States With Specific Gender-Affirming Care Restrictions
A number of states have passed legislation restricting gender-affirming care. These laws are not specific to audiology or speech-language pathology services, but it is unclear whether the restrictions may impact working with transgender clients. The language used below is consistent with state statutes.
This information is reviewed on an annual basis. Please be advised that laws, regulations, and policies may change at any time, so always check with your state for the most up-to-date information. This material is shared for informational purposes only and should not be construed as legal advice, which can only be provided by an attorney.
See also: Gender-Affirming Voice Therapy Advocacy
Alabama
Alabama bans any “person” (which is widely defined) to engage in or cause any practices to be performed upon a minor to attempt to alter the appearance or affirm a minor’s perception of their gender, including: prescribing, administering medication, or performing surgeries to delay or transition the gender of minors. Violations of the law are a Class C Felony.
The law exempts individuals who were born with medically verifiable disorder of sex development.
Reference: HB 184 (2022) [PDF]
Arizona
Arizona prohibits physicians from providing irreversible gender reassignment surgery to minors.
The law exempts individuals who were born with medically verifiable disorder of sex development, treatment of injury caused by a gender transition procedure, or other physical injury or illness that would put the individual in imminent danger of death or impairment.
Reference: SB 1138 (2022) [PDF]
Arkansas
Arkansas law prohibits physicians or other health care professionals from providing hormonal or surgical gender transition procedures or making a referral for such. The law also prohibits the payment of public funds to any entity, organization or individual who provides gender transition procedures to minors, including Medicaid. No other health benefit policy plan may include reimbursement for these services. Provision of these services will be subject to discipline by the appropriate licensing entity. The law allows a private right of action against health care professionals for damages brought about by the provision of these services.
The law exempts individuals who were born with medically verifiable disorder of sex development, treatment of injury caused by a gender transition procedure, or other physical injury or illness that would put the individual in imminent danger of death or impairment.
Reference: HB 1570 (2021) [PDF]
Arkansas allows a private right of action against health care professionals by a minor who has been injured by a gender transition procedure or related treatment and the after effect of a gender transition procedure or related treatment. The law lists defenses to the civil action.
The law exempts individuals who were born with medically verifiable disorder of sex development, treatment of injury caused by a gender transition procedure, or other physical injury or illness that would put the individual in imminent danger of death or impairment.
Reference: SB 199 (2023) [PDF]
Florida
Florida prohibits the provision of or referral for sex-reassignment prescriptions or procedures for minors, including puberty blockers, administration of hormones or medical procedures to affirm a person’s perception of their sex if that perception is inconsistent with their biological sex. The law also prohibits the use of public funds on gender-affirming care for both minors and adults. Provision of these services is a felony and will be subject to discipline by the appropriate licensing entity.
The law exempts individuals who were born with medically verifiable disorder of sex development, treatment of injury caused by a gender transition procedure, or other physical injury or illness that would put the individual in imminent danger of death or impairment.
Reference SB 254 (2023) [PDF]
This law is currently in effect but pending appeal in the Eleventh Circuit Court of Appeals.
Georgia
Georgia law prohibits irreversible procedures or therapies from being performed on minors for treatment of gender dysphoria, including sex reassignment surgeries or other surgeries to alter sexual characteristics or hormone replacement therapy. Practitioners who violate the law will be held accountable to the licensing board.
The law exempts individuals who were born with medically verifiable disorder of sex development, who are being treated for other medical conditions or where sex reassignment is deemed medically necessary, who are diagnosed with partial androgen insensitivity syndrome or continued hormone replacement that was started prior to July 1, 2023.
Reference: SB 140 (2023) [PDF]
This law is currently in effect but pending appeal in the Eleventh Circuit Court of Appeals.
Idaho
Idaho law prohibits medical providers from altering the appearance of or affirming the child’s perception of their sex if that perception is inconsistent from their biological sex, including both surgical and hormone therapies. Providing such care is a felony and may carry monetary penalties.
The law exempts individuals who were born with medically verifiable disorder of sex development, or treatment of injury caused by a gender transition procedure.
Reference: HB 71 (2023) [PDF]
Idaho law also prohibits taxpayer dollars from being used to provide gender-affirming care, including treatment in government facilities by physicians employed by taxpayer-funded entities. It also bans reimbursement of those services by Idaho Medicaid.
Reference: HB 668 (2024)
Indiana
Indiana law prohibits physicians or other practitioners from providing gender transition procedures to a minor, including performing medical or surgical services or prescribing drugs related to gender transition. The law also prohibits aiding another provider in provision of the services. A violation is subject to discipline by the licensing board. The law allows a private right of action against health care professionals for damages brought about by the provision of these services.
The law exempts individuals who were born with medically verifiable disorder of sex development, treatment of injury caused by a gender transition procedure, or other physical injury or illness that would put the individual in imminent danger of death or impairment.
