Developments in Transgender Rights:
This issue of the Digest covers an expansive investigation requested by the Department of Health and Human Services into the provision of gender-affirming care, major federal litigation, state court developments, administrative policy shifts, and crucial grassroots resources. Federal employees have filed a Title VII class action lawsuit against the Office of Personnel Management to challenge the administration’s healthcare exclusions, while civil rights attorneys navigate harmful judicial rulings in Michigan and the Eleventh Circuit alongside ongoing battles over inclusive school policies in Virginia, Idaho, and North Carolina. Meanwhile, health systems in Connecticut and Texas submitted to federal pressure by halting gender-affirming care services for transgender youth, and South Dakota officials are drafting a restrictive policy targeting driver’s license updates. In positive developments, Vermont voters will consider Proposal 4 to constitutionally protect gender identity and expression in the upcoming November election, and the Campaign for Southern Equality has launched the next phase of its Trans in the South Access Project to support transgender adults in the region facing healthcare disruptions.
Want access to a detailed analysis of the transgender rights law in every U.S. state and territory? Please view our free Policy Resource Hub for Transgender Rights, 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
Overview
U.S. Department of Health and Human Services (HHS) Secretary Robert Kennedy Jr. called on the agency’s Office of the Inspector General to launch investigations into over 100 provider institutions to determine whether they have engaged in fraudulent diagnosis or billing practices by providing gender-affirming care.
Federal employees and civil rights advocates filed a landmark class action lawsuit against the Office of Personnel Management (OPM), challenging the Trump administration’s discriminatory policy stripping gender-affirming healthcare coverage from federal employee insurance plans under Title VII of the Civil Rights Act.
Department of Health and Human Services Calls for Investigation into Provision of Gender-Affirming Care, Releases Report and Documentary
On August 12, 2026, HHS Secretary Kennedy sent a letter to Inspector General T. March Bell calling for his office to investigate a swath of providers, prescribers, pharmacies and other entities to determine whether they have engaged in billing fraud for prescribing activities he claimed his report Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of “Gender Medicine” would expose.
One day later, on August 13, 2026, the report, citing to and contributed to by anti-trans far-right anti-science thinktanks, was published alongside an inflammatory short-form documentary.
According to the press release associated with these publications, Vice President JD Vance also referred hospitals and clinics identified by the report to the Department of Justice (DOJ) for possible violations of federal law.
Federal Employees File Class Action Lawsuit Over OPM Ban on Gender-Affirming Care Coverage
In response to the Trump administration’s removal of coverage for gender-affirming care from federal insurance plans in January 2026, U.S. federal employees and their families have joined a class-action lawsuit against OPM, the agency governing human resources, healthcare, life insurance, and retirement benefits for federal civil government employees, retirees, and their dependents.
Their complaint, filed on August 3, claims the ban violates Title VII of the Civil Rights Act of 1964, which prohibits employment discrimination based on race, color, religion, sex and national origin. Plaintiffs filed after exhausting available administrative remedies through OPM’s Equal Employment Opportunity Office.
OPM’s new gender-affirming care policy explicitly exempts mental health counseling, including faith-based counseling, and offers a vague and ill-defined exception for people currently receiving treatment. But even that exception is required to expire at the end of this year, according to a follow-up carrier letter published in March.
Plaintiffs, represented by attorneys from Human Rights Campaign Foundation, challenging the OMB policy represent a class of at least 39,400 enrollees affected by its prohibition on gender-affirming care coverage, according to Williams Institute research from July.
Legislation & Litigation Developments
Overview
The state of Michigan has entered into a court settlement with Catholic Charities of Jackson Lenawee, and Hillsdale Counties, agreeing to halt enforcement of its statutory ban on conversion therapy for minors.
The Eleventh Circuit has overturned a lower court injunction, allowing Florida to enforce its statute restricting minors from attending adult live performances.
Students and families have filed a federal lawsuit against the King George County School Board in Virginia for unconstitutionally blocking the formation of a middle school Gay-Straight Alliance (GSA).
Public School districts in Idaho and North Carolina are facing coordinated legal pressure by anti-LGBTQ+ legal organizations, students, and their parents over inclusive restroom and locker room policies supporting transgender students.
In the U.S. District Court for the District of Columbia, Judge Royce Lamberth denied a motion from attorneys to enforce a preliminary injunction against the Bureau of Prisons, permitting the Trump administration to proceed with transferring incarcerated transgender women into a restrictive segregated prison unit.
Michigan Halts Enforcement of Youth Conversion Therapy Ban
In July, Michigan filed a stipulated order agreeing not to enforce its statutory ban on conversion therapy for LGBTQ+ minors, after the Sixth Circuit held that the ban violated First Amendment prohibitions on censoring speech.
Michigan Attorney General Dana Nessel expressed grave concern over the profound risks this poses to the safety and welfare of LBGTQ+ youth, saying the agreement leaves vulnerable minors exposed to discredited practices.
As legal advocates evaluate alternative remedies such as pursuing state consumer protection actions against practitioners of these fraudulent methods, this development underscores an alarming judicial erosion of the state’s authority to protect children from systemic harm.
11th Circuit Revives Florida's Law Targeting Drag Performances
In an 8-5 decision, the full U.S. Court of Appeals for the 11th Circuit overturned a lower court injunction, allowing Florida to enforce its 2023 statute restricting minors from attending certain “adult live performances.”
The lawsuit, originally brought by Hamburger Mary’s, a franchise restaurant chain that hosts drag shows, challenged the measure as an unconstitutional infringement on First and Fourteenth Amendment protections. Reversing course, the majority accepted the state’s framing of the restriction as a permissible effort to protect minors, dismissing arguments that its subjective terms unconstitutionally chill protected speech. This decision weakens First and Fourteenth Amendment safeguards across the circuit by giving state actors broad license to reclassify queer artistry, such as drag, as inherently obscene.
