Written by: Allison Chapman & Alyssa Morrison
Developments in Transgender & Reproductive Rights:
Welcome to this special omnibus edition of the Transgender Rights Digest & Reproductive Health Digest. Last week, we celebrated Law Day of Action with 75 coordinated events taking place across 65 cities in 25 states with 3,000+ participants representing state and local bar associations, national legal advocacy organizations, law schools, and affinity bar groups. We are back at our desks, packing two intense weeks of bodily autonomy news and legal updates into one special issue. We hope you get tremendous benefit from it – please let us know what you think!
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Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.
Top Line News Stories
Trump Administration Has Major Impact on Transgender Mental Health:
New reports from the Trevor Project and Williams Institute reveal the deep psychological harm caused by the Trump administration's policies targeting the transgender community.
The Trevor Project report showed the devastating results of anti-LGBTQ+ policies on the lives of young people within the United States – especially those who are transgender and nonbinary. The Trevor Project found that 40% of transgender and nonbinary people have seriously considered attempting suicide in the past year. Young people who lack access to gender-affirming hormones are twice as likely to attempt suicide as those with such access.
The Williams Institute’s April report included findings that 66% of transgender or nonbinary parents reported that their children had become more fearful under the Trump administration, and 73% of transgender or nonbinary parents reported that they were pursuing or considering pursuing self-defense classes to better protect themselves and their families.
2023 FDA Policy On Mifepristone Back In Effect After SCOTUS Pauses 5th Circuit Ruling:
On May 1, 2026, a panel of Republican-appointed judges on the 5th Circuit Court of Appeals granted Louisiana’s request to pause a 2023 Food and Drug Administration (FDA) policy allowing the abortion medication mifepristone to be prescribed online and sent by mail. This created widespread confusion about what care was still legally permissible.
Intervenor pharmaceutical companies that produce mifepristone quickly appealed the 5th Circuit’s grant, and on May 4, 2026, the Supreme Court issued a temporary stay, allowing the telehealth provision of mifepristone until at least May 11, 2026. The briefing in the case was due on Thursday, May 7th.
Read more analysis from L4GG legal fellow Zane McNeill on our website.
Legislation & Litigation Developments
Federal Agencies Continue To Target Transgender Rights:
The animus against transgender people continues to spread across all governmental agencies. The Federal Trade Commission (FTC) and Federal Communications Commission (FCC) are the latest federal agencies to target transgender people, signaling their willingness to fall in line with r the president’s agenda.
Over the past few months, the FTC has begun targeting transgender healthcare under the guise of consumer protections. In February, the organization sent civil investigative demands (CIDs) to the American Academy of Pediatrics, World Professional Association for Transgender Health, and the Endocrine Society. A former FTC employee has flagged multiple unusual happenings within the department, from the targeting of nonprofit organizations to hiring lawyers specifically for investigating gender affirming healthcare.
The FCC has requested public comment on the current TV rating system and whether programs should be rated differently or contain descriptions flagging transgender or gender nonconforming content. The request for comments states that the FCC believes that the lack of warnings undermin[e] the ability of parents to make informed choices for their families.” If changes are implemented, it could result in LGBTQ+ people being censored in the media.
Pennsylvania Court Strikes Down Ban on Medicaid Coverage of Abortion:
In late April, a Pennsylvania court struck the state’s ban on using state Medicaid funds for abortion coverage and found that the Pennsylvania Constitution includes a right to abortion. The case, Allegheny Reproductive Health Center v. Pennsylvania Dep’t. of Human Services was first filed in 2019 and has gone through a winding procedural history centering on the question of whether and to what extent equal protection considerations require state coverage of reproductive healthcare. In 2024, the Pennsylvania Supreme Court overturned state precedent holding that the Medicaid ban did not violate the constitution and instead found that it constituted a form of sex-based discrimination by allowing healthcare coverage for men’s reproductive healthcare without covering women’s. The court further found that the ban should be subject to strict scrutiny - the most rigorous test for a state to pass in examining the constitutionality of a statute. The ruling is a huge victory for reproductive health in Pennsylvania and provides a vital reprieve as healthcare faces massive defunding at the federal level. It also places Pennsylvania among the ranks of states whose courts, legislature, or voters have determined that their state constitution protects abortion rights. The state may appeal the ruling.
