A total of 25 states now have restrictions on gender-affirming care. Below is a list of the effective dates, exemptions, and penalties to clinicians for providing gender-affirming care. This list will be updated as new information becomes available.
Note that some bans may be blocked due to ongoing legal battles.
Alabama
In effect: May 8, 2022
Exemptions: A "medically verifiable disorder of sex development" including a chromosome disorder
Risks to Physicians: Felony offense with up to 10 years in prison and a fine up to $15,000
Arizona
In effect: March 31, 2023
Exemptions: A "medically verifiable disorder of sex development" including a chromosome disorder, or if patients need treatment for an injury related to their gender-affirming care
Risks to Physicians: No penalty specified
Arkansas
Note: A federal judge the ban on June 20, 2023. The state’s attorney general plans to appeal.
In effect: March 13, 2023
Exemptions: A "medically verifiable disorder of sex development" including a chromosome disorder, or if patients need treatment for an injury related to their gender-affirming care. Also if the provider has seen the minor for 2 years and the minor has seen a mental health professional who certifies the minor does not have other mental health conditions
Risks to Physicians: Minor or their guardian may bring civil action against the provider for physical, psychological, emotional, or physiological injury
Florida
Note: A federal judge bans on gender care for youth and adults, but the block was and can now be enforced.
In effect: May 17, 2023
Exemptions: A "medically verifiable genetic disorder of sexual development", and the state's osteopathic and medical boards must draft rules for situations where a minor may continue treatment
Risks to Physicians: Third-degree felony or first-degree misdemeanor depending on violation, with up to 5 years in prison and fines up to $5,000
Georgia
In effect: July 1, 2023
Exemptions: A "medically verifiable disorder of sex development" including chromosome abnormality, or if it's necessary to the health of the patient. Doctors can continue treatment for those who began prior to July 1, 2023 if treatments are irreversible
Risks to Physicians: Physicians can be "held administratively accountable" to the medical board
Idaho
In effect: April 14, 2024
Exemptions: A "medically verifiable genetic disorder of sex development," if it's necessary to the health of the patient, or if it's to treat any injury from their gender-affirming care
Risks to Physicians: Felony offense with up to 10 years prison and a fine up to $5,000
Indiana
In effect: July 1, 2023
Exemptions: Doctors may continue giving hormone treatment to grandfathered patients until the end of 2023
Risks to Physicians: Minors can bring a case against a physician until they are 28; can face medical board disciplinary action
Iowa
In effect: March 22, 2023
Exemptions: A "medically verifiable genetic disorder of sex development," if it's necessary to the health of the patient, or if treating any injury from gender-affirming care
Risks to Physicians: Treatment is considered "unprofessional conduct" and doctors are subject to discipline by the medical board; providers can be sued
Kentucky
In effect: March 29, 2023
Exemptions: A "medically verifiable disorder of sex development" or if they need treatment related to their gender-affirming care
Risks to Physicians: A doctor's medical license can be revoked and providers can be sued
Louisiana
In effect: January 1, 2024
Exemptions: A "medically verifiable disorder of sex development"; providers can continue care but it must be withdrawn by the end of 2024.
Risks to Physicians: A doctor's medical license can be revoked and providers can be sued
Mississippi
In effect: February 28, 2023
Exemptions: A "medically verifiable disorder of sex development" or to treat any injury related to gender-affirming care
Risks to Physicians: Treatment is considered "unprofessional conduct" and a doctor's medical license can be revoked, in addition to up to a $500 fine; providers can be sued
Missouri
In effect: August 28, 2023
Exemptions: A "medically verifiable disorder of sex development," if previous gender-affirming care caused an injury, or if there is a physical condition that places a person in "imminent danger of death or impairment of a major bodily function"
Risks to Physicians: Treatment is considered "unprofessional conduct" and healthcare providers can have their license revoked and be sued
Montana
Note: A state judge enforcement of the ban on September 27, 2023.
