Know What’s Changing. What you can Do, and Where you can Do It.
In 2026, the legislative focus on transgender Americans has shifted from targeting minors to adults. Advocates and transgender people alike have been warning that this would become the focus all along. Remember when they just wanted non-permanent items to help kids who feel they may be transgender or nonbinary experiment with gender expression? Now we are here restricting adults across healthcare, identification legal documents, public spaces, and federal records.
Welcome to Trumps Attack on Transgender People
As of February 2026, more than 700 anti-transgender bills are under consideration. These envelope 41 states, according to the Trans Legislation Tracker, ACLU’s MAP, and, HRC State of Emergency Map. Of the things we will speak of some are only proposals. Others are already in effect.
This post compiles current trends, specific state actions, and available protections.
A Resource for Help You Facilitate Change.
Trans Formations Project– this is a national tracker dedicated to educating the public about the anti-transgender legislative crisis. As well as a database of state and national representatives to facilitate direct advocacy. Use as a resource for contacting your representatives while supporting transgender people’s rights!
Healthcare & Insurance Restrictions
Several states are expanding or proposing limits on gender-affirming care beyond minors to effect transgender adults as well.
Oklahoma- SB 129-
Prohibits gender-affirming care for adults up to age 26, and makes it a felony for physicians to provide it.
Tennessee- HB 1215-
Prohibits medicaid from covering or reimbursing gender-affirming procedures for adults.
Maryland- HB 1399-
Though primarily for minors, it proposes life imprisonmentfor providers, creating a fear around providing transition related healthcare in-general.
The Erasure
At the federal and state levels, new rules for 2026 plan on the removal of gender-affirming care as a required “essential health benefit” coverage category. Thus, increasing insurance uncertainty for transgender U.S. citizens.
Redefining “Sex” in State Law
A growing legislative strategy involves codifying “biological sex” definitions that eliminate legal recognition of gender identity. Let’s not pretend that legal erasure and actual existence are not the same. We will always remain.
Kansas, SB 180 & SB 244
Titled the “Women’s Bill of Rights,” the original law defining sex as biological sex at birth for statutory purposes. Used by Attorney General Kris Kobach to halt gender marker changes, the Kansas court of appeals ruled in 2025 that it did not explicitly authorize the invalidation of existing licenses. Thus leading to the creation of SB 244 to “close the loophole”.
While SB 180 defines sex as assigned at birth. SB 244 follows up by using SB 180 to restrict current and future updates to driver’s licenses and birth certificates. This act invalidated already existing documents overnight and without providing funding for these replacements.
- Female: Defined as an individual whose system is developed to produce ova.
- Male: Defined as an individual whose system is developed to fertilize the ova of a female
Mass ID Invalidation
Kansas is currently the only state to execute a direct mass invalidation campaign.
Under Senate Bill 244, effective February 26, 2026, approximately 1,500 to 1,700 transgender residents who previously updated their gender markers legally received letters. These letters were declaring the individuals driver’s licenses and state issued identification cards invalid immediately. The American Civil Liberties Union (ACLU) of Kansas has filed legal challenges against the policy.
Texas, HB 229-
Often referred to as a “Women’s Bill of Rights,” codifies binary definitions of sex, man, and woman in state statute. It also excludes gender identity from state-level employment non-discrimination protections.
North Carolina HB 805-
This defines sex strictly by biological characteristics present at birth. While it explicitly states that “gender identity” is not legally or biologically equivalent to sex. All official state documentation, including driver’s licenses, must identify individuals by their sex at birth. While individuals can still technically amend the sex designation on a birth certificate, the state is now required to keep the original record attached to the updated one as a “multi-page document” rather than replacing it. This bill also prohibits the use of state funds for gender transition procedures for prisoners
Ohio- HB-33 & What it Grew-
House Bill 33 established the official policy of the State of Ohio to recognize only two sexes, male and female, declaring these sexes “not changeable and grounded in fundamental and incontrovertible reality
HB 693- this bill creates a new phrase in state law “affirming a child’s sex” which is defined as acknowledging only the biological sex a child was born with. It provides legal protections for parents and guardians who reject a child’s gender identity.
These definitions are also used to prohibit gender-affirming care for minors and restrict sports participation based on birth sex.
Indiana– SB 182 & SB 441-
SB 182 passed in 1/2026 mandates that local health officers mark sex only as male or female based on reproductive biology. It prohibits amending these markers except in very narrow cases of diagnosed sex development disorders
SB 441 wants to require the DOH to identify and revert previously altered birth certificates back to the sex assigned at birth. This bill has seen varying levels of movement.
Identification Changes at the Federal Level
Following a 2025 executive order:
Passports
Gender marker updates on U.S. passports are temporarily halted. New, renewed, or replacement passports must now reflect the applicant’s biological sex. Passports with previously updated markers remain valid for travel until they expire. However, once they are renewed or replaced (e.g., due to a name change), the marker will revert to the individual’s biological sex. On November 6, 2025, the U.S. Supreme Court stayed a lower court injunction. In order to allow the administration to enforce these restrictive policies while litigation continues.