Community advocates and legal groups continue to emphasize that artistic expression remains protected and vital. Following the decision, grassroots organization Qommittee updated its Florida guidance, emphasizing that drag itself is not banned, urging artists not to stop performing, and providing practical steps for venues and performers to protect themselves.
Families Sue Virginia School Board Over GSA Ban
Students and their families have filed a federal lawsuit against the King George County School Board in Virginia for blocking the formation of a middle school GSA.
After students followed proper protocol to establish the club, school officials scrambled to rewrite policies and ban noncurricular organizations, all while hypocritically permitting numerous other student groups to operate. Civil rights advocates argue that this blatant double standard violates the First Amendment and the federal Equal Access Act.
Legal teams, including from the ACLU of Virginia, are seeking an injunction to strike down the district’s discriminatory hurdles and protect students’ constitutional rights to speak, organize, and build community without being silenced by school officials.
Restroom Access Litigation Targets School Districts
Public school districts in Idaho and North Carolina are facing legal pressure over inclusive restroom and locker room policies that support transgender students.
In Idaho, an Ada County court allowed a lawsuit against the Boise School District, filed by conservative legal group Idaho Family Policy Center, to proceed to trial over a school gender support plan, an administrative document outlining how a school will affirm and support a transgender student regarding their name, pronouns, facility access, and safety.
In North Carolina, two federal lawsuits were filed by conservative legal organization America First Legal against the Cabarrus County school district, seeking to dismantle inclusive facility policies under Title IX and state constitutional claims.
In many jurisdictions, inclusive facility policies are explicitly required by state anti-discrimination laws, giving school districts legal defenses grounded in state civil rights mandates.
Federal Judge Allows Trump Administration’s Segregated Prison Transfers
U.S. District Court Judge Royce Lamberth has rejected a motion from civil rights attorneys to enforce a preliminary injunction against the federal Bureau of Prisons.
Lamberth found that the Trump administration did not violate court orders by transferring incarcerated transgender women into a restrictive segregated prison unit, because his ruling only directed them not to transfer the inmates to a male facility. He further ruled that he did not have jurisdiction to decide whether the plaintiffs were entitled to housing in the general population facility, but invited plaintiff counsel to amend their complaint and bring evidence for a preliminary injunction on that issue.
Trend and Policy Watch
Overview
Major hospital systems in Connecticut and Texas yielded to federal intimidation by entering into settlements with the Department of Justice to halt essential gender-affirming care for trans youth.
South Dakota state officials are drafting a policy requiring an amended birth certificate to update driver’s licenses.
Vermont voters will decide in November on Proposal 4, a constitutional amendment that would explicitly prohibit state discrimination based on gender identity and expression.
Hospitals Submit to Federal Intimidation and Cut Healthcare for Trans Youth
In an alarming pattern of health systems yielding to federal intimidation, both Connecticut Children’s Medical Center and Texas Children’s Hospital have entered into settlement agreements with the DOJ to halt essential gender-affirming care for trans youth.
In response to the Trump administration’s attack on legal care, these institutions agreed to cease providing safe, evidence-based treatments including puberty blockers, hormone therapy, and surgeries, despite maintaining that they violated no federal law and faced no legal finding of liability.
GLAD Law Staff Attorney Hannah Hussey sharply condemned the agreement, warning that “the Trump administration is using unprecedented threats to go after established medical care for the small population of transgender adolescents” and asserting that “these tactics should chill every American who believes that health care decisions should be made by parents, patients, and doctors who understand the care, not by a federal government with a political agenda.”
South Dakota Prepares Policy Restricting Gender Marker Updates on Driver’s Licenses
South Dakota is set to become the eleventh state to prohibit transgender residents from updating gender markers on their driver’s licenses. The quiet administrative change by the Department of Public Safety will require an amended birth certificate for any gender marker update.
Because recent state legislation and court rulings already prevent trans people from amending their birth certificates, tying driver’s license updates exclusively to birth certificates creates an inescapable administrative trap that blocks trans people from obtaining accurate identification.
However, while state officials are awaiting final implementation directives, trans residents in South Dakota may still have a narrow window to update their identity documents. Before enforcement begins, trans South Dakotans can connect with the Transformation Project for legal document support or review the South Dakota ID resources published by Advocates for Trans Equality.
Vermont Voters to Decide on Constitutional Amendment Protecting Civil Rights
In November, Vermont voters will head to the polls to decide on Proposal 4, a state constitutional amendment that would explicitly prohibit state discrimination based on race, ethnicity, sex, religion, disability, sexual orientation, gender identity, gender expression, or national origin.
As Vermont leaders have highlighted, enshrining these protections in the state constitution ensures that anti-discrimination protections will establish an explicit, enforceable barrier against legislative rollbacks and protect marginalized communities from growing national threats to civil rights.
New York amended its state constitution in 2024 to explicitly protect against discrimination based on an even further expanded set of protected classes, drafted to align with its state anti-discrimination law. Many other states have equal protection clauses in their constitutions, but most are limited to a narrow set of protected characteristics such as race, religion and national origin.
Helpful New Resources
Campaign for Southern Equality Launches Next Phase of Trans in the South Access Project
The Campaign for Southern Equality has announced the next phase of the Trans in the South Access Project to help transgender adults navigate regional healthcare barriers.
The updated platform includes an expanded directory of affirming medical and legal providers across 13 Southern states, alongside expanded guides on telehealth options and transition funding.
Crucially, the project is piloting one-on-one navigation support services for trans adults in Tennessee and North Carolina to help individuals manage care disruptions and find reliable options to continue their medically necessary care.