The 2020s anti-LGBTQ movement in the United States is an ongoing political backlash from social conservatives against LGBTQ movements. It has included legislative proposals of bathroom use restrictions, bans on gender-affirming care, anti-LGBTQ curriculum laws, laws against drag performances, book bans, boycotts, and conspiracy theories around grooming. Between 2018 and 2023, hundreds of anti-LGBTQ laws were considered, with more than one hundred passed into law.

The backlash has been described as a moral panic, and part of a larger culture war in the United States. Scholars have cited rising anti-LGBTQ attitudes and policies as an example of democratic backsliding. The backlash has been connected to similar conservative developments in Europe, as well as the Middle East.

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Members of the far-right and a number of mainstream conservatives, mostly in the United States, have used the term "groomer" to falsely accuse LGBTQ people, as well as their allies and progressives in general, of systematically using LGBTQ sex education and campaigns for LGBTQ rights as a method of child grooming and enabling pedophilia. Usage of this term increased in the 2020s.

In the United States, the popularization of the term has been linked to Christopher Rufo, who tweeted about "winning the language war", and James A. Lindsay in August 2021. Following the Wi Spa controversy in July 2021, Julia Serano noted a rise in false accusations of grooming directed towards transgender people, saying that it appeared as if there was a movement to "lay the foundation for just smearing all trans people as child sexual predators". Libs of TikTok (LoTT) also slurs LGBTQ people, supporters of LGBTQ youth, and those who teach about sexuality as "groomers." In 2021, LoTT made false claims that the Trevor Project was a "grooming organization" and that Chasten Buttigieg was "grooming kids". LoTT creator Chaya Raichik said on the Tucker Carlson Today show that LGBTQ people "Want to groom kids. They're recruiting."

The conspiracy theory then moved into the American conservative mainstream, with a number of high-profile cases of its use in spring 2022, including its use by members of the Republican Party. On February 24, the right-wing Heritage Foundation issued a tweet stating that the Florida Parental Rights in Education Act "protects young children from sexual grooming". During the debate over the act, Christina Pushaw, press secretary to the state's governor Ron DeSantis, tweeted that anyone who opposes the act was "probably a groomer". In April 2022, Marjorie Taylor Greene referred to the Democratic Party as "the party of killing babies, grooming and transitioning children, and pro-pedophile politics". Also that month, a group of far-right extremists and conspiracy theorists held a demonstration at Disney World in which they accused Disney of grooming. Disney has been the focus of several other uses of the conspiracy – Jim Banks and 19 other members of the Republican Study Committee published a letter to Disney accusing the corporation of "purposefully influencing small children with its political and sexual agenda".

Since then, numerous right wing pundits have described the behavior of parents and teachers who support minors in their transgender identities as grooming, and the term "groomer" has widely been used by conservative media and politicians who want to denounce the LGBTQ community and its allies by implying that they are pedophiles or pedophile-enablers. Slate Magazine later described the word "grooming" as "the buzzword of the season". In March 2022, Fox News host Laura Ingraham claimed that schools were becoming "grooming centers for gender identity radicals", dedicating an entire segment of her show to the topic a couple of weeks later. In April 2022, the left-leaning media watchdog Media Matters published a study stating that within a three-week period spanning from March 17 to April 6, Fox News ran 170 segments on trans people, throughout which the network "repeatedly invoked the long-debunked myth that trans people pose a threat to minors and seek to groom them".

In July 2022, a wave of anti-LGBTQ curriculum resurgence saw ten such laws beginning to take effect in six different states. Some states enacting these new laws appear to have mirrored similar laws from other states.

In Florida, the Parental Rights in Education law and Florida Board of Education policy bans education on "sexual orientation" or "gender identity" unless it is mandated under state academic standards or as part of an optional reproductive health course or lesson. In August 2023, the state of Florida dropped AP Psychology as a course offering, due to a required section on sexual orientation and gender identity. The same month, Tampa-area schools announced they would restrict teaching of the works of Shakespeare in order to comply with the Parental Rights in Education law.

Alabama bans the topics for kindergarten to grade 5, except for instruction deemed "age or developmentally appropriate". Five other states (Montana, Arizona, Arkansas, Tennessee and Florida) require parental notification of instruction on LGBTQ issues and allows parents to opt-out of such instruction.

In California—where state law requires students to learn about the "role and contributions" of LGBTQ people in history—multiple protests against the inclusion of LGBTQ-friendly curriculum resulted in violence. At a June 2023 protest in Glendale, individuals seen protesting LGBTQ curriculum were identified as members of hate groups, such as the Proud Boys.

Local K-12 school boards across the country adopted a variety of policies regarding trans students, ranging from allowing fully equal rights and non-discrimination for trans students, to requiring trans students to submit to a criminal background check to be allowed to use the bathroom consistent with their gender identity, to implementing full bans on expressing one's self-declared gender at all, including bans on chosen pronouns and pride flags, to even bans on mentioning the very existence of trans people. State and local officials in the South used indecency and obscenity laws to ban books from school libraries.

In June 2021, the Biden administration reinforced that Title IX protected LGBTQ students from discrimination by including sexual orientation and gender identity in its list of protections.

In August 2021, Tennessee and nineteen other states sued the Department of Education in Tennessee v. Department of Education, alleging that the new Title IX governance constitutes government overreach. A preliminary injunction was granted by a Tennessee judge in July 2022, blocking enforcement of the new guidance. In December 2022, the Department of Education appealed the decision, which is still pending.

The new guidance was rejected by the Florida Department of Education, calling the guidance a "sexual ideology" that risks the "health, safety, and welfare of Florida students".

As many as 13 U.S. states banned gender affirming health care for transgender youth in the early-2020s.

Many Republican legislators across the country are increasingly proposing legislation that would restrict gender-affirming care for adults or make such treatments harder to access. However, no states have succeeded at outright banning gender-affirming care for adults in a way similar to what is being done with minors. Efforts to restrict adults' access to healthcare relies heavily on claims from self-described "gender-critical" organizations such as Genspect that young people should not be recognized as adults until they turn 25.

As of January 2024, seven states limit access to gender-affirming care for adults in some way without banning it, such as allowing private health plans, Medicaid, and correctional facilities to exclude all coverage for gender-affirming care, prohibiting the use of federal funds for gender-affirming care or requiring informed consent practices beyond those typically required in medical practice.