Wyoming Court Blocks State’s Fetal Heartbeat Ban:
On April 27th, a Wyoming court blocked the state’s recently passed ban on abortion after detection of fetal cardiac activity, which occurs around 6 weeks of gestational age. The so-called “heartbeat ban” was rushed through the state legislature after the Wyoming Supreme Court ruled in January that the state constitution protects a right to choose abortion and struck down a previously passed total abortion ban. The Supreme Court based its ruling on a 2012 amendment to the state constitution that was passed in response to the Affordable Care Act and guarantees Wyoming citizens the right to make their own healthcare decisions. In the April 27th order, the judge found that the plaintiffs challenging the new 6-week ban had shown a likelihood of success and demonstrated irreparable harm if the ban stays in place during the pendency of litigation. The state will continue to fight to enforce the ban. In the meantime, Governor Mark Gordon has signed an alternate provision banning abortion after viability.
Indiana Case Challenging Abortion Ban On Religious Grounds Will Go Directly to the State Supreme Court:
As we reported on in the Repro Health Digest in March, an Indiana court recently blocked the state’s abortion ban for cases in which it conflicts with a person’s sincerely held religious beliefs. Although Indiana is currently enforcing a total abortion ban, the plaintiffs argued in their complaint that Jewish beliefs around when life begins, and Jewish laws’ requirement of prioritizing the mother’s physical and mental health prior to birth, mean that their faith would, in certain circumstances, dictate pregnancy termination as the proper course of action. A Marion County Court agreed, but the state appealed. Now, the case will go directly to the Indiana Supreme Court, bypassing the state’s court of appeals. Oral arguments will be held on September 10th.
Six Transgender Iowians Challenge State Bathroom Ban:
On April 29, 2026, six transgender Iowa residents filed a class action lawsuit in federal court challenging the restroom provision of H.B. 752. The lawsuit argues that the law violates the plaintiffs’ constitutional rights to due process, equal protection, and informational privacy.
Ninth Circuit Stays Removal of Surgery Prerequisite For Arizona Gender Marker Changes
On April 28, 2026, the Ninth Circuit issued a stay pending appeal of a preliminary injunction in Roe v. Johnston that would have required Arizona to remove its surgery prerequisite for gender marker changes on birth certificates beginning on April 30, 2026.
Trend and Policy Watch
Gun Control: But Only If You Are Transgender:
Experts have warned that a new rule from the U.S. Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF) could deter trans people from buying guns due to a mandatory requirement to report their sex assigned at birth when purchasing a firearm.
This could give the ATF the ability to create a list of transgender gun owners. In a statement to The Independent, Patrick G. Eddington, a senior fellow in homeland security and civil liberties at the Cato Institute and ex-CIA analyst said that "it's pretty clear that [Trump's team] want to try to collect data on individuals who don't fit the regime's idea of who is male and female... [creating] a de facto registry of people by gender identity."
Last fall, the Department of Justice reportedly weighed options to ban transgender people from obtaining firearms in response to the assassination of right-wing activist Charlie Kirk. For years, right-wing figures have repeatedly fearmongered that transgender people are likely to carry out acts of mass violence. Despite the accusations, transgender shooters are statistically inconsequential with the majority of attacks being carried out by cisgender men.
Texas Is Still Texas:
Texas is oftentimes a testing ground for right-wing policies and strategies. Lawmakers nationwide take note of what works and fails to then implement similar theories and policies at both the state and federal levels. In a prescient article by Legal Fellow Zane McNeill in The New Republic on December 9, 2024, Project Fellow, Allison Chapman was quoted, warning about potential FTC investigations into gender affirming care after Texas utilized a similar strategy. “The ultimate goal of these attacks is to have transgender people disappear from public life. Attacking the basic right to privacy would help create those conditions. So I think it’s absolutely possible this will be a continual issue and we’ll continue to see regulations and legislation to make this happen.”
Next Texas Attorney General May Take Aim at Marriage Equality:
In November, Texans will vote for a new attorney general (AG), ending Ken Paxton’s 10+ year tenure in the role. Right-wing groups are hopeful that the next AG will be even more aggressive than Paxton in advancing a regressive agenda that would seek to overturn key Supreme Court precedents and roll back civil rights.
