Western United States
The western U.S. includes several states that actively protect transgender rights, including access to gender-affirming care. States such as California, Oregon, and Washington are considered affirming. Other western states may have partial restrictions or slower implementation, so access to care and policies can vary.
Central United States
The central U.S. has widespread restrictions. Most states ban gender-affirming care for minors and limit trans-inclusive school policies. States such as Texas, Oklahoma, and Arkansas are among the most restrictive. Only a few states in this region maintain affirming policies.
Eastern United States
The eastern U.S. is a mix of affirming and restrictive states. States like New York and New Jersey protect trans rights, while others impose bans or limitations on healthcare, public facilities, or school policies affecting transgender people. Overall, access is heavily restricted in many areas.
Threats of Institutionalisation
Trans people face threats of forced institutionalisation in some states, making this a severe ongoing risk.
Threat Level: 9/10
State-Level Bans on Gender-Affirming Care
Most U.S. states ban gender-affirming care for minors, including hormone therapy, puberty blockers, and surgeries.
Threat Level: 10/10
Other Ongoing Threats
Legal, social, and online harassment continues to target transgender people, particularly in restrictive states.
Threat Level: 8/10