In January 2024, several Republican legislators expressed their desire to ban gender-affirming healthcare altogether saying their 'endgame' was to ban it completely for people of all ages.

As part of his 2024 presidential campaign, Donald Trump has stated that if elected, he will sign an executive order instructing every federal agency to cease the promotion of sex or gender transition at any age as well as ask Congress to pass a bill stating that the United States will only recognize two genders as determined at birth, and has promised to crackdown on gender-affirming care for all ages. Additionally, Trump stated that he would make hospitals and health care providers that provide transitional hormones or surgery no longer qualify for federal funding, including Medicare and Medicaid funding. Trump has also stated he will push to prohibit hormonal and surgical intervention for minors in all 50 states.

These states have policies making it easier for trans adults to sue their doctors:

• Utah: In January 2023, Utah stripped liability protections from any doctor who treats a trans person under the age of 25, and allowing any trans person under 25 to retroactively "disaffirm" consent and sue the doctor for providing care they had at the time consented to.
• South Dakota: In February 2023, South Dakota passed a similar law as Utah's, but without any age limit.
• Arkansas: On March 13, 2023, Governor Sarah Huckabee Sanders signed a bill giving adults 15 years to file malpractice lawsuits for gender-affirming care they received as minors, whereas for other types of care (under preexisting law) a malpractice lawsuit must generally be filed within two years.

These states have policies that restrict treatment for trans adults, as well as younger people:

• Florida: In August 2022, the state of Florida voted to require any trans adult seeking gender affirming healthcare to receive approval from the Florida Board of Medicine at least 24 hours in advance. On May 17, 2023, DeSantis signed a law banning insurance providers from covering gender-affirming care for adults, as well as banning nurse practitioners and physicians' assistants (estimated to make up 80% of gender affirming care providers) from administering it, and banning it from being offered via telehealth. The Florida state legislature had passed the bill the previous month. In June 2024, a judge permanently blocked the law from taking effect. In August 2024, the 11th Circuit Court of Appeals stayed the permanent injunction while the matter is appealed.
• Missouri: In April 2023, the state attorney general issued an emergency order instituting a three-year waiting period of continuous documented dysphoria before qualifying for gender-affirming care, disqualifying people if they have untreated depression or anxiety, mandates a screening for autism, and mandating regular screenings for "social contagion". This has been characterized by many as a de facto ban on trans healthcare for adults, since depression and anxiety are common symptoms of gender dysphoria. A judge temporarily blocked enforcement of the order and scheduled a hearing for May 11. The attorney general withdrew this order on May 16 after the state legislature passed two bills restricting gender-affirming care for trans youth. On June 7, 2023, Governor Mike Parson signed a bill that contained a provision banning gender-affirming care for prisoners, which took effect on August 28.

Gender-affirming care for minors has been available in the U.S. for more than a decade and is endorsed by major medical associations, but it has increasingly come under attack in many conservative legislatures. According to the ACLU, in 2023 alone, over 500 anti-LGBTQ bills were submitted in the US, over 130 of which were about healthcare. Efforts to prohibit gender-affirming care for minors had begun several years earlier, but did not receive much attention from state legislatures until more recently. The conservative organization Do No Harm was influential in developing model legislation that appeared starting in 2022 in Arkansas, Florida, Iowa, Mississippi, Montana, New Hampshire, and West Virginia legislatures.

In February 2024, the American Psychological Association approved a policy statement supporting unobstructed access to health care and evidence-based clinical care for transgender, gender-diverse, and nonbinary children, adolescents, and adults, as well as opposing state bans and policies intended to limit access to such care.

As of July 2024, 26 states had enacted some form of ban on gender-affirming care for minors, 19 of which were enacted in 2023. However, 16 of these bans are being challenged in court as of January 2024. Furthermore, only 18 of the 26 states have complete bans which are fully in effect. Six states have only partial bans and two are currently blocked from taking effect. While some states have banned all forms of medical transition, others such as Arizona, Nebraska, New Hampshire and Georgia have banned only specific types such as hormone therapy or surgery. Six states have exceptions which allow minors who were already receiving gender affirming care prior to the ban to continue their treatments. Currently, all 26 states make exceptions for puberty blockers, hormones and surgery for cisgender and intersex children. Only one state, West Virginia, makes exceptions in cases of "severe dysphoria". There is also currently only one state, Missouri, that has a ban which is set to expire after a certain period of time. Nearly all states with restrictions include specific provisions with penalties for providers and 4 states include provisions directed at parents or guardians. An additional 4 states include laws/policies that impact school officials such as teachers and counselors, among others.

At the same time, many Democrat-controlled states have gone in the opposite direction and enacted laws protecting access to gender affirming care for minors and adults. These laws, often called "shield" laws, often explicitly combine protections for gender-affirming care and abortion and cover a variety of protections including protecting both providers and patients from being punished, mandating insurance providers to cover the procedures and acting as "sanctuary states" that protect patients traveling to the state from other states that have banned such treatments among other things. As of June 2024, 16 states and the District of Columbia have enacted "shield" laws.

Of the approximately 1.6 million Americans who are transgender, about 300,000 are under the age of 18. As of October 2023, approximately 105,200 transgender youth aged 13 to 17 lived in states where gender affirming care is banned for minors. However, around 26,000 of those youth are currently still able to access care in their state due to court orders that prohibit enforcement of the laws. Conversely, around 146,700 transgender youth live in states that have passed gender-affirming care "shield" laws that support access to care by protecting doctors and parents who prescribe or seek access to medical care for youth. An analysis from KFF in late January 2024 estimated that 38% of trans youth between the ages of 13–17 in the United States lived in states with laws limiting youth access to gender-affirming care.

Bans on gender-affirming care have been criticized as governments interfering with the patient-doctor relationship and taking away healthcare decisions from parents and families for their children. State level bans on gender-affirming care in the United States have led some families with transgender children to move out of their states.

On October 17, 2024, Texas attorney general Ken Paxton filed suit against a doctor who allegedly provided gender-affirming care to 21 minors after the treatments had been banned for minors in Texas, the first time that such a suit has been brought in the U.S.

