Mapping Transgender Policies

The current onslaught of anti-trans legislation has resulted in an inconsistent mix of state-level policies across the country. Some states have introduced bills that ban trans youth from accessing gender-affirming care, even though having access to care, such as puberty blockers and gender-affirming hormones, decreases the odds of depression and suicidality in genderqueer youth. This patchwork of policies can influence different social and political factors that may improve or impede health equity among trans individuals.

Researcher Nolan Kline and colleagues examined state-level policies to identify laws that may affect the health and well-being of trans individuals. They conducted a nationwide scan of laws and bills involving trans populations and identified 698 that may affect trans individuals’ health and impact health equity.

While the visibility of transgender people has increased rapidly over the last decade, many still experience implicit and explicit forms of discrimination, physical and emotional violence, and rejection from family and friends. In the largest survey of trans people, 39% of respondents felt significant psychological distress, and 23% avoided seeing medical professionals because of fear of mistreatment. In addition, a trans individual’s experience can be directly tied to the physical place they are; trans individuals may face hostility and discrimination in public spaces, such as on mass transit.

The researchers calculated a ratio of the affirming and exclusionary bills and created inclusivity scores for each state, as depicted in the map above. The findings show that the policy landscape is deeply polarized, with some states passing more inclusive policies and others passing more exclusionary ones. These findings suggest that trans individuals’ experiences can vastly differ depending on their location.

Databyte via Nolan S. Kline, Nathaniel J. Webb, Kaeli C. Johnson, et al. Mapping transgender policies in the US 2017–2021: The role of geography and implications for health equity. Health & Place, 2023.