U.S. Rep. Chip Roy (R) has signaled that overturning a Supreme Court case that prohibited Texas from excluding undocumented students from public school is one of his “foremost priorities in running for attorney general.” He has also expressed his desire to see marriage equality overturned, referring to it as “a war raging against our souls as Texans.”
has taken similar positions.
Attorneys general have not always acted as agents of public policy change at a national level. However, since the 1990s that has gradually changed, and state authorities have increasingly viewed themselves as key players in shaping (and fighting) federal law and policy. Georgetown Law professor and constitutional scholar Steve Vladeck explains, [t]he notion that the attorney general of any one state, even Texas, should be leading the charge in defining what the Constitution means on a nationwide basis, is, to me, the epitome of hubris.”
Texas Therapists Unsure About How to Proceed with Counseling LGBTQ+ Minors:
Last month, the Supreme Court issued an 8-1 ruling finding that Colorado’s ban on conversion therapy violated Christian counselor Kaley Chiles’ First Amendment rights by censoring the kinds of speech that she could engage in with her patients. Although many have rightly criticized the ruling for prohibiting states from banning a demonstrably harmful, discredited, and clinically unsupported form of ‘therapy,’ others have also pointed out that the ruling could make it more difficult for states to prohibit gender-affirming talk therapy. This is at odds with an opinion issued by AG Ken Paxton that purported to apply Texas’s ban on gender-affirming care for minors to mental health providers and prohibit them from “transitioning” youth. Although the Supreme Court’s reasoning in Chiles should apply to protect affirming therapy, experts have expressed concern that courts will adhere to it and apply it equally in the context of transgender healthcare.
Texas Medical Board Sanctions Physicians in Connection with Pregnant Patients Deaths:
Three Texas doctors who had been previously investigated by ProPublica following their patients’ deaths after improper or delayed care under the state’s total abortion ban have been disciplined by the Texas Medical Board.
Two of the doctors were found to have failed to provide proper medical care to a teenager who was suffering from a life-threatening pregnancy complication. The teen ultimately died after seeking emergency medical care on three separate occasions within 12 hours.
The third doctor was disciplined due to failing to administer a D&E to a patient with severe bleeding after a miscarriage. The doctor gave the patient misoprostol as an alternative, which should have been contraindicated due to excessive bleeding. The patient ultimately bled to death.
Texas’s abortion ban prohibits abortion at all gestational ages, with only a narrow exception for the life of the patient. And, physicians face a potential life sentence if they are found to have violated the law. When physicians are forced to make emergency decisions under threat of severe legal penalty, patient care suffers.
Texas’s Total Abortion Ban Falls Heavily on the Shoulders of Immigrant Communities:
In the Rio Grande Valley (RGV) in southern Texas, Texas’s total abortion ban has had devastating effects. The geographic isolation of the RGV makes it extremely difficult to access care. “People in my community are having to travel more than 12 hours to drive out of state,” said Zaena Zamora, executive director of Frontera Fund. “If they’re taking a bus, that’s a 24-hour bus ride. If they’re taking a flight, it’s a two- or three-hour flight to get their care.”
Immigration crackdowns have only exacerbated this problem. Immigration checkpoints are located approximately 100 miles from the border, requiring those seeking an abortion to be interrogated about their citizenship status and subjecting them to warrantless searches. These restrictions can leave people in impossible and sometimes life-threatening situations.
Take Action!
Tell HUD: Protect LGBTQ Housing
On April 28, the Trump administration announced a proposal to rescind the Equal Access Rule (EAR), which guarantees equal access to programs and services funded by the U.S. Department of Housing and Urban Development (HUD) regardless of sexual orientation, gender identity, or marital status.
The Equal Access Rule benefits all people seeking access to housing and homeless services, but its impact is vital for transgender and nonbinary people seeking the services of homeless shelters. HUD officials are proposing to eliminate the EAR and replace it with a new rule that would force recipients of federal funding to discriminate against the trans community.
Please submit your comment with our partners at A4TE, and if you need support drafting a substantive comment, stay tuned for an L4GG comment training!