Bans of gender-affirming healthcare for people under 18

State	Authority	Signed	Effective	Notes
Arkansas	State legislature	April 6, 2021	Permanently blocked	On April 6, 2021, the legislature—overriding Governor Asa Hutchinson's veto on a bill that banned puberty blockers, hormones, and surgery for minors and from referring them to other providers. However, courts temporarily and then permanently blocked the law.
Texas	Texas AG Ken Paxton Governor Greg Abbott	February 22, 2022 June 2, 2023	Blocked by injunction (order) September 1, 2023 (legislation)	In February 2022, the state Attorney General ordered a ban on gender-affirming care for trans youth, with criminal penalties for failing to report suspected violations. However, the order is currently blocked by injunction. In June 2023, the governor signed a law to ban this care for minors. On August 25, 2023, a district court judge blocked the law from taking effect. In response, the Attorney General's office filed an appeal with the Texas Supreme Court, a move that automatically pauses the judge's injunction and allowed the law to go into effect on September 1, 2023, as originally planned. On June 28, 2024, the Texas Supreme Court upheld the law.
Alabama	Governor Kay Ivey	April 8, 2022	May 8, 2022	It is a felony for a medical provider to give gender-affirming healthcare to transgender people under 19 (the age of majority in Alabama). In May 2022, a federal judge ruled that the ban on surgery was enforceable. However, the ban on puberty blockers and hormones was not enforceable while the law is challenged in court. In August 2023, the 11th U.S. Circuit Court of Appeals reversed the decision, allowing the ban on puberty blockers and hormones to take effect.
Utah	Governor Spencer Cox	January 27, 2023
South Dakota	Governor Kristi Noem	February 13, 2023
Mississippi	Governor Tate Reeves	February 28, 2023
Tennessee	Governor Bill Lee	March 2, 2023
Florida	Florida Board of Medicine Governor Ron DeSantis		August 26, 2024 (legislation) Blocked (state board of medicine rule)	The state board of medicine rule took effect on March 16, 2023. Additionally, on May 17, 2023, Governor DeSantis signed a ban into law, and it took effect immediately. It applies only to new patients, not those who were already receiving gender-affirming care. However, on June 6, 2023, a court temporarily blocked enforcement of both the board rule and the law. In June 2024, a judge permanently blocked the law from taking effect. In August 2024, the 11th Circuit Court of Appeals stayed the permanent injunction while the matter is appealed.
Iowa	Governor Kim Reynolds	March 22, 2023
Georgia	Governor Brian Kemp	March 23, 2023	July 1, 2023	Bans hormones and surgery while continuing to allow puberty blockers. Minors who began hormones prior to July 1, 2023, are allowed to continue treatment.
West Virginia	Governor Jim Justice	March 29, 2023		The bill makes exceptions for minors who have received parental consent and are diagnosed with "severe gender dysphoria" by two doctors. Due to this exception, experts do not expect the ban to have much of an impact.
Kentucky	State legislature	March 29, 2023	July 14, 2023	The legislature overrode Governor Andy Beshear's veto, banning gender-affirming healthcare for trans minors. Federal appeals judges allowed the ban to remain in effect during legal challenges to overturn it.
Arizona	Governor Doug Ducey	March 30, 2022	March 31, 2023	Bans gender-affirming surgery for minors, but not hormones and puberty blockers. The bill also makes some exceptions, including in the case of someone born intersex. In mid 2023, a new Governor, Katie Hobbs reversed course by signing a series of executive orders which include shield-style protections for gender-affirming care, ensuring that it remains legal in Arizona. It also bans conversion therapy, requires insurance plans to cover gender-affirming care and bars state agencies from cooperating with civil and criminal cases in states where gender-affirming health care is illegal.
Idaho	Governor Brad Little	April 4, 2023	April 15, 2024	It would also make it a felony for any medical practitioner to help a minor seek gender-affirming treatment. On December 27, 2023, a federal judge blocked the law from taking effect. On April 15, 2024, the US Supreme Court responded to an emergency request filed in February by temporarily allowing the ban to go into effect while further legal challenges to it play out in the lower courts. The ruling did not resolve the underlying legal challenges raised by the case nor did the justices rule on the larger issue of bans on gender-affirming treatment for minors. The ruling also does not apply to the two plaintiffs in the lawsuit.
Indiana	Governor Eric Holcomb	April 5, 2023	February 27, 2024	On June 16, 2023, a federal judge temporarily blocked the law from taking effect. On February 27, 2024, the 7th Circuit Court of Appeals reversed the decision allowing the ban to take effect.
North Dakota	Governor Doug Burgum	April 20, 2023		On April 20, 2023, North Dakota Governor Doug Burgum signed a law criminalizing trans health care for minors. However, the law notably makes exceptions for medication treatment for "rare circumstances with parental consent". The law also allows medication treatment for early onset puberty and minors who were already receiving gender-affirming care will still be able to receive treatment.
Montana	Governor Greg Gianforte	April 28, 2023	Blocked	Treatments such as puberty-blockers and breast-reduction surgery will still be legal for minors who are not suffering from gender dysphoria. On September 27, 2023, a Montana District Court judge prevented it from taking effect.
North Carolina	State legislature		August 17, 2023	Ban on gender-affirming care, such as hormones, puberty blockers, and surgery, for minors. The ban only applies to transgender children and still allows such treatments for intersex and cisgender children. The ban also only applies to new patients. Transgender children who started treatment prior to August 1, 2023, will be allowed to continue receiving treatment. Governor Roy Cooper vetoed the bill on July 5, 2023, but the state legislature overruled his veto on August 17, therefore making the bill law.
Missouri	Governor Mike Parson	June 7, 2023	August 28, 2023	People receiving puberty blockers or hormones before the ban went into effect may continue taking them. Otherwise, blockers and hormones are banned until 2027. Surgery is also banned.
Louisiana	State Legislature		January 1, 2024	On June 29, 2023, John Bel Edwards vetoed a ban on blockers, hormones, and surgery for minors. On July 18, the Louisiana State Legislature overrode his veto.
Oklahoma	Governor Kevin Stitt	May 1, 2023		On May 1, 2023, Governor Kevin Stitt signed a bill that makes it a felony for doctors to provide gender-transition medical care for anyone under the age of 18. In October 2023, a judge declined to stop the law from taking effect.
Nebraska	Governor Jim Pillen	October 2, 2023	October 2, 2023	On October 2, 2023, the state Department of Health and Human Services announced that Republican Governor Jim Pillen had approved emergency regulations banning gender affirming surgeries for minors. Puberty blockers and hormone treatments for minors still remain legal, however applicants must now wait seven days and undergo at least 40 hours of "clinically neutral" therapy before starting them. The new regulations went into effect immediately.
Ohio	State legislature		August 6, 2024	On January 5, 2024, Governor Mike DeWine signed an executive order banning gender-affirming surgeries for minors. Previously, on December 29, 2023, he had vetoed the Saving Adolescents from Experimentation (SAFE) Act (HB68) passed (mostly along party lines) by the Ohio Legislature on December 13 which banned gender-affirming surgeries as well as hormones and puberty blockers for minors. The bill includes exceptions for this kind of care for non-transgender youth, and it allows children who were already receiving gender-affirming care in Ohio to continue their treatment. On January 24, 2024, the legislature overrode DeWine's veto thereby making HB68 law. On April 16, 2024, a judge temporarily blocked the ban from taking effect. On August 6, 2024, a judge overturned the injunction and allowed the law to take effect immediately. The plaintiffs immediately announced an appeal.
Wyoming	Governor Mark Gordon	March 22, 2024	July 1, 2024	On March 22, 2024, Wyoming Governor Mark Gordon signed a law criminalizing trans health care for minors.
South Carolina	Governor Henry McMaster	May 21, 2024	May 21, 2024	On May 21, 2024, South Carolina Governor Henry McMaster signed a law banning trans health care for minors. The law, which went into effect immediately, also requires principals, teachers and other school staff members to tell parents when their children want to use a name other than their legal one, or pronouns that do not match their sex assigned at birth. It also bars adults under 26 from using Medicaid to cover the costs for trans health care. This part of the bill is in direct opposition to a 4th U.S. Circuit Court of Appeals ruling from the month prior which ruled that state Medicaid bans on gender-affirming care in the 4th Circuit, which includes South Carolina, are unconstitutional.
New Hampshire	Governor Chris Sununu	July 19, 2024	January 1, 2025	On July 19, 2024, New Hampshire Governor Chris Sununu signed a law banning gender-affirming genital surgeries for minors. However, puberty blockers, hormones and non-genital surgeries such as mastectomies remain legal for trans youth.

