations.

Comprehensive State-by-State Reference List

Below is a consolidated reference of states with anti-transgender laws on the books as of 2026. This list covers the major categories: healthcare restrictions for minors (HC), healthcare restrictions for adults (HCA), sports bans (S), bathroom restrictions (B), pronoun or curriculum restrictions (P/C), ID document restrictions (ID), and drag or performance restrictions (D). Not every law fits neatly into one category, and some states have additional measures not captured here.

• Alabama: HC, S, B, P/C
• Arizona: HC, S
• Arkansas: HC, S, B, P/C
• Florida: HC, HCA, S, B, P/C, ID, D
• Georgia: HC, S
• Idaho: HC, S, B
• Indiana: HC, S, P/C
• Iowa: HC, S, B, P/C
• Kansas: S, B, ID
• Kentucky: HC, S, P/C
• Louisiana: HC, S, P/C
• Mississippi: HC, S
• Missouri: HC, S
• Montana: HC, S, ID, D
• Nebraska: HC, S
• New Hampshire: S
• North Carolina: HC, S, B, P/C
• North Dakota: HC, S, P/C, D
• Ohio: HC, S
• Oklahoma: HC, S, HCA, B
• South Carolina: HC, S
• South Dakota: HC, S
• Tennessee: HC, S, B, P/C, ID, D
• Texas: HC, S, D
• Utah: HC, S
• West Virginia: HC, S, ID
• Wyoming: S

A few notes on this list. First, it reflects laws that have been enacted, not merely introduced. Hundreds of additional bills have been proposed but failed to pass. Second, the enforcement status of these laws varies: some are fully in effect, others are partially or fully blocked by court orders. Third, this list doesn’t capture executive orders, administrative policy changes, or attorney general opinions that may have similar practical effects without being formal legislation.

States not on this list generally have not enacted anti-transgender legislation, and several have passed protective measures. California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, Minnesota, New Jersey, New Mexico, New York, Oregon, Vermont, and Washington have enacted shield laws or other protections for transgender individuals. These states have taken steps to protect access to gender-affirming care, prevent the enforcement of other states’ anti-transgender laws within their borders, and in some cases, provide refuge for families fleeing restrictive states.

The geographic pattern is stark. Anti-transgender legislation is concentrated in the South, Midwest, and Mountain West, while protective legislation is concentrated on the coasts and in the upper Midwest. This creates a patchwork legal landscape where a transgender person’s rights can change dramatically depending on which side of a state line they’re on.

For anyone looking for a list of all states with anti-transgender laws, this reference should serve as a starting point, but the situation is fluid. New laws are being passed, existing laws are being challenged in court, and enforcement varies widely even within states that have enacted restrictions. Checking current resources from organizations like the ACLU, Lambda Legal, and the Movement Advancement Project (MAP) is essential for the most up-to-date information.

Legal Challenges and Current Status of Enforcement

The legal battles over anti-transgender legislation have been intense, and the outcomes have been mixed. Some laws have been blocked or struck down; others have survived challenges and are being enforced. The U.S. Supreme Court’s 2024 decision to hear United States v. Skrmetti, a case challenging Tennessee’s ban on gender-affirming care for minors, marked a turning point. The Court’s ruling in that case has had ripple effects across the country.

Federal Court Injunctions and Stay Orders

Several anti-transgender laws were immediately challenged in court after passage, and federal judges have issued injunctions blocking enforcement of some provisions.

Arkansas’s SAFE Act was one of the first to be challenged. A federal judge blocked enforcement of the law in 2023, finding that it likely violated the Equal Protection Clause and the rights of parents to make medical decisions for their children. The case, Brandt v. Rutledge, was appealed, and the Eighth Circuit Court of Appeals initially upheld the injunction before the legal landscape shifted following the Supreme Court’s involvement in related cases.

Alabama’s law faced a similar challenge in Eknes-Tucker v. Governor of Alabama. A federal judge initially blocked the law’s criminal penalties for providers, but the Eleventh Circuit Court of Appeals reversed that decision, allowing the law to take effect. The case highlighted the different approaches federal circuits have taken to these laws.

Indiana’s healthcare ban was blocked by a state court judge in 2023, with the judge finding that the law violated the Indiana Constitution’s protections for parental rights and medical decision-making. That injunction was later narrowed on appeal.

The Supreme Court’s decision to take up the Tennessee case in 2024 was significant because it addressed whether laws that classify based on transgender status are subject to heightened judicial scrutiny under the Equal Protection Clause. The outcome of that case, handed down in 2025, has shaped the legal framework for evaluating all of these laws. The Court’s ruling that such classifications are subject to rational basis review rather than heightened scrutiny made it significantly harder to challenge these laws in court, though it did not foreclose all legal avenues.

Some laws remain partially blocked. Florida’s adult healthcare restrictions have been challenged on multiple grounds, including First Amendment claims related to compelled speech by providers. Idaho’s sports ban has been the subject of ongoing litigation since 2020, with the case going through multiple rounds of rulings and appeals.

The enforcement picture is complicated by the fact that even when a law is technically in effect, practical enforcement varies. In some states, providers have stopped offering gender-affirming care to minors out of an abundance of caution, even during periods when the law was technically enjoined. In others, local officials have declined to enforce provisions they view as unworkable or unjust.

Resources for Legal Aid and Advocacy

For transgender individuals and families affected by these laws, several organizations provide legal assistance, information, and advocacy.

The ACLU has been the most active litigator, filing challenges to anti-transgender laws in multiple states. Their website maintains a tracker of anti-transgender legislation that is updated regularly and provides state-by-state information on the status of bills and legal challenges.

Lambda Legal focuses specifically on LGBTQ+ civil rights litigation and has been involved in several of the major court cases challenging healthcare bans and sports restrictions. They offer a legal help desk for individuals who believe their rights have been violated.

The National Center for Transgender Equality provides policy analysis, advocacy resources, and practical guides for transgender individuals dealing with issues like identification document changes, healthcare access, and discrimination.

The Trevor Project offers crisis intervention and suicide prevention services specifically for LGBTQ+ youth. Given the documented mental health impact of anti-transgender legislation on young people, their resources are particularly relevant.

The Transgender Law Center and the Transgender Legal Defense and Education Fund both provide direct legal services, policy advocacy, and public education. They can connect individuals with attorneys experienced in transgender rights cases.

For families considering relocation, the Movement Advancement Project (MAP) maintains a comprehensive database of state laws and policies affecting LGBTQ+ individuals, including an interactive map that allows users to compare states across multiple categories.

State-level organizations also play a critical role. Groups like Equality Florida, Equality Texas, and similar organizations in other states provide localized information, community support, and advocacy specific to their state’s legal landscape.

If you or someone you know is directly affected by anti-transgender legislation, contacting one of these organizations is a concrete first step. Many offer free or low-cost legal consultations, and they can help individuals understand their rights and options under the specific laws in their state.

The landscape of anti-transgender legislation in the United States is vast, fast-moving, and deeply consequential for the people it affects. More than half of U.S. states have enacted some form of restriction targeting transgender individuals, with the most common measures being bans on gender-affirming healthcare for minors and restrictions on transgender students’ participation in school sports. The legal challenges to these laws are ongoing, and the Supreme Court’s recent rulings have reshaped the terrain for future litigation. For transgender individuals and their families, staying informed and connected to legal and advocacy resources is not optional: it is essential. The laws will continue to evolve, and so will the resistance to them.