Reference: SB 480 (2023) [PDF]
Iowa
Iowa law prohibits health care professionals from performing surgeries on or prescribing hormones to a minor for the purpose of attempting to alter the appearance of, or affirm the minor’s perception of, their gender or sex if that appearance or perception is inconsistent with the minor’s biological sex. The law also prohibits aiding another provider in provision of the services. A violation is considered unprofessional conduct and subject to discipline by the licensing board. The law allows a private right of action against health care professionals for damages brought about by the provision of these services.
The law exempts individuals who were born with medically verifiable disorder of sex development, treatment of injury caused by a gender transition procedure, or other physical injury or illness that would put the individual in imminent danger of death or impairment.
Reference: SF 538 (2023) [PDF]
Kansas
Kansas law prohibits health care providers from treating a child whose gender identity is inconsistent with the child’s sex. The law allows a private right of action against health care professionals for damages brought about by the provision of these services and requires professional discipline against a health care provider who performs such treatments. The law restricts the use of state funds to provide or subsidize medication or surgery as a treatment for gender transitioning and prohibits professional liability insurance from covering damages for health care providers that provide gender transition treatment to children.
The law exempts individuals who were born with medically verifiable disorder of sex development.
Reference: SB 63 (2025) [PDF]
Kentucky
Kentucky law prohibits a health care provider from performing surgery or prescribing hormone therapy for any minor for the purposes of altering the appearance of or validating their perception of their sex if it is inconsistent with their biological sex. Violations of the law will result in the loss of license. The law allows a private right of action against health care professionals for damages brought about by the provision of these services.
The law exempts individuals who were born with medically verifiable disorder of sex development or treatment of injury caused by a gender transition procedure.
Reference: SB 150 (2023) [PDF]
Louisiana
Louisiana law prohibits physicians or other medical health care professionals from providing gender transition procedures to any minor. Violations of the law will result in the loss of license for two years. The law allows a private right of action against health care professionals for damages brought about by the provision of these services.
The law exempts individuals who were born with medically verifiable disorder of sex development, treatment of injury caused by a gender transition procedure, or other physical injury or illness that would put the individual in imminent danger of death or impairment.
Reference: HB 648 (2023)
Mississippi
Mississippi law prohibits health care professionals from providing gender transition procedures to minors, including performing surgery or prescribing hormone therapy. The law also prohibits the use of public funds for gender transition procedures. A health care professional who violates this law will have their license to practice revoked. The law allows a private right of action against health care professionals for damages brought about by the provision of these services.
The law exempts individuals who were born with medically verifiable disorder of sex development or treatment of injury caused by a gender transition procedure.
Reference: HB 1125 (2023) [PDF]
Missouri
Missouri law prohibits a health care provider from performing gender transition surgery or prescribing hormones for the purpose of gender transition for minors. The law allows minors who began taking hormones prior to August 28, 2023, to continue with treatment. Gender-affirming surgeries for adult inmates and prisoners is prohibited. Violations of the law will result in the loss of license due to unprofessional conduct. The law allows a private right of action against health care professionals for damages brought about by the provision of these services. The bill also prohibits the use of public funds for gender-affirming care for adults or minors.
The law exempts individuals who were born with medically verifiable disorder of sex development, treatment of injury caused by a gender transition procedure, or other physical injury or illness that would put the individual in imminent danger of death or impairment.
Reference: SB 49 (2023) [PDF]
Montana
Montana law prohibits health care professionals from providing surgical or hormone treatment to address a minor’s perception of their biological sex. A violation of the law shall be considered unprofessional conduct and shall result in the revocation of the health care provider's professional license. Additionally, the prescription or administration of cross-sex hormones or puberty-blocking drugs to a minor for a gender transition shall be grounds for a cause of action against the health care provider.
The law exempts individuals who were born with medically verifiable disorder of sex development or treatment of injury caused by a gender transition procedure.
Reference: SB 99 (2023) [PDF]
The Fourth Judicial District Court Missoula County permanently blocked SB 99 (2025).
Nebraska
Nebraska law prohibits health care practitioners from performing surgical gender-altering procedures on individuals under the age of 19. The law also bans hormones and puberty blockers for minors unless the individual, family, and provider are able to meet specific criteria outlined by the State. This does not prevent continued hormone treatment if started prior to the date of the law. A violation of the law is considered unprofessional conduct. The law allows a private right of action against health care professionals for damages brought about by the provision of these services.
The law exempts individuals who were born with medically verifiable disorder of sex development, treatment of injury caused by a gender transition procedure, or other physical injury or illness that would put the individual in imminent danger of death or impairment.
