A Personal Introduction to our First Issue
Happy Transgender Day of Visibility (TDOV) and thank you for joining us for our Transgender Rights Digest launch. While TDOV should be a day of celebration, it is becoming increasingly obvious that visibility has not made transgender people safer.
When I joined Lawyers for Good Government nearly four years ago, the stakes already felt impossibly high — Dobbs had just been leaked, and we faced the worst legislative session for trans rights in history. Still, those days seem almost peaceful now.
Today, the threats are existential. Anti-choice extremists are contorting environmental laws to attack medication abortion. Hospitals turn away pregnant people to hemorrhage in parking lots. And healthcare providers are being targeted as violating consumer protection laws because they believe trans children and provide the care they need to survive. I was one of those children. If just one adult had said "I believe you — and I will support you," it might have saved me years of pain. Instead, I was forced to choose between hiding who I was or losing my family. I attempted suicide at 15, survived two years of homelessness while attending high school and working multiple jobs, and nearly died from a persistent infection at 17 — after which I went home and agreed to live as a girl.
More than 30 years later, I am proud, happy, and affirmed — but terrified. Since I joined this fight, more than half the country has moved to prohibit best-practice medical care for transgender youth, ban students from sports consistent with their gender identity, restrict bathroom access in schools and government buildings, and forcibly out transgender students to their parents. This year alone, 747 anti-trans bills have been introduced — 23 already signed into law, including civil rights preemptions, religious exemptions permitting discrimination in foster care and adoption, identity document restrictions, bathroom bans, bans on gender-affirming care, sports participation bans, and anti-trans redefinitions of sex reaching across the books. Laws like these cause a 72% increase in suicide attempts among trans and nonbinary youth. The Trump Administration is weaponizing federal agencies, restricting our right to travel, and calling us terrorists. And the organizations we turned to for leadership in the fight for marriage equality are being defunded and investigated for refusing to abandon us. It looks incredibly bleak. But I have hope — because of you.
You are why we created this Digest — and why our team of pro bono attorneys updates our free Policy Resource Hub for Transgender Rights every single business day across all 56 states and territories. Every two weeks, this Digest will deliver the most impactful developments in transgender rights law straight to your inbox: legislation, litigation, policy, and emerging trends.
Please read on and contribute your creativity, hope, and determination to ensuring that whenever any of us tries to tell the world who we are, we hear "I believe you — and I will support you."
— Khadijah Silver (he/they), Director, Gender Justice and Health Equity at L4GG
This Week’s Must-Read:
On March 11, the Lemkin Institute for Genocide Prevention and Human Security released its third red flag alert regarding the Trump administration’s attacks on the transgender community. The Lemkin Institute, which works to connect grassroots efforts with tools for genocide prevention, stated that it “believes that the United States is squarely within the early to middle stages of a genocidal process against trans people, the goal of which is to completely erase transgender people not only from public life but also from existence in the U.S. and globally.” The Institute further warns that if the American public does not reject the Trump administration’s genocidal rhetoric and policies targeting transgender people, “the entire country [will] become[] responsible for greater atrocity crimes against the trans community in the future.”
Legislation & Litigation Developments
Overview:
The Fourth Circuit Court of Appeals held that West Virginia could exclude coverage for gender-affirming surgeries from state Medicaid coverage after the Supreme Court remanded the case for reconsideration after its ruling in United States v. Skrmetti;
A federal judge issued an order from the bench in Oregon v. Kennedy that blocked Health and Human Services Secretary Robert F. Kennedy, Jr. from restricting federal funding for gender-affirming care of transgender youth based on Kennedy’s December “Declaration;”
In Kansas, a judge declined to issue a temporary restraining order that would have prevented SB 244 from going into effect, meaning the law prohibiting trans people from using public bathrooms on government property that align with their gender identity and invalidates state-issued driver’s licenses with updated gender markers can be applied during this period of active litigation;
The Montana Governor signed a sweeping anti-trans bill into law that redefines sex, which affects sports in public schools, school policies regarding trans kids, the ability of trans people to obtain accurate identification documents and marriage licenses, and erodes protections for trans people under state anti-discrimination laws;
Utah enacted a bill which allows landlords to effectively discriminate against trans residents by exempting landlords who prohibit trans people from accessing housing in dormitories, boarding houses, shared rental properties or other group-living accommodations that align with their gender identity from violating the Utah Fair Housing Act;
Washington Governor Bob Ferguson signed SB 6081 into law, which protects Washingtonians from the unauthorized disclosure of gender marker changes in birth certificates, driver’s licenses, enhanced driver’s licenses, and state-issued identification cards; and,
Iowa now prohibits city and local governments from expanding civil rights protections beyond those provided by the Iowa Civil Rights Act, thus preempting gender identity protections.