"Shield" laws protecting access to gender-affirming healthcare for people under 18

State	Authority	Signed	Effective	Notes
Connecticut	Governor Ned Lamont	May 5, 2022	May 5, 2022	On May 5, 2022, Governor Ned Lamont signed House Bill 5414, a shield law that designates Connecticut as a "safe harbor" which protects people who provide abortions and gender affirming care in the state, as well as legal protections for people seeking abortions and gender-affirming health care from out-of-state.
Massachusetts	Governor Charlie Baker	July 29, 2022	July 29, 2022	On July 29, 2022, Governor Charlie Baker signed a shield law which protects access to abortion and gender-affirming health care in the state.
California	Governor Gavin Newsom	September 30, 2022	January 1, 2023	On September 30, 2022, Governor Gavin Newsom signed SB 107, a shield law which designates California as a "sanctuary state" for trans youth and their families who are fleeing from other states that have banned the practice.
District of Columbia	Mayor Muriel Bowser	November 21, 2022	November 21, 2022	On November 21, 2022, Mayor Muriel Bowser signed into law D.C. ACT 24-646, the Human Rights Sanctuary Amendment Act of 2022, which protects the right to bodily autonomy and of those seeking care for abortion, contraception, sexual conduct, intimate relationships, and gender affirmation.
Illinois	Governor JB Pritzker	January 13, 2023	January 13, 2023	On January 13, 2023, Governor JB Pritzker signed into law HB4664, a reproductive rights and gender affirming care omnibus bill that protects health care providers and their patients from legal attacks by neighboring states and expands reproductive and gender affirming health care access and options across the state. The bill takes historic action to protect Illinois providers and their patients, thousands of whom have traveled to Illinois to access essential care now banned in their home states.
New Mexico	Governor Michelle Lujan Grisham	March 16, 2023	March 16, 2023	On March 16, 2023, Governor Michelle Lujan Grisham signed into law House Bill 7, the Reproductive and Gender-Affirming Health Care Act, which prohibits public bodies, including local municipalities, from denying, restricting, or discriminating against an individual's right to use or refuse reproductive health care or health care related to gender.
Vermont	Governor Phil Scott	March 29, 2023	September 2023	On March 29, 2023, Governor Phil Scott signed into law House Bill 89 and Senate Bill 37, which establish a slate of protections for both providers and seekers of gender affirming health care, as well as those seeking or administering abortions.
New Jersey	Governor Phil Murphy	April 4, 2023	April 4, 2023	On April 4, 2023, Governor Phil Murphy signed Executive Order No. 326 establishing New Jersey as a safe haven for gender-affirming health care by directing all state departments and agencies to protect all persons, including health care professionals and patients, against potential repercussions resulting from providing, receiving, assisting in providing or receiving, seeking, or traveling to New Jersey to obtain gender-affirming health care services.
Colorado	Governor Jared Polis	April 14, 2023	April 14, 2023	On April 14, 2023, Governor Jared Polis signed into law a trio of health care bills enshrining access to abortion and gender-affirming procedures and medications in Colorado. These bills ensure people in surrounding states and beyond can go to Colorado to have an abortion, begin puberty blockers or receive gender-affirming surgery without fear of prosecution.
Minnesota	Governor Tim Walz	April 27, 2023	April 27, 2023	On April 27, 2023, Governor Tim Walz signed a shield law which protects minors fleeing from other states to receive gender-affirming care.
Washington	Governor Jay Inslee	May 9, 2023	May 9, 2023	On May 9, 2023, Governor Jay Inslee signed a shield law designating Washington as a "sanctuary state" for trans youth.
Maryland	Governor Wes Moore	June 6, 2023	June 6, 2023	On June 6, 2023, Governor Wes Moore signed an executive order to protect gender affirming health care in Maryland. The order will protect those seeking, receiving, or providing gender affirming care in Maryland from attempts at legal punishment by other states.
New York	Governor Kathy Hochul	June 26, 2023	June 26, 2023	On June 26, 2023, Governor Kathy Hochul signed a shield law designating New York as a "sanctuary state" for trans youth. This law protects access to transition-related medical care for transgender minors and bars state courts from enforcing the laws of other states that might authorize a child to be taken away if the parents provide gender-affirming medical care, including puberty blockers and hormone therapy. It also prohibits New York courts from considering transition-related care for minors as child abuse and bars state and local authorities from cooperating with out-of-state agencies regarding the provision of lawful gender-affirming care in New York.
Arizona	Governor Katie Hobbs	June 28, 2023	June 28, 2023	On March 30, 2022, Governor Doug Ducey signed a bill banning gender-affirming surgery for minors, but not hormones and puberty blockers. The bill also makes some exceptions, including in the case of someone born intersex. On June 28, 2023, a new Governor, Katie Hobbs reversed course by signing a series of executive orders which include shield-style protections for gender-affirming care, ensuring that it remains legal in Arizona. It also bans conversion therapy, requires insurance plans to cover gender-affirming care and bars state agencies from cooperating with civil and criminal cases in states where gender-affirming health care is illegal.
Oregon	Governor Tina Kotek	July 13, 2023	July 13, 2023	On May 9, 2023, Governor Tina Kotek signed a law protecting access to abortion and gender affirming care for trans youth. Minors between the ages of 15 and 17 can receive gender affirming care without parental permission, whereas youth ages 14 and under must have parental permission.
Maine	Governor Janet Mills	April 23, 2024	April 23, 2024	On April 23, 2024, Governor Janet Mills signed a shield law designating Maine as a "sanctuary state" for gender-affirming care and abortion providers and makes access to such treatments "legal rights" in Maine. It states that criminal and civil actions against providers and patients are not enforceable if the access to that care occurred in Maine. Additionally, the bill prevents cooperation with out-of-state arrest warrants for gender-affirming care and abortion that happen within the state. It also protects doctors who provide gender-affirming care and abortion from actions by medical boards, malpractice insurance, and other regulating entities that seek to economically harm them or dissuade them from providing care. The bill also explicitly enshrines WPATH's Standards of Care into state law for the coverage of transgender healthcare.
Rhode Island	Governor Daniel McKee	June 25, 2024	June 25, 2024	On June 25, 2024, Governor Daniel McKee signed a shield law designating Rhode Island as a "sanctuary state" for gender-affirming care and abortion providers and makes access to such treatments "legal rights" in Rhode Island. The bill also protects providers from being sued for providing care.