Social Security Cards
Effective January 31, 2025, the SSA stopped processing requests to change gender markers in its records. Thought the cards do not physically display a gender marker, the SSA maintains this data in its database. Which is often used for identity verification and can be cross-referenced by other federal agencies, including the State Department. Court-ordered name changes are still being processed by the SSA and the State Department.
Department of Veterans Affairs
Announced plans to phase out most gender-affirming medical services for veterans in compliance with federal directives.
Effective immediately, the VA will not initiate cross-sex hormone therapy for any veteran with a new diagnosis or history of gender dysphoria.
VA has rescinded VHA Directive 1341, eliminating the following for alltransgender and intersex veterans:
Prosthetics and Aids: Wigs, chest binders, packers, and dilators.
Support Services: Voice training, hair removal (electrolysis/laser), and cryopreservation (fertility storage).
Referral Barriers: VA doctors are now prohibited from completing forms or providing letters of support for veterans seeking gender-affirming surgeries through private providers at their own expense
Veterans are now required to use bathrooms and locker rooms in VA facilities that align with their biological sex at birth.
Bathroom and Public Facility Restrictions
Ohio, HB 183
Requires all public and private K-12 schools, as well as colleges and universities, to designate multi-occupancy restrooms, locker rooms, and shower rooms for the exclusive use of either biological males or biological females.
“Biological sex” is defined by the bill as the sex assigned at or near birth, typically as indicated on an original birth certificate.
Utah, HB 257
Students are prohibited from using sex-specific restrooms, locker rooms, or changing rooms that do not match their biological sex at birth.
Schools must provide “privacy plans” for students who do not feel comfortable using their birth-assigned facilities. These plans may include access to single-occupant or faculty restrooms.
It is a criminal offense for an individual to enter a sex-designated changing room such as a locker room or shower room, that does not match their sex at birth.
As of February 2026, the Utah Legislature is considering further restrictions. HB 174 (2026) aims to permanently ban puberty blockers and hormone therapy for minors.
While HB 193 (2026) seeks to prohibit public funds or government-sponsored insurance from covering gender-affirming care for adults
West Virginia- SB 456-
Signed into law on March 12, 2025. Also known as the “Riley Gaines Act” or the “Stand with Women Legislation.” This Senate Bill codifies legal definitions of male and female based on biological characteristics at birth. While it also restricts access to single-sex spaces.
Iowa- SF- 482-
Requires all public and private K-12 schools to designate multi-occupancy restrooms and locker rooms for use only by individuals of the same biological sex. Students who do not wish to use facilities matching their sex at birth must submit a written parental request for “reasonable accommodations
Any Iowa citizen can file a complaint with the Attorney General if they believe a school is not complying.
Sanctuary and Shield States
Seventeen states and Washington, D.C., have enacted “shield” laws protecting individuals seeking gender-affirming care or helping with relocating them from hostile states.
Most Protective States
- Massachusetts
- Washington
- California
- Rhode Island
- Colorado
Common protections include:
Refusal to cooperate with out-of-state investigations
Mandatory insurance coverage for gender-affirming care
Strong employment and housing nondiscrimination laws
California’s SB 59 automatically seals court records related to gender transitions to protect privacy.
Sanctuary Cities
Some municipalities in restrictive states have declared limited sanctuary status.
Kansas City and Columbia, Missouri:
KC: Passed a resolution in May 2023 declaring itself a sanctuary for those seeking or providing gender-affirming care. It directs city staff to make enforcement of state-level restrictions their “lowest priority”.
Columbia: Approved a sanctuary ordinance in February 2024 that protects LGBTQ+ individuals and instructs law enforcement not to enforce state laws targeting gender-affirming care or bathroom access.
Lawrence, Kansas:
Formally identified as a sanctuary city to protect transgender residents’ rights and access to healthcare in defiance of state-level restrictions.
Austin, Texas:
One of the earliest major cities in a restrictive state to take local action to protect transgender residents and providers from state-level prosecution.
Madison, Wisconsin:
Declared itself a sanctuary city for transgender and nonbinary individuals in 2023, pledging not to use city resources to assist in out-of-state investigations related to gender-affirming care.
Small tip
Local enforcement priorities may differ from state-level directives.
Mutual Aide Saves Lives.
The 2026 legislative environment reflects a shift toward adult-focused restrictions, broader statutory definitions of sex, and administrative enforcement mechanisms such as ID invalidations.
However, protective states and sanctuary cities, continue to provide avenues for legal protection and relocation help.
Anyone directly impacted should verify current bill status through official state legislature websites and consult qualified legal counsel when necessary.
All Poeaxtry’s links