The Fourth Circuit Court of Appeals Holds that West Virginia Medicaid Can Exclude Coverage for Gender-Affirming Surgeries
On March 10, the Fourth Circuit Court of Appeals reversed a lower court in Anderson v. Crouch, upholding West Virginia’s ban on Medicaid coverage for gender-affirming care. The Court held that the state’s policy denying such care does not violate the Equal Protection Clause, the Affordable Care Act, or the Medicaid Act.
The Fourth Circuit initially affirmed the district court’s ruling in favor of the plaintiffs in April, 2024. However, the United States Supreme Court later vacated that decision and remanded the case for reconsideration in light of its ruling in United States v. Skrmetti, which upheld Tennessee’s ban on gender-affirming care for transgender youth.
The Fourth Circuit in March explained that under Skrmetti’s reasoning, policies that exclude transgender individuals do not facially classify people based on sex but instead “classifies based on medical diagnosis [i.e. gender dysphoria] and applies evenhandedly to everyone.”
The Fourth Circuit also stated in its holding that it is not an “irrational” public policy for legislatures to “encourage citizens ‘to appreciate their sex’ and not ‘become disdainful of their sex’ by refusing to fund experimental procedures that may have the opposite effect.” This reasoning may have widespread impact in future litigation challenging anti-trans laws.
The plaintiff-appellee filed an en banc petition in Anderson v. Crouch on March 24, 2026, asking the full appeals court to revisit the ruling.
Judge Blocks RFK Jr. from Restricting Federal Funding for Gender-affirming Care for Minors
On December 18, 2025, Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. posted a “Declaration” to the HHS website titled “Safety, Effectiveness, and Professional Standards of Care for Sex-Rejecting Procedures on Children and Adolescents.” This Declaration purported to set a new U.S. standard for healthcare relating to gender-affirming care for trans youth and asserted that HHS could bar healthcare providers and institutions from participating in Medicare, Medicaid, and other federal healthcare programs if they treated any children or adolescents with best practice medical care for transgender youth, even outside of those federally funded programs.
HHS began referring the Office of Inspector General to investigate children’s hospitals offering best practice medical care for trans youth, based solely on this Declaration. A number of hospitals ceased offering care in fear of losing access to federal funding.
On December 23, 2025, twenty states and the District of Columbia filed a lawsuit challenging the Kennedy Declaration and alleging that it exceeded the Secretary's statutory authority, violated notice and comment requirements, and contradicted Medicaid Act provisions regarding federally approved state plans and provider choice.
On March 19, U.S. District Judge Mustafa T. Kasubhai issued a bench order, siding with the states, granting their motion for summary judgment and denying the defendants' motion to dismiss the lawsuit. The Judge found Kennedy’s Declaration unlawful and ordered the federal government to stop threatening to cut off providers and hospitals from Medicaid and Medicare programs for offering best practice medical care for trans youth.
While this is good news, the Centers for Medicare & Medicaid Services (CMS) released a notice of proposed rulemaking to bar hospitals that provide such care from participation in Medicare and Medicaid programs. Although the final regulations have not yet been published and implemented, more hospitals stopped offering care after the notice was published.
Judge Denies Temporary Restraining Order Against Kansas Bathroom Ban, License Revocation Law
In February, the Kansas legislature passed a “bounty hunter” bathroom ban bill prohibiting transgender people from using public bathrooms on government property that align with their gender identity and creating a right of action allowing anyone who suspects a person is transgender and violating the law to sue for $1,000 in damages.
The bill also invalidated state-issued driver’s licenses that have updated gender markers reflecting the holder’s gender identity. And, after the bill passed and the governor’s veto of the bill was overridden by the legislature, trans people across the state received letters alerting them that their licenses were immediately invalidated.
The American Civil Liberties Union (ACLU), the ACLU of Kansas, and Ballard Spahr LLP filed a legal challenge to the law on behalf of two trans men who had their licenses invalidated under the law, seeking a temporary restraining order (TRO) blocking enforcement of the bill.
On March 10, 2026, a judge for the District Court of Douglas County denied the TRO. However, the Plaintiffs’ are also seeking a preliminary injunction which would block the law. An evidentiary hearing on their motion for preliminary injunction is scheduled to begin on September 29, 2026.