While all 50 states had previously allowed transgender people to change their legal names and documented genders to match their true selves, many states in the 2020s implemented newfound restrictions. These restrictions ranged from requiring sterilization to obtain amended documents, to making it a criminal offense to carry a state ID not matching one’s assigned gender at birth.

Some U.S. states passed legislation restricting the participation of transgender youth in high school sports or of trans women and girls in women's sports.

26 U.S. States have banned transgender people from sports under their gender identity in various capacities. These states include Texas, Arkansas, Florida, Alabama, Oklahoma, Kentucky, Mississippi, Tennessee, West Virginia, South Carolina, Utah, South Dakota, Montana, Iowa, Arizona, Idaho, Wyoming, Indiana, Louisiana, Kansas, Georgia, North Dakota, New Hampshire, North Carolina, Alaska and Ohio. The passage of legislation against transgender youth has seen increases in calls to Trans Lifeline, a suicide crisis hotline run by and for transgender people. Some of these bans only apply to school sports and some only apply to transgender women, but not transgender men. The US Department of Education has said transgender students are protected under Title IX.

• In Indiana, schools rely on anatomical sex, requiring gender reassignment surgery for trans athletes to participate in the sport of their identified gender.
• Nebraska has formed a Gender Identity Eligibility Committee that decides on a case-by-case basis of how each transgender athlete can participate as their self-identified gender.
• Texas, Alabama, North Carolina, Kentucky, Idaho, and Florida require trans athletes to compete based on their biological sex.
• In Alaska, Connecticut, Georgia, Kansas, Pennsylvania, and Wisconsin, each school district makes their own decision on how to include transgender athletes.
• Maine gives approval for students to choose which team they wish to play on, approving based on safety and fairness.
• New Jersey and New Mexico require that trans athletes provide evidence that they have transitioned or are transitioning.
• Missouri and Ohio require athletes to undergo hormone treatment. Ohio requires that the athlete must have been on the hormones for at least a year prior to competing.
• Oregon allows those who identify as male to participate on male teams, and they are then on excluded from girls' competitions. Those transitioning from male to female must be on hormone treatment for at least a year.
• Iowa bans transgender girls and women from playing female sports. No such stipulation applies to transgender boys and men with regard to male sports.
• Oklahoma requires that any student participating in sports must submit a notarized affidavit of gender assigned at birth, under penalty of perjury.

In an early example of an anti-trans bathroom bill, the Public Facilities Privacy & Security Act in North Carolina, was approved as a law in 2016. The bill, however, sparked widespread condemnation and threats of boycotts, and portions of the measure were repealed in 2017 as part of a compromise between the Democratic governor and Republican-controlled Legislature. Also in 2016, guidance was issued by the U.S. Departments of Justice and Education stating that schools which receive federal money must treat a student's gender identity as their sex (for example, in regard to bathrooms). This policy was revoked in 2017.

In the 2020s, bathroom bills have been proposed and debated in a number of state legislatures. According to the American Civil Liberties Union there are currently 469 anti-LGBTQ bills in the US, most targeting transgender people. Current examples include Kansas SB 180. Several state bills are based on and closely resemble model legislation provided by the conservative lobbying organization Alliance Defending Freedom (ADF), which has been classified by the Southern Poverty Law Center as an anti-LGBTQ hate group. The ADF's model legislation proposes giving any public school or university student the right to sue for $2,500 for each time they encountered a transgender classmate in a locker room or bathroom.

A number of the bills put forth and passed made it some form of criminal offense, often a sex offense, for a transgender person to use a bathroom, locker room, changing room, or other similar facility not corresponding with their assigned sex. The most severe of these was that of Arkansas, which made it an offense of "sexual indecency with a child" for a trans person to use any such facility if said facility contained anyone under 18 at the time of use.