Reference: LB 574 (2023) [PDF]
New Hampshire
New Hampshire law prohibits gender reassignment surgery or the use of puberty blockers or cross-sex hormone medication for minors. Any referral for or provision of these services to a minor is considered unprofessional conduct and is subject to discipline by the appropriate licensing entity. The law allows a private right of action against health care professionals for damages brought about by the provision of these services.
Reference: HB 619 (2024) and HB 377 (2025)
North Carolina
North Carolina law prohibits medical professionals from performing gender transition surgery or prescribing hormone treatment to a minor. Violations of the law will result in the loss of license. The law allows a private right of action against health care professionals for damages brought about by the provision of these services. The use of state funds for gender-affirming care for minors is prohibited.
The law exempts individuals who were born with medically verifiable disorder of sex development, treatment of injury caused by a gender transition procedure, or other physical injury or illness that would put the individual in imminent danger of death or impairment.
Reference: HB 808 (2023) [PDF]
North Dakota
North Dakota law prohibits surgery or hormone therapy for minors to change or affirm their perception of their sex if it is inconsistent with their biological sex. This does not prevent continued hormone treatment if started prior to the date of the law. Provision of surgical gender-affirming care is considered a felony and provision of hormone therapy is a misdemeanor.
The law exempts individuals who were born with medically verifiable disorder of sex development or treatment of injury caused by a gender transition procedure.
Reference: HB 1254 (2023) [PDF]
Ohio
Ohio law prohibits physicians from providing gender reassignment surgery or hormone therapy for minors. This does not prevent continued hormone treatment if initiated prior to the effective date of the law. The use of state funds for gender-affirming care for minors is prohibited.
Reference: HB 68 (2024) [PDF]
Oklahoma
Oklahoma law prohibits physicians from providing surgical gender reassignment treatment or hormones and puberty blockers to minors. A violation of the law is considered unprofessional conduct. The law allows a private right of action against health care professionals for damages brought about by the provision of these services.
The law exempts individuals who were born with medically verifiable disorder of sex development.
Reference: SB 613 (2023) [PDF]
South Carolina
South Carolina law prohibits health care professionals from performing gender transition procedures to minors. Violations of the law are considered unprofessional conduct and a felony. The law allows a private right of action against health care professionals for damages brought about by the provision of these services. The use of state funds for gender-affirming care is prohibited.
Reference: H. 4624 (2024)
South Dakota
South Dakota prohibits health care professionals from performing surgery or prescribing hormone treatment for the purpose of attempting to alter the appearance of, or to validate a minor's perception of their sex, if that appearance or perception is inconsistent with their biological sex. Violations of the law will result in loss of license.
The law exempts individuals who were born with medically verifiable disorder of sex development or treatment of injury caused by a gender transition procedure.
Reference: HB 1080 (2023) [PDF]
Tennessee
Tennessee law prohibits a health care provider from performing or offering to perform, or administering or offering to administer to a minor, a medical procedure if the performance or administration of the procedure validates a minor's perception of their sex, if that appearance or perception is inconsistent with their biological sex, including via telehealth. Violations are a class B misdemeanor. The law allows a private right of action against health care professionals for damages brought about by the provision of these services.
The law exempts treatment of a congenital defect, disease or physical injury, or a procedure that began prior to the law.
Reference: SB 1 (2023) [PDF]
Texas
Texas law prohibits a health care provider from performing surgery or hormone therapy for the purposes of transitioning a child’s biological sex to affirm their perception of their sex if it is inconsistent with their biological sex. Violations of the law will result in the loss of license. The use of state funds for gender-affirming care is prohibited.
The law exempts individuals who were born with medically verifiable disorder of sex development or precocious puberty.
Reference: SB 14 (2023) [PDF]
Utah
Utah law prohibits a health care provider from providing surgery or hormonal treatment on a minor for the purpose of effectuating or facilitating an individual's attempted sex change. Violations of the law are considered professional misconduct. The law allows a private right of action against health care professionals for damages brought about by the provision of these services.
The law exempts individuals who were born with medically verifiable disorder of sex development or precocious puberty.
Reference: SB 16 (2023) [PDF]
West Virginia
West Virginia law prohibits a physician from providing irreversible gender reassignment surgery or gender-altering medication to minors.
The law exempts individuals who were born with medically verifiable disorder of sex development, treatment of injury caused by a gender transition procedure, or other physical injury or illness that would put the individual in imminent danger of death or impairment. The law also exempts minors experiencing severe gender dysphoria if they meet certain criteria.
Reference: HB 2007 (2023) [PDF]
Wyoming
Wyoming law prohibits transitioning a child's biological sex as determined by the sex organs, chromosomes and endogenous profiles of the child or affirming the child's perception of the child's sex if that perception is inconsistent with the child's biological sex. Violations of the law will result in practitioners having their licenses revoked, suspended, or limited.
The law exempts individuals who were born with medically verifiable disorder of sex development or precocious puberty.
Reference: SF 99 (2024)
