New Democracy Maps

Transgender Healthcare "Shield" Laws

Transgender people’s access to best-practice health care—sometimes also called gender-affirming care—is increasingly under attack. In response, a growing number of states are taking action to protect access to this medically necessary health care. These “shield” or “refuge” laws can vary from one state to the next, but their primary goal is to protect transgender people, their families, and their medical providers against these ongoing attacks and to protect access to transgender-related health care.  For example, if a person travels from a state where transgender healthcare is banned and receives that care in another state, a "shield" law can protect the recipient and/or provider of that healthcare against civil or criminal charges from the state where healthcare is banned. 
United States Map
Washington New York U.S. Virgin Islands Puerto Rico Guam Commonwealth of the Northern Mariana Islands American Samoa New Hampshire Vermont Virginia Pennsylvania New York Maine West Virginia Ohio Kentucky Indiana Michigan Illinois Wisconsin North Carolina South Carolina Tennessee Georgia Florida Mississippi Missouri Arkansas Louisiana Iowa Minnesota Oklahoma Kansas Nebraska South Dakota North Dakota Texas 33 Colorado Wyoming Montana Idaho Arizona Utah Nevada Oregon California Hawaii Alaska Massachusetts Rhode Island Connecticut New Jersey Delaware Maryland Washington D.C. New Hampshire Vermont
  • State has "shield" law protecting access to transgender health care (9 states + D.C.)
  • State has "shield" executive order protecting access to transgender health care (1 state)
  • No "shield" law or policy protecting access to transgender health care (40 states, 5 territories)
  • State bans or restricts best practice medical care for transgender youth (see this map for more information) (20 states)
Note: For more information about how these laws vary, click "Citations" to find more information and additional sources.

Recommended citation: 
Movement Advancement Project. "Equality Maps: Transgender Healthcare 'Shield' Laws." Accessed 06/06/2023.

Percent of Transgender Population Covered by Laws

*Note: These percentages reflect estimates of the transgender population (ages 13+) living in the 50 states and the District of Columbia. Estimates of transgender people in the U.S. territories or under age 13 are not available, and so cannot be reflected here. Population estimates are from The Williams Institute.


27 % of transgender population (ages 13+) live in states that have "shield" law protecting access to transgender health care


3 % of transgender population (ages 13+) live in states that have "shield" executive order protecting access to transgender health care


70 % of transgender population (ages 13+) live in states that have no "shield" law or policy protecting access to transgender health care

  • State has this lawState has "shield" law or executive order
  • ,
State "Shield" Law Protecting Transgender Healthcare Access Year Passed
American Samoa
California State has this law 2022
Colorado State has this law 2023
Connecticut State has this law 2022
District of Columbia State has this law 2023
Illinois State has this law 2023
Massachusetts State has this law 2022
Minnesota State has this law 2023
New Hampshire
New Jersey State has this law 2023
New Mexico State has this law 2023
New York
North Carolina
North Dakota
Northern Mariana Islands
Puerto Rico
Rhode Island
South Carolina
South Dakota
U.S. Virgin Islands
Vermont State has this law 2023
Washington State has this law 2023
West Virginia

Data current as of 06/02/2023
This map is powered by

Stay Informed

Be the first to know about new reports and MAP news by signing up for our newsletter

Request User Access

A limited set of materials is restricted to the staff and board members of LGBTQ movement organizations. Click below to request user access.

Join MAP

View our privacy policy.

Sexual Orientation Policy Tally

The term “sexual orientation” is loosely defined as a person’s pattern of romantic or sexual attraction to people of the opposite sex or gender, the same sex or gender, or more than one sex or gender. Laws that explicitly mention sexual orientation primarily protect or harm lesbian, gay, and bisexual people. That said, transgender people who are lesbian, gay or bisexual can be affected by laws that explicitly mention sexual orientation.

Gender Identity Policy Tally

“Gender identity” is a person’s deeply-felt inner sense of being male, female, or something else or in-between. “Gender expression” refers to a person’s characteristics and behaviors such as appearance, dress, mannerisms and speech patterns that can be described as masculine, feminine, or something else. Gender identity and expression are independent of sexual orientation, and transgender people may identify as heterosexual, lesbian, gay or bisexual. Laws that explicitly mention “gender identity” or “gender identity and expression” primarily protect or harm transgender people. These laws also can apply to people who are not transgender, but whose sense of gender or manner of dress does not adhere to gender stereotypes.

Choose an Issue