Since 2021, Alabama, Arkansas, Oklahoma, Tennessee, and Idaho have enacted bathroom bills. State legislatures in Arizona, Illinois, Kansas, Kentucky, Massachusetts, Minnesota, Mississippi, Missouri, South Carolina, Tennessee, and Texas have proposed bathroom bills. The National Center for Transgender Equality, an LGBTQ advocacy group, calls these bills discriminatory.

In December 2022, sitting en banc, the United States Court of Appeals for the Eleventh Circuit ruled in Adams ex rel. Kasper v. School Board of St. Johns County, Florida that separating the use of male and female bathrooms in public schools based on a student's biological sex doesn't violate the Equal Protection Clause of the Fourteenth Amendment or Title IX of the Education Amendments Act of 1972. Previously, in August 2020, a three judge panel of the United States Court of Appeals for the Eleventh Circuit affirmed a 2018 lower court ruling in Adams v. The School Board of St. Johns County that discrimination on the basis of gender identity is discrimination "on the basis of sex" and is prohibited under Title IX (federal civil rights law) and the Equal Protection Clause of the 14th Amendment to the US Constitution.

Protests against drag performances, especially Drag Queen Story Hour, increased after the 2021 attack at the United States Capitol. The most vocal opponents are mostly affiliated with alt-right groups. Former Fox News host, Tucker Carlson, suggested that drag events could "indoctrinate or sexualize" children. Protestors also have expressed concern about homophobic conspiracy theories that performers are grooming children. The Anti-Defamation League reported that child abuse conspiracy theory has been fueled by the Libs of TikTok, a far-right Twitter account. The Gay & Lesbian Alliance Against Defamation reported over 120 threats against drag shows in the US, throughout 2022.

In mid-June 2022, the Twitter account, Libs of TikTok, condemned the upcoming Coeur d'Alene, Idaho's "Pride in the Park" festival due to a "family-friendly drag performance." On June 11, 2022, during the pride event, law enforcement arrested 31 members of the white nationalist and hate group Patriot Front, later charging them with conspiracy to riot. In May 2023, masked neo-Nazi groups in Ohio protested drag events in Wadsworth and Columbus, carrying anti-drag and anti-trans banners, such as one that read, "There Will Be Blood." A report from GLAAD noted there were 138 documented incidents of anti-LGBTQ harassment, vandalism or assault at drag shows in the United States from June 2022 through April 2023. An Institute for Strategic Dialogue report indicated that the Proud Boys were the leading group spreading anti-LGBTQ sentiment.

On March 2, 2023, Tennessee governor Bill Lee signed the Adult Entertainment Act, which prohibits drag performances for children. This bill sparked outrage from the LGBTQ community. On June 3, 2023, a federal judge ruled that the law is unconstitutional. On July 18, 2024, a three judge panel on the Sixth Circuit reinstated the law by ruling that the plaintiffs had lacked the standing to sue. The ruling did not address whether the law was constitutional.

The states of Florida, Montana, and Texas have also passed laws banning public drag performances. However, all three of these drag bans were blocked by courts from taking effect.

In response to a concurring opinion by Justice Clarence Thomas in Dobbs v. Jackson Women's Health Organization arguing the Court should reconsider Obergefell v. Hodges, Congress passed the Respect for Marriage Act in 2022. RFMA officially repealed the Defense of Marriage Act and required the federal government to recognize same-sex and interracial marriages, thus codifying parts of Obergefell, the 2013 ruling in United States v. Windsor, and the 1967 ruling in Loving v. Virginia. In addition, it compelled all U.S. states and territories to recognize the validity of same-sex and interracial marriages if performed in a jurisdiction where such marriages are legally performed; however, it does not legally compel states to perform same-sex marriages if Obergefell is overturned.

The following year, the Tennessee House of Representatives passed House Bill 878, which would grant an individual the right to refuse to solemnize a marriage if the individual has a religious or conscience-based objection to that partnership. In Texas, McLennan County Justice of the Peace Dianne Hensley filed a lawsuit to allow her to refuse to marry gay couples, citing the 2023 U.S. Supreme Court case 303 Creative LLC v. Elenis.

Legislation was introduced or passed in at least 29 states taking aim at lessons that teach children about race and LGBTQ people, with most of the laws framed around putting a stop to critical race theory and “gender ideology”. These laws, which use broad language prohibiting teaching about privilege related to race or sex, or systemic bias in the United States, have led to many book removals. NBC News described the use of the term "critical race theory" in this context as "a catch-all term to refer to what schools often call equity programs, teaching about racism or LGBTQ-inclusive policies". The Takeaway's Melissa Harris-Perry cited discomfort with issues like gender identity as one of the common reasons for challenges, but that "this discomfort is likely imposed by adults onto young learners" who are otherwise more accepting and more likely to think outside traditional gender roles.

An example of such bans is that passed by Florida in March 2022, which created a list of sanctioned reading material for students in educational settings, and punished any teacher or school librarian whose classrooms or libraries contained unsanctioned books with felony charges. Sanctioned books must be reviewed by the state to be free of "prohibited material harmful to minors", which critics have said that under Florida state law includes content regarding the LGBTQ community and black history.

Conservative activists urged for boycotting any company which publicly supported, or collaborated with members of, the LGBTQ community. Some of the most well-known examples included the 2023 Anheuser-Busch boycott against Bud Light for a sponsorship with actress and TikToker Dylan Mulvaney, and the campaign against Disney by Florida governor Ron DeSantis for publicly opposing the state's anti-LGBTQ curriculum law. Other targeted companies include Nike, Adidas and Ford. In May 2023, Target removed several Pride Month items from stores in the Southern United States after anti-LGBTQ hate groups threatened violence against its employees.

According to a 2023 report by the Department of Homeland Security, threats of violence against the LGBT community rose in the early-2020s. The FBI also noted a sharp uptick in the number of hate crimes committed against LGBT people, with the 54 percent increase representing the fastest rise in hate crimes of all groups in the country. In New York City, hate crimes against LGBT people doubled from 2021 to 2022, and they grew by 29% in California during the same period. In August 2023, Lauri Carleton, a business owner in Southern California, was shot and killed for keeping a pride flag outside her store.

