Where the Bans Stand
Twenty-seven states now restrict or ban gender-affirming medical care for transgender minors. That includes puberty blockers and hormone therapy. Most of these laws passed between 2023 and 2025.
Latest: On June 30, 2026, the Supreme Court upheld state bans on trans girls in school sports, extending the same wave of state restrictions into athletics.
27 states now restrict or ban gender-affirming care for trans youth. Most passed bans in under three years.
The Supreme Court made things worse in June 2025. In United States v. Skrmetti, the Court ruled 6-3 that Tennessee’s ban on gender-affirming care for minors does not violate the Equal Protection Clause. The majority held that the law classifies by age and medical use, not by sex or transgender status, and applied the lowest level of legal scrutiny.
The ruling did not ban care nationally. But it removed the main constitutional argument against state bans, leaving 25 existing laws intact and clearing the path for more.
The Federal Push
The Trump administration is not waiting for states. On December 18, 2025, CMS proposed two rules that would bar any Medicare- or Medicaid-certified hospital from providing gender-affirming care to anyone under 18. The rules use the term “sex-rejecting procedures” and cover puberty blockers and hormones with narrow exceptions.
A second proposed rule would prohibit state Medicaid and CHIP plans from covering the same treatments. If finalized, that rule takes effect October 1, 2026. The public comment period closed February 17, 2026. Legal challenges are expected.
This is not just about hospitals that currently provide the care. It is about threatening any hospital’s Medicare certification (its financial lifeline) if it does not comply.
Courts Are Still Pushing Back
Not every state ban is surviving legal challenge.
| State | Status |
|---|---|
| Kansas | Judge blocked SB 63 in May 2026, finding it likely violates state constitutional protections for personal autonomy and parental rights |
| Montana | Ban permanently enjoined by court order |
| Arkansas | Ban permanently enjoined by court order |
On May 16, 2026, Kansas Judge Carl Folsom wrote a 117-page ruling and questioned the credibility of most of the state’s expert witnesses. Kansas Attorney General Kris Kobach called the ruling “judicial activism” and plans to appeal.
These state-level fights are where the legal action is now. Read more on our LGBTQ Rights hub.
What You Can Do
- Check the KFF policy tracker to see where your state stands. Call your state legislators to oppose any pending ban or to support shield laws that protect families.
- If the CMS rule has not been finalized, contact your U.S. senators and ask them to oppose the proposed hospital and Medicaid rules. Name the rule numbers: CMS-2025-1823 (hospital conditions) and CMS-2025-23464 (Medicaid funding).
- Support organizations providing direct legal defense for families, including the ACLU’s trans rights project and Lambda Legal.
Update, July 7, 2026: Three federal court rulings have imposed new limits on Trump administration policies targeting transgender Americans, the Washington Blade reports. On June 30, a federal district court certified Talbott v. USA as a class action, extending any future rulings to all active-duty transgender service members rather than only the original six plaintiffs. A federal appeals court had separately blocked the discharge of those named plaintiffs on June 1.
In Z.A. v. Blanche, the U.S. District Court for the Northern District of California issued an emergency order one day before a federal grand jury subpoena was set to be enforced on July 2, blocking the Department of Justice from obtaining confidential medical records from California families whose children receive gender-affirming care. The court relied in part on HIPAA, the 1996 federal law governing medical record privacy, to halt the subpoena.
In Doe v. Blanche, a federal district court in Washington, D.C., granted a preliminary injunction blocking a Bureau of Prisons policy that would require incarcerated transgender women to be housed in men’s facilities without individualized safety assessments. That policy also conflicts with the Prison Rape Elimination Act, enacted by Congress in 2003 to address sexual abuse in correctional facilities. All three cases remain ongoing.
Sources
-
Louisiana lawmakers pass a congressional map to dismantle a majority-Black district — NPR Politics (2026-05-29, update)
-
The GOP Is Targeting Black Voters in the Former Confederacy With Surgical Precision — Mother Jones (2026-05-29, update)
-
Supreme Court opinion in United States v. Skrmetti (June 2025)
-
CMS proposed rule: Hospital conditions of participation (December 2025)
-
CMS proposed rule: Medicaid/CHIP funding prohibition (December 2025)