In Effect: October 1, 2023
Exemptions: "Medically verifiable" disorders of sex development, including chromosomal abnormalities
Risks to Physicians: Subject to medical board discipline that must include at least a year-long suspension; providers can be sued
Nebraska
In effect: October 1, 2023
Exemptions: A "medically verifiable disorder of sex development," and the state's chief medical officer will make rules around exceptions for nonsurgical procedures, such as puberty blockers and hormones for an "intense pattern of gender nonconformity or gender dysphoria"
Risks to Physicians: Treatment is considered "unprofessional conduct" and providers are subject to disciplinary action
North Carolina
In effect: October 1, 2023
Exemptions: A "medically verifiable genetic disorder of sexual development"
Risks to Physicians: Physicians can be disciplined and fined by the medical board
North Dakota
In Effect: April 20, 2023
Exemptions: "If performance or administration of the medical procedure on the minor began before the effective date of this Act." Minors currently receiving gender-affirming care will still be able to receive treatment
Risks to Physicians: Felony offense for surgery up to 10 years in prison and a fine up to $20,000, misdemeanor offense for gender-affirming medication up to 1 year in prison and a fine up to $3,000
Ohio
In effect: August 6, 2024
Exemptions: A "medically verifiable disorder of sex development," including chromosome abnormality, or treatment for an injury related to gender-affirming care.
Risks to physicians: Physicians can be sued, and treatment is considered "unprofessional conduct" subject to medical board discipline.
Oklahoma
In effect: May 2, 2023
Exemptions: Doctors can continue to provide puberty blockers or hormones for 6 months to help patients ultimately discontinue therapy
Risks to Physicians: Physicians face felony charges and license revocation, and lawsuits can be filed by a parent or guardian
South Carolina
In effect: May 21, 2024
Exemptions: Doctors can taper patients who started puberty blockers or hormones prior to August 1, 2024 until January 21, 2025
Risks to physicians: Physicians can be sued, and treatment is considered "unprofessional conduct" subject to medical board discipline
South Dakota
In effect: July 1, 2023
Exemptions: A "medically verifiable disorder of sex development" including chromosome abnormality, or treatment for an injury related to gender-affirming care
Risks to Physicians: Physicians can lose their license and providers can be sued
Tennessee
In effect: July 1, 2023
Exemptions: Patients are allowed to continue treatment if they started it before July 1, 2023, but care must end by March 31, 2024
Risks to Physicians: $25,000 per violation; license actions also possible; providers can be sued
Texas
In effect: September 1, 2023
Exemptions: Those currently on hormones or puberty blockers and those who have attended at least 12 sessions of mental health counseling over 6 months before starting treatment can continue, but should gradually be weaned.
Risks to Physicians: Physicians can lose their license
Utah
In effect: January 28, 2023
Exemptions: Hormonal treatments are prohibited for patients who haven't been diagnosed with gender dysphoria by the time the law went into effect. It also requires the state health department to conduct a systematic review of the evidence on hormonal treatments. In addition, the state's licensing department must create a "transgender treatment certification" for healthcare professionals by July 1, 2023
Risks to Physicians: Providing treatment without a transgender treatment certification will be considered "unprofessional conduct"; providers can be sued
West Virginia
In effect: January 1, 2024
Exemptions: Patients can get hormone therapy with parental consent and a diagnosis of severe gender dysphoria from two clinicians, including a mental health provider or an adolescent medicine specialist. Doctors can also prescribe hormones if a teenager is considered at risk for self-harm or suicide
Risks to Physicians: No penalty specified
Wyoming:
In effect: July 1, 2024
Exemptions: Treatments with consent of a parent or guardian that are for a "medically verifiable genetic disorder of sex development" or for "medically verifiable central precocious puberty."
Risks to Physicians: Physicians, nurses, or pharmacists can have their licenses suspended, revoked, or restricted.
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