According to the Public Religion Research Institute, support for mandating that trans people use the bathroom corresponding to their gender assigned at birth rose among all religious groups, with white evangelical Protestants seeing the largest change, going from 41% in support to 72% in support between 2017 and 2021. 41% of total Americans held this stance, with 31% disagreeing, and 28% not taking either position.

60% of American adults reported in the summer of 2022 that they opposed allowing nonbinary marker options on government documents, while 58% reported supporting mandating that trans athletes compete on teams matching their gender assigned at birth.

An April 2021 PBS NewsHour/NPR/Marist poll with the question "Do you support or oppose legislation that would prohibit gender transition-related medical care for minors" found 66% of Americans would oppose a ban, including 69% of Democrats, 70% of Republicans, and 64% of Independents.

A February 2022 poll by LGBTQ support service The Trevor Project and Morning Consult found that 52 percent of American adults expressed some level of support for transgender minors having access to puberty blockers if it is recommended by their doctor and supported by their parents.

In a poll from Data for Progress in March 2023, when asked about the more than 400 pieces of anti-trans legislation working their way through statehouses, 64 percent of respondents, including 55 percent of Republicans, agreed with the statement "This is too much legislation. Politicians are playing political theater and using these bills as a wedge issue," while 25 percent agreed with the statement "This is the right amount of legislation. Politicians are dealing with a real danger that needs to be addressed." As a result, pollsters and strategists from both parties warned that Republican's intense focus on restricting the rights and health care of about 0.6 percent of the American population could risk putting off independents and swing voters in the next election.

A Washington Post/KFF poll conducted in November 2022 found that 68 percent of adults oppose access to puberty-blocking medication for transgender children ages 10 to 14, and 58 percent oppose access to hormonal treatments for transgender children ages 15 to 17.

In a January 2023 Deseret News/HarrisX poll, 55 percent of Americans supported banning gender hormone therapy for transgender minors with parental or guardian approval, while 45 percent opposed such a ban.

A May 2023 poll by The Washington Post/KFF found that a majority of Americans support some anti-trans policies despite also claiming to oppose discrimination for trans people.

A September 2023 poll by 19th News/SurveyMonkey found that 39 percent of American adults supported transgender minors having access to any kind of gender-affirming care, including puberty blockers, hormones, therapy, and surgery. Another poll by The 19th/SurveyMonkey that same month found that in a survey of 20,000 American adults, 17 percent believed politicians should focus on restricting gender-affirming care, while 33 percent believed they should focus on protecting access to gender-affirming care. The rest believed politicians should not focus on trans issues at all. A separate poll conducted by The 19th that month found that 7 in 10 Americans, including majorities in both major parties and independents, do not think politicians are informed enough about gender-affirming care to make fair policies on it.

A 2023 Gallup poll found that while 26% of Americans think trans athletes should be allowed to play on sports teams that match their gender identity, polls in five battleground states conducted by The New York Times/Siena College found a majority of Americans think society should accept transgender people's gender identities.

A February 2024 survey by YouGov found that a majority of Americans support laws and policies protecting transgender people from hate crimes and discrimination in employment, permitting transgender people to serve in the military, allowing government employees to use pronouns that match their gender identity and outlawing conversion therapy for transgender minors. However, it also found that a majority of Americans support laws and policies banning transgender women from women's sports and prisons, prohibiting minors from attending drag shows and creating a law that "defines gender as a person's sex assigned at birth". Additionally, the survey found that while 54% of Americans oppose allowing transgender minors to access gender-affirming care, only 45% support laws and policies banning the treatments for minors.

A March 2024 poll by GLAAD found that more than half of both registered and likely voters surveyed said they would not support a candidate who "speaks frequently about restricting access to health care and participation in sports for transgender youth."

A Gallup Poll released in June 2024 found that over 60% of U.S. adults oppose banning gender-affirming care for minors, but also found that just 44% of U.S. adults believe that change one's gender is morally acceptable, with 56% of 18-29 year olds saying it is morally acceptable compared to 38% of adults over age 65.

A June 2024 poll by the University of Chicago found that 70% of Democrats and 29% of Republicans supported laws that protect access to gender-affirming care for minors.

An October 2024 poll by the HRC found that only 5% of voters say they are concerned about gender-affirming care and 61% said they will not support candidates who support banning gender-affirming care, including 41% of Republicans. The poll also found that 70% of voters think that anti-LGBTQ+ legislation has gone too far and that politicians have targeted trans people to divide Americans and "maintain their political power."

An October 2024 poll by Baldwin Wallace University in Ohio found that 60% of registered voters in Ohio supported schools teaching 6th-12th grade students about sexual orientation but only 43% supported teaching students in those same grades about gender identity. Additionally, the poll found that 51% of voters in Ohio believe parents should not have direct control over what books are in the school library and 55% believe that parents should not be able to stop schools from teaching topics that they do not like. The poll also found that 72% of voters in Ohio would oppose policies or laws allowing medical professionals to provide someone younger than 18 with medical care for a gender transition and 73% would oppose policies or laws allowing transgender athletes to play on the team that matches their gender identity and 56% would support policies or laws requiring public schools to notify parents if it is discovered that a student identifies with a gender that does not align with their biological sex.

During the 2024 presidential election, anti-trans advertisements became commonplace, with the Republican party making trans issues a top issue in their campaign, spending over $215 million dollars on anti-trans ads and more than on ads regarding housing, immigration, and the economy combined. On the contrary, Democrats largely avoided discussing transgender issues during the election campaign period. The ads became especially common during the closing days of the race, often pushing disparaging claims about transgender healthcare, existence in society, and participation in sports. Democrats did not formerly respond to the ads during the campaign period. Former President Bill Clinton privately expressed concern about the ads and encouraged the Harris campaign to respond to it. However, he was told by the campaign that the ads "were not necessarily having an impact" and never addressed his concerns publicly. The Harris campaign had originally planned to release an ad responding, but the ad ended up performing poorly in internal tests and was ultimately never run.

According to an analysis by Future Forward, the political slogan "Kamala is for they/them, President Trump is for you" was ranked as one of the Trump's most effective 30-second attack ads, shifting the race 2.7 percentage points in favor of Trump after viewers watched it. On the contrary, an analysis by Change Research studying the effects of the ads found that they did not sway swing voters. A study by Ground Media also found that the ads did not sway voters into supporting Republicans, but they did succeed at slightly eroding public support for trans people in general. David Rochkind, the CEO of Ground Media, gave a press release saying "What this demonstrates is that attacking the trans community isn't just a weak and feckless political strategy — it's a deeply cynical one. ... These ads weaponize trans-identity to sow fear and division, making our country less safe for everyone." A poll by Blueprint surveyed the most important issues to voters and found that trans issues ranked second to last among young men. Another poll by Data for Progress found that a majority of voters from both major parties believe the government should stop involving themselves in the lives of trans people and that politicians should focus less on transgender issues and more on other issues like the economy. It also found that a majority of voters from both major parties believe republicans leaning so heavily on anti-trans ads is "sad and shameful". An October 2024 Gallup Poll surveying the most important issues to registered voters ahead of the 2024 presidential election found that of the 22 issues voters were asked about, transgender issues ranked last with only 18 percent of voters describing it as "extremely important". Democrats were also more likely than Republicans to say transgender issues were extremely important to them, 25% to 12%.

Vox Media said that anti-trans ads have "no impact on whether people are likely to vote" and compared them to the "rising tide of fascism in the United States". Kelley Robinson, the president of the Human Rights Campaign, called the ads "desperate" and accused Republicans of focusing on "sowing fear and chaos" instead of talking about other issues like the economy. Jay Brown, chief of staff at the Human Rights Campaign said that the ads have had a negative impact on the mental health of trans people due to it being "in their faces all the time." LGBTQ Nation called the ads "wildly unpopular" among voters and said "there is a solid chance that the fate of transgender rights could mirror that of gay rights, becoming a sport of "political albatross" that instantly kills support for candidates. As politicians become more anti-trans, some members of their base oppose them more — likely due to people perceiving this issue as irrelevant and mean-spirited."

These ads led two Democrat politicians, Sherrod Brown and Colin Allred, to capitulate, ceding the issue at least partially to the Republican position. After Donald Trump won the 2024 election, two Democrat politicians, Tom Suozzi and Seth Moulton, partially blamed their party's loss on their support for trans issues. Other Democrat politicians and human rights organizations disputed these claims, saying polls showed that trans issues were not important to most voters and that voters were instead mobilized to vote for Trump due to other issues like inflation and the economy. Texas Democratic Party Chair, Gilberto Hinojosa also expressed anti-transgender sentiments following the 2024 election. Hinojosa subsequently apologized for his comments and resigned from his position after receiving backlash from other Democrats and LGBTQ advocacy groups. The Harris campaign's LGBTQ engagement director, Sam Alleman, urged voters not to blame trans people for Harris' loss in the election saying "Please do not blame trans issues or trans people for why we lost. ... No exit polling or data is showing this as a significant decision point for voters."

An NBC News exit poll for the 2024 election found that Kamala Harris garnered more support from LGBTQ voters than any other presidential candidate in history, with 86% of LGBTQ voters backing Harris and 12% backing Donald Trump - a margin 15% larger than the edge Joe Biden had over Trump in 2020.

Supporters of LGBT rights argue that major US media outlets have taken part in furthering the backlash by publishing and promoting stories criticized by many experts and advocates as misinformation, fringe theories, fearmongering, and pseudoscience about LGBT people, and in particular trans people. Among these outlets were Reuters, Fox News, The Washington Post, The Atlantic, and most prolifically, The New York Times. These pieces have often been cited in legislation and court cases to restrict LGBT rights.

Some trans people and their families have fled to other states or countries, including the families of those who actively advocated against anti-trans laws in their states. Many families cite increasing social pressure and restrictions on gender-affirming care as reasons for moving.

Several states passed legislation preventing trans people and their families, as well as their healthcare providers relocating from other states, from being extradited. In 2022, Connecticut became the first state to implement such a law, alongside similar protections for reproductive healthcare providers and recipients. Massachusetts, California, Illinois, Minnesota, New Jersey, Maryland, and Washington, D.C. have passed similar laws.

Some trans Americans have considered claiming asylum in other countries, including European countries or Canada. However, some political analysts note that asylum applications will likely be denied, as no federal law exists restricting LGBT safety and because transgender individuals can likely move to a safer state in their own country. Others worry that potential asylum applications could overwhelm immigration systems and prevent asylum access for those from more dangerous territory.

The increased targeting of LGBT people by right-wing militia groups such as the Proud Boys and the Oath Keepers, has led some LGBT people, particularly in conservative states such as Texas, to stockpile and train to use weapons and gear, including AR-15 rifles and modern body armor.

In May 2023, the Human Rights Campaign issued a travel advisory for the state of Florida, citing new laws targeting the LGBT community.

After a ten-day tour in which he met with State officials in Alabama, Florida, and California in August 2022, Victor Madrigal-Borloz, a United Nations Independent Expert on protection against violence and discrimination, warned about the erosion of LGBT rights in the United States. Madrigal-Borloz stated, "I am deeply alarmed by a widespread, profoundly negative riptide created by deliberate actions to roll back the human rights of LGBT people at state level. The evidence shows that, without exception, these actions rely on prejudiced and stigmatising views of LGBT persons, in particular transgender children and youth, and seek to leverage their lives as props for political profit."

In August 2023, the Government of Canada issued a travel warning for LGBT visitors to the United States, advising citizens to check their destination's local laws before traveling.

• 21st century anti-trans movement in the United Kingdom
• Alt-right
• Anti-gender movement
• Democratic backsliding in the United States
• Homophobia
• LGBTQ history in the United States
• LGBTQ rights in the United States
• LGBTQ rights opposition in the United States
• Transphobia in the United States
• Transgender genocide
• Transgender rights in the United States
• United States anti-abortion movement
• Parental rights movement

• Mapping Attacks on LGBTQ Rights in U.S. State Legislatures, per ACLU
• Map: Attacks on Gender Affirming Care by State, per Human Rights Campaign
• 2023 Anti-Trans Legislation, per Track Trans Legislation
• 2023 LGBTQ Equality by State, per Movement Advancement Project
• Restrictions on Drag Performances, per Movement Advancement Project