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Talking About Transgender Peop…

Talking About Transgender People and Restrooms

Authors

Movement Advancement Project

Partners

Advocates for Trans Equality

Equality Federation Institute

GLAD Law

GLAAD

National Center for LGBTQ Rights

PFLAG National

The Trevor Project

The Bottom Line

Just like any other family, the family of a transgender young person should have the freedom to work with doctors to ensure that their child can receive the health care they need. When transgender youth receive the care they need, they are able to thrive and have healthy, happy childhoods that set them up for success in life. But anti-LGBTQ politicians are enacting laws to ban this medically necessary care, putting the health and well-being of transgender young people are risk.

This guide provides layered approaches for conversations that can help audiences understand why this care is so vitally important for transgender youth, and why banning it is so harmful.

Talking About Transgender Youth Health Care

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Recommended citations:

Movement Advancement Project. March 2023 (updated August 2025). “Talking About Transgender Youth Health Care.” MAP’s Talking About LGBT Issues Series. https://www.mapresearch.org/talking-about-transgender-youth-health-care

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Equality Methodology

Key Definitions

LGBTQ: The term “LGBTQ” stands for lesbian, gay, bisexual, transgender, and queer, though the acronym can also refer to and include other sexual orientations or gender identities that are not explicitly listed in the acronym.

Sexual Orientation: The term “sexual orientation” is loosely defined as a person’s pattern of emotional, romantic, or sexual attraction (or lack thereof) to other people. Laws that explicitly mention sexual orientation primarily protect or harm lesbian, gay, bisexual, queer, and other non-heterosexual people. That said, transgender people who are also lesbian, gay, bisexual, or queer can be affected by laws that explicitly mention sexual orientation.

Gender Identity: “Gender identity” is a person’s deeply-felt inner sense of their own gender, including being male, female, or something else or in-between. For transgender people, their gender identity typically does not match the sex they were thought to be at birth. “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 each independent of sexual orientation, and transgender people may identify as heterosexual, lesbian, gay, bisexual, queer, or another orientation. 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 self or gender expression does not adhere to gender stereotypes.

Methodology

As of June 1, 2025, MAP tracks over 50 LGBTQ-related laