Anti-Trans National Risk Assessment Map: March Edition

At the two-month mark of Donald Trump's presidency, the risk for transgender people has deteriorated nationwide. The United States now carries a "Do Not Travel" rating for transgender people.

Short summary of updates: The risk level for transgender youth and adults has significantly deteriorated in the latest update. Most notably, the United States has now been designated “Do Not Travel” for foreign citizens—a designation I do not make lightly. But recent developments, including Marco Rubio’s visa directive targeting transgender applicants and the detention of lawful visa holders and resident immigrants, demand such a warning. Domestically, the national risk level has been set to “Worst Laws Passed.” While no new federal laws have been enacted, Trump’s executive orders are producing sweeping overcompliance and are being treated as de facto law across institutions. For transgender adults, many states have worsened due to newly enacted bathroom bans, ID reversions, and legal redefinitions that erase transgender recognition. For youth, even states once considered “safe” have backslid, as hospitals cut off care for new patients under 19 and comply with discriminatory sports bans.

About The Map

I have tracked anti-transgender legislation for 5 years. Every day, I’ve gotten messages from worried people wondering how they are supposed to assess their risk of staying in their home state. The messages range from parents of trans youth wondering if their children will be taken from them to trans teachers wondering if their jobs will be safe in coming years. Sometimes people just want to know if there is a safer state they can move to nearby.

I created the legislative risk map specifically to help answer that question. Now more than ever, it is a question that needs answering for so many transgender people facing forced medical detransition, arrests for using the bathroom, bans on the use of our names, pronouns, and identification documents, and many other curtailments of our rights to exist in public life.

In previous iterations of the map, the focus was entirely on the risk to transgender youth. When the map was first developed, bills targeting transgender youth were far more common. Unfortunately over the last two years, the transgender youth map has lost all granularity, largely reducing to just two colors: red and blue, a set of states criminalizing trans youth and a set of states protecting them. You can still find this map at the end of the document, and it will be continually updated. The primary map of focus, though, will be the transgender adult map, as bills targeting trans adults have become far more common.

Methodology

The methodology used is primarily qualitative, with a scoring-rubric element for the worst bills. Part of the methodology is my own expert assessment of laws, of which I am well equipped to do. I have read all 800 bills targeting transgender people this year. I have watched hundreds of hours of hearings on anti-trans legislation and am fully aware of all of the players nationally as well as where they are making their pushes against trans rights. I have followed the vote count and regularly talk to activists on the ground in each state. I am looking at how similar states are moving in their legislative cycles. Lastly, I watch for statements by governors and bill drafts to see if the Republican party in various states seems to be pushing anti-trans legislation heavily - you can see many examples of such legislation in this newsletter.

In terms of actual laws, I keep a rubric of the various types of laws that target transgender people. For transgender youth, the most concerning laws are those that prohibit gender-affirming care and mandate detransition. Additionally, bathroom bans, laws that rigidly define sex as binary, and restrictions on social transition are other key factors that negatively impact a state's ranking. For transgender adults, the primary legislative concerns include adult gender affirming care bans, bathroom bans, prohibitions on drag specifically aimed at trans people and pride events, restrictions on changing birth certificates and drivers licenses, and laws that end legal recognition for trans people entirely. These factors play a significant role in how I assess and rank a state's legislative risk.

The Adult Trans Legislative Risk Assessment Map

Moves in this update: Wyoming (High Risk → Worst State Laws), South Dakota (Moderate Risk → Worst State Laws), Iowa (High Risk → Worst State Laws), West Virginia (High Risk → Worst State Laws), Virginia (Low Risk → Moderate Risk), Nationwide Foreign Risk (Do Not Travel)

• Summary of updates: The national risk landscape for transgender adults in the United States has sharply deteriorated since the 2024 election, confirming earlier projections made in anticipation of a Republican victory. Multiple states—including Wyoming, South Dakota, Iowa, and West Virginia—have passed sweeping laws eliminating legal recognition of transgender people and/or imposing bathroom bans. Virginia, previously considered low risk, has been downgraded to moderate risk due to state officials pushing hospitals and nonprofits to comply with Trump’s executive orders targeting transgender care. With further orders expected, and state enforcement intensifying, conditions for transgender adults are worsening across the country.

Nationwide Risk: Worst Laws Passed. The wave of executive orders targeting transgender Americans has reshaped the national landscape in chilling fashion. These directives have forced nonprofits to scrub the word “transgender” from their websites, stripped transgender history from the Stonewall National Monument, withdrawn federal funding from schools and hospitals that recognize or research transgender people, and imposed new barriers to obtaining passports and legal documents, making it hard to travel abroad. The result is a sweeping, nationwide rollback of rights and recognition for transgender adults. For international visitors, the risk is even more severe: citing the sharp escalation in legal and bureaucratic targeting, several countries have issued travel advisories. Marco Rubio’s cables targeting trans adult visa seekers with potentially permanent bans on entry is alarming. Following suit, I’ve designated the United States a “Do Not Travel” zone for non-essential travel for transgender people without a full understanding of the legal environment, due to the heightened risk of visa revocation, denial of entry, or detention.

Here are the categories and where each state falls:

• Do Not Travel (FL, TX): Two states have earned “Do Not Travel” advisories: Florida and Texas. Florida has a law that allows for the arrest of transgender people for using bathrooms according to their gender identity and another policy targets transgender people’s drivers licenses. Florida has also put into effect a policy that says trans people “misrepresenting” their gender on their drivers license could be guilty of fraud. Local LGBTQ+ orgs as well as HRC have issued travel advisories for the state. This analysis likewise concurs with such a rating. In Texas, the state is not only ignoring court ordered drivers license changes for trans adults, but it is also creating a database of people attempting to make such changes. Meanwhile, Odessa, TX has passed a bounty ordinance that puts $10,000 bounties on transgender people in bathrooms, with more legislation expected this year.

• The Worst States (AL, IA, ID, KS, LA, MS, MT, OH, OK, ND, SD, TN, UT, WV, WY): These states have passed deeply troubling legislation targeting transgender adults in extremely harmful new ways. Kansas and Utah have bathroom bans for transgender adults. Alabama has also passed a Don’t Say Gay bill that includes a bathroom ban on college campuses. Many states, including Kansas, Louisiana, Mississippi, Montana, Oklahoma, and Tennessee, and others listed in this category have gone so far as to legislatively erase transgender people, effectively removing any legal rights associated with their gender identities. Other states, such as Kansas, Montana, North Dakota, Oklahoma, and Tennessee, prohibit any changes to birth certificates, forcing trans people to out themselves when showing their documents. In Kansas, this law could even force individuals who have updated their driver's licenses and birth certificates to see their gender markers reverted. These states also could start targeting adult gender affirming care - Florida has already done so, banning 80% of such care. Idaho has an extreme ban on state funds for gender affirming care.

• High-Risk States (AR, GA, IN, MO, NE, NH, SC): All of these states have passed anti-trans laws, but they haven't reached the same level of severity as the worst states. Missouri for example, prohibits gender-affirming care for incarcerated adults as well as transgender youth and have seen new laws proposed this cycle going even further. Nebraska’s governor has issued an executive order ending legal recognition of trans people. Additionally, some of these states, including Arkansas, have laws that permit the refusal of medical care to LGBTQ+ individuals on religious grounds. Although each of these states has laws targeting transgender adults, none have done so to the extent of the worst states.

• Moderate-Risk States (AK, KY, NC, VA): These states have either passed one or two laws aimed at transgender adults or have enacted multiple laws targeting transgender youth, or are advancing negative laws quickly. For states focusing on trans youth, history shows they are more likely to introduce anti-trans legislation for adults in subsequent years. Most of these states are under Republican control, either through supermajorities in the legislature or Republican governorships. Many have enacted "Don't Say Gay" provisions, which frequently result in the banning of transgender teachers. Additionally, many have passed religious refusal rights bills. However, most of these states have either not yet ventured into anti-trans adult legislation or have only passed milder forms of such laws. In Virginia’s case, the state has already seen transgender care to the age of 19 effectively shut down at some clinics, which impacts some trans adults who are 18-19, and the state AG has encouraged compliance with anti-trans executive orders.

• Low-Risk States (AZ, DE, MI, NV, PA, WI, DC): These states have largely refrained from targeting transgender adults, although they haven't taken extraordinary steps to protect adult transgender rights either. For example, Arizona and Virginia have enacted anti-trans policies affecting youth but, due to state-specific factors, appear unlikely to extend such policies to adults. Conversely, Michigan, and Nevada have enacted fairly robust non-discrimination policies but fall short in ensuring healthcare equity and providing protections for incarcerated transgender individuals. While these states generally offer a safer environment for transgender adults, they stop short of going the extra mile to make their jurisdictions unequivocally safe places to reside. In the case of the District of Columbia, it may fall under attack from Congress and executive actions, meaning it can no longer be considered “most protective.” This most recently was manifested with the DC House bathroom ban.

• Most Protective States (CA, CO, CT, HI, IL, MA, MD, ME, MN, NJ, NM, NY, OR, RI, VT, WA): These states have gone above and beyond in safeguarding the rights and well-being of transgender individuals, making them highly desirable places to live for those in search of security. States like Colorado, Hawaii, Maryland, and Washington have enacted comprehensive health insurance laws that cover facial hair removal and an expanded range of medical procedures. Each of these states offers refugee protections for individuals fleeing more repressive states with anti-trans laws. Care is not only supported but also enjoys legal reinforcement from the state, ensuring accessibility as long as such treatments remain lawful at the national level. These states are the most likely to counteract federal anti-trans regulations if faced with a Republican presidency.

The Youth Trans Legislative Risk Assessment Map

Very few states now occupy the middle ground in the realm of anti-trans legislation for transgender youth. Those marked in dark red have enacted bans on gender-affirming care for transgender youth, with many even mandating medical detransition for these young people. Conversely, states shown in dark blue have implemented refugee protection laws for trans youth seeking to escape the harsh legal environments of more restrictive states.

Moves in this update: Arizona (Low Risk → Medium Risk), New York (Safest States → Low Risk), Pennsylvania (Low Risk → Medium Risk), Maine (Safest States → Low Risk), Colorado (Safest States → Low Risk)

• Summary of updates: The most significant shifts on the youth risk map are occurring in states once considered “safe” or “low risk.” Maine and New York have both been downgraded to “low risk” amid escalating conflicts over federal executive orders and institutional over-compliance. In New York, NYU Langone—one of the state’s largest providers of gender-affirming care—has halted services for new patients and remains one of the few major institutions not to resume care for new patients following court victories against Trump’s executive order. In Maine, a high-profile clash between Governor Janet Mills and President Trump over transgender sports participation has put the state’s protections in flux. Colorado has also seen clinics drop transgender care. Arizona and Pennsylvania have also deteriorated a tier in risk: both have experienced clinic closures for transgender youth, and Pennsylvania’s athletic association has enacted a ban on transgender participation in school sports.

Nationwide Risk: Worst Laws Passed. A wave of executive orders has targeted transgender youth in sweeping and extreme ways. Nonprofits have halted services for trans youth, healthcare providers face federal bans via executive orders, and teachers have been warned they could be investigated for “practicing medicine without a license” simply for using a trans student’s chosen name. The cumulative effect is a chilling rollback of basic recognition and care—one that signals even more punitive measures may be on the horizon.