Today the Movement Advancement Project (MAP) released Banning Medical Care and Legal Recognition for Transgender People, the fifth in MAP's report series, Under Fire: The War on LGBTQ People in America.
The report details how the dramatic increase in political attacks on transgender youth are just the tip of the iceberg and part of a coordinated effort to eliminate transgender people of all ages from public life.
This year alone, state legislatures introduced more than 725 anti-LGBTQ bills—shattering previous records.
In 2023, more states enacted bans on transgender youth medical care than passed bans on marriage equality in 2004, one of the worst years in the fight for marriage equality.
"While most of the public focus has been on recent efforts to ban medical care for transgender youth, these attacks are part of a much larger, coordinated effort to try to erase transgender people from public life entirely," said Logan Casey, Senior Policy Researcher & Advisor at MAP. "Anti-LGBTQ extremists want to make it impossible for transgender people to be ourselves and to be legally recognized according to our gender identity."
This latest report in the Under Fire series from MAP identifies five core tactics opponents are using in their attempts to erase transgender people from public life:
Tactic 1: Banning health care for transgender youth
The pace at which states are banning access to this care is remarkable. For example, prior to 2021, no states banned medical care for transgender youth. Today, 22 states have enacted this kind of ban — 19 of them during this year alone.
Currently more than 1 in 3 transgender youth live in a state that bans or severely restricts health care for them.
These kinds of laws have been enacted in all but two states in the U.S. South, leaving transgender youth in nearly an entire region without access to medically necessary care.
Tactic 2: Banning health care or severely restricting health care for transgender adults
Bill introduced across the country are more explicitly targeting transgender adults' access to care.
Nearly one-third of youth-focused medical care ban bills introduced in 2023 would also limit health care for at least some transgender adults.
Some legislation seeks to ban healthcare for transgender adults by redefining a minor to include adults up to age 26.
At least nine states explicitly exclude transgender-related healthcare from Medicaid coverage for adults as well as youth. Some states also ban coverage transgender-related care in state health insurance plans.
Roughly one in seven bills attacking transgender health care included provisions to ban or restrict coverage in private health insurance.
Tactic 3: Limiting transgender people's ability to live openly and participate in daily life
Anti-LGBTQ forces are increasingly targeting the ability of transgender people to live openly and safely as themselves throughout their daily lives. This includes making it impossible or extremely difficult to obtain accurate ID, banning the use of bathrooms, restricting social transition, and more.
ID documents: Four states ban people from updating the gender marker on their birth certificates and another 12 states impose invasive and overly burdensome medical requirements.
Bathroom bans: Nine states now ban transgender people from using bathrooms and other facilities that match their gender identity. New bans, especially in Florida, are expanding their scope to apply not only to schools but also to other government-owned buildings and spaces; Florida's ban includes major airports, sports arenas, and much more.
Forced outing: Five states now require schools to out transgender students to their families, often regardless of whether this might put the child at risk of harm.
Tactic 4: Rolling back legal recognition and protections
Opponents are also working to overturn the existing but limited protections for transgender people, while also working to enact new ways to remove opportunities for legal recognition.
Just in 2023, four states have enacted a new kind of law that defines "sex" throughout state law to allow discrimination against transgender and nonbinary people. Two additional states' governors issued executive orders to the same effect.
Fewer than half of states have explicit nondiscrimination protections for transgender people. Some states are working to undermine those existing protections with religious exemptions.
Tactic 5: Criminalizing and harassing supporters of transgender people
Even supporters of transgender equality are being targeted.
Healthcare providers for transgender people are facing loss of their licenses or even criminal penalties for providing medically necessary care that is endorsed by major medical associations. In five states, it is now a felony to provide best-practice medical care to transgender youth.
Dozens of hospitals have reported receiving bomb threats and other serious harassment for providing medically necessary care to transgender youth.
Many bills in recent years also target parents who support their transgender children. Florida legislation introduced in 2023 would have allowed the state to remove children from their families if the parents were even suspected of supporting them in receiving best-practice medical care.
"Make no mistake — this swift and coordinated attack on transgender people in the U.S. is part of a larger war on LGBTQ people," said Casey. "It's essential that we see beyond one bill or policy to understand the broader scope of what is occurring. This is a coordinated and organized effort to try to erase not just transgender people, but LGBTQ people overall, from being able to publicly live our lives."
▸▸ The entire "Under Fire" series is available here: www.mapresearch.org/under-fire-report .
About MAP: MAP's mission is to provide independent and rigorous research, insight and communications that help speed equality and opportunity for all. MAP works to ensure that all people have a fair chance to pursue health and happiness, earn a living, take care of the ones they love, be safe in their communities, and participate in civic life. www.mapresearch.org .
