Click to expand Image Lily, a 10-year-old trans girl, said she was devastated when her family felt forced to relocate to protect her from anti-trans hostility. © 2025 Illustrations by Barrack Rima, Art directed by Studio Safar for Human Rights Watch Laws banning gender-affirming care for transgender youth in the United States are inflicting severe harm on young people and their families as well as health care systems and civil society.Under the Trump administration, families are being pushed to the brink, forced to navigate impossible barriers to care, while the federal government intensifies its assault on transgender rights.The US has international legal obligations to protect the rights of transgender youth. Lawmakers should repeal these bans, ensure access to care, and protect transgender youth and their families.(New York) – Laws banning gender-affirming care for transgender youth in the United States are inflicting severe harm on young people and their families, Human Rights Watch said in a report released today. Since 2021, 25 states have enacted sweeping bans targeting this best-practice medical care, replacing gradual, evidence-based treatments with blunt and politically driven restrictions.The 98-page report, “‘They’re Ruining People’s Lives’: Bans on Gender-Affirming Care for Transgender Youth in the US,” documents the devastating consequences of these bans for transgender youth, including increased anxiety, depression, and, in seven reported instances, suicide attempts. Human Rights Watch found that these laws contribute to an increasingly hostile, anti-trans climate, compelling youth to hide their identities and socially withdraw. The bans also destabilize health care systems and undermine civil society and create geographic and financial challenges in accessing care. The impact has intensified since early 2025, when the administration of President Donald Trump took a series of executive actions escalating federal attacks on transgender rights. “US officials have cut off transgender youth from essential, life-affirming care, throwing them instead into the crosshairs of a cultural war,” said Yasemin Smallens, LGBT Rights Officer. “Families are being pushed to the brink, forced to navigate impossible barriers to care, while the federal government intensifies its assault on transgender rights.” June 3, 2025 “They’re Ruining People’s Lives” Bans on Gender-Affirming Care for Transgender Youth in the US Download the full report in English Human Rights Watch interviewed 51 people in 19 states who have been affected by these legislative bans, including transgender youth, parents, health care providers, and advocates. Human Rights Watch also consulted 32 LGBT rights organizers and conducted an additional round of interviews after President Trump’s inauguration to document the impact of his administration’s new policies. More than 100,000 transgender youth live in states with legislative bans on gender-affirming care for youth. Six states classify providing this care as a felony and eight state laws include vague “aiding and abetting” provisions that could penalize providers for making referrals or refilling prescriptions. The Trump administration has further attempted to restrict access through a January 28 executive order, which while not fully enforced, has caused some clinics to halt services in states where the care remains legal. A case challenging Tennessee’s ban, Skrmetti v. United States, is before the US Supreme Court, with a decision expected in June.Families affected by bans said that their children lost access to medical care with little or no notice and often without alternative options. Eleven families said they were compelled to travel out of state to consult physicians or obtain prescriptions. Several youth said they were unable to begin care due to legal barriers combined with geographic and financial obstacles. One family relocated to another state. “I want [lawmakers] to know they’re ruining people’s lives,” said an 18-year-old trans woman whose care was interrupted by a state ban. Youth who have retained access to care said the hostile legal and political environment has exacerbated their feelings of anxiety, depression, and isolation. State bans have compelled many health care providers to shut down or curtail services. People interviewed reported instances in which providers or institutions ceased services more than may have been legally required. State bans have had a cascading negative impact on health care systems, Human Rights Watch found, as providers in states with bans reported difficulty retaining existing providers and recruiting new doctors. Every health care provider interviewed said that they had experienced targeted anti-trans harassment. Providers said their institutions have increased their security budgets, diverting funds that could be used for patient care. Civil society organizations reported facing similar threats, alongside rising costs for safety measures.In Texas, affected individuals described the state’s extreme targeting of transgender people, including a 2022 directive that classified certain forms of gender-affirming care for youth as “child abuse.” As a result, some families reported avoiding health care interactions altogether to protect their children, whose transgender identity, if disclosed, could trigger child abuse investigations. In April 2025, President Trump issued a proclamation asserting that parents who affirm their child’s gender identity are committing abuse.“People are scared they're going to lose their kids,” one advocate said. “You don’t have to legislate it if you scare people so much that they self-police.”In the US, transgender youth typically undergo months or years of comprehensive evaluation before any medical interventions are initiated. Major medical organizations, including the American Medical Association, American Academy of Pediatrics, American Psychological Association, and the American Academy of Child and Adolescent Psychiatry, support access to this evidence-based, developmentally appropriate care.“The rhetoric in these legislative sessions suggests you just walk in and they’re handing you hormones and blockers,” one father said. “None of that happened. In the first year or more, not one prescription was written. They [doctors] said, ‘We're here to listen to you and react based on what you think your needs are.’ Which was incredible as a parent. It puts you at ease … It's a slow, methodical process.” The US has international legal obligations to protect the rights of transgender youth, including access to gender-affirming care, as part of its obligation to guarantee the rights to health, nondiscrimination, family integrity, and personal autonomy.“These laws are upending lives, driving young people into crisis, compelling families to uproot their lives, and fueling anti-trans hostility,” Smallens said. “Lawmakers should repeal these bans, ensure access to care, and protect transgender youth and their families so they can live safely and with dignity.”