Montana Governor Signs Sweeping Anti-Trans Bill into Law
On March 25, 2026, Montana Governor Greg Gianforte signed Senate Bill 437, which codifies and revises state law by establishing new trans-exclusionary definitions for the words "sex," "female," "male," "man," "woman," "father," and "mother" when referring to a human being. These definitions are then applied by amendment across dozens of areas of Montana law, including the following:
Under SB 437, all interscholastic, intercollegiate, intramural, or club athletic teams sponsored by public schools or institutions must be designated based on the statute’s trans-exclusionary definition of “sex,” and athletic teams designated for females, women, or girls may not be open to students of the male sex as defined by SB 437.
School districts must develop procedures by which a parent must provide written consent before their child uses a pronoun that does not align with the child's sex as assumed at birth as defined under SB 437, Section 1. Even if a parent provides written consent, no person (e.g., a teacher or staff member) may be compelled to use pronouns that do not align with the child's sex assumed at birth.
Parents must be notified and provide consent before their child shares a room or sleeping quarters with a person of the "opposite sex" on a school-sponsored trip, with sex determined by the bill.
Each driver's license application must include the applicant's sex as defined by the bill.
The definition of "sex" in the vital statistics chapter — which governs birth certificates and related records — is amended to align with the bill’s trans-exclusionary definition of sex.
Marriage license applications must include the sex of each party as defined by the bill.
SB 437 also amends Montana's civil rights statute to specify that the right to be free from discrimination because of sex is governed by the bill’s anti-trans definition of sex.
Utah Enacts Law Allowing Landlords to Discriminate Against Trans Residents
On March 23, 2026, Utah Governor Spencer Cox signed HB 404 into law. This law creates an exemption in the Utah Fair Housing Act to allow a landlord to designate housing as single-sex based on sex as assumed at birth. It specifically applies to dormitories, boarding houses, shared rental properties or other group-living accommodations, and a private landlord or property owner. The law does not apply where such designations would conflict with federal law or conditions tied to federal funding, and it excludes certain government-owned or operated housing.
Washington State Now Protects Transgender People's Gender Marker Changes
On March 16, Washington Governor Bob Ferguson signed SB 6081 into law, a bill that protects Washingtonians from the unauthorized disclosure of gender marker changes in birth certificates, driver’s licenses, enhanced driver’s licenses, and state-issued identification cards.
Iowa Bans Towns From Passing Nondiscrimination Protections on the Basis of Gender Identity
On March 10, a law took effect that prohibits city and local governments from enacting their own civil rights protections, effectively preventing them from expanding protections beyond those provided by the Iowa Civil Rights Act.
Last year, Iowa became the first state in the U.S. to rollback its civil rights code to remove civil rights protections for trans Iowans.
Trend and Policy Watch
State Department Issues Anti-Trans Rule for Visa Program
On March 11, 2026, the Department of State issued a final rule for the Diversity Immigrant Visa (DV) Program requiring applicants to submit additional information from their passports and comply with the Trump administration’s anti-trans definition of sex.
This rule, which is set to take effect on April 10, 2026, is likely to subject lottery applicants to greater scrutiny by the State Department and make it harder for trans immigrants to obtain correct, uniform papers.
DOJ Says It Will “Take All Necessary Actions” to Defend NY Hospital if NY Attorney General Pursues Legal Action Against It
In February 2026, NYU Langone, one of the largest providers of transgender healthcare in New York, announced that it was ending its Transgender Youth Health Program, primarily due to the "current regulatory environment."
Shortly thereafter on February 25, 2026, New York Attorney General Letitia James issued an enforcement order directing NYU Langone Health to immediately restore its transgender youth health program. James has been adamant that hospitals ceasing such care would violate the state’s anti-discrimination laws.
On March 18, 2026, the Department of Justice (DOJ) warned James that it would “take all necessary actions” to defend the hospital if she pursues legal action against it for discontinuing best practice medical care for trans youth.
DOJ Investigating Maine and California for Housing Trans Women in Women’s Prisons
In a March 26, 2026, press release, the DOJ announced that it is investigating Maine and California for housing trans women in women’s prisons, asserting that doing so may violate the constitutional rights of cisgender women housed in women’s prisons.
This is only the most recent attempt by the Trump administration to target incarcerated transgender people. The administration has also issued new policies aimed at ending transgender-related care in federal prisons, proposed limiting Prison Rape Elimination Act (PREA) protections for transgender inmates, and sought to place transgender people in prison housing that does not align with their gender identity.
Transgender Women and Intersex Athletes Banned From Competing in Female Olympic Events
The International Olympic Committee (IOC) announced on March 26, 2026, that it will ban transgender and intersex athletes from competing in women’s events, based on the results of mandatory genetic testing.
The nonprofit Advocates for Intersex Youth released a statement on IOC’s policy, saying that it “discriminates against transgender and intersex women with Olympic dreams through mandated sex testing that invades the privacy and dignity of all women athletes.”