“They’re Ruining People’s Lives” : Bans on Gender-Affirming Care for Transgender Youth in the US

Abstract

"This care was lifesaving. We didn't know it was lifesaving until it was gone. — Sarah, mother of a 17-year-old trans girl in a state with a ban in place, April 8, 2024 Since 2021, a wave of legislation targeting transgender health care has swept across the United States, with 25 states enacting blanket bans on gender-affirming care for transgender youth as of March 2025. These legislative bans, often vague and sweeping in scope, have disrupted healthcare access for over 100,000 transgender youth, and imposed significant geographic, financial, and emotional burdens on their families.

The election of President Donald Trump in November 2024 has deepened the crisis facing transgender youth and their families. In early 2025, the administration launched a series of executive actions amounting to a federal assault on transgender people’s rights.

This report, based on 51 interviews with transgender youth, parents, healthcare providers, and advocates across 19 states, examines the far-reaching impacts of legislative bans on gender-affirming care for transgender youth in the United States, documenting the cascading effects on individuals, families, healthcare systems, and communities.

Gender-affirming care encompasses a set of social, medical, and psychological interventions that help transgender individuals align their gender identity with their physical bodies. It is a personalized, holistic, and iterative process tailored to the unique needs of the individual. Evidence shows that this care significantly reduces suicidality and provides long-term mental health benefits. Nearly all transgender youth continue their care into adulthood, most studies show, and satisfaction rates are high. Despite its proven efficacy, legislative bans have disrupted or denied access to this health care, replacing nuanced medical decisions with blunt, all-encompassing restrictions.

In interviews conducted after the bans were enacted, healthcare providers described to Human Rights Watch how their previous gender-affirming care practices had been tailored to each patient's needs. They emphasized the importance of working in multidisciplinary teams that often included pediatric subspecialists, mental health professionals, and social workers. This collaborative approach ensured that care was both medically appropriate and supportive of the patient's overall well-being, addressing not just physical health but also social and emotional needs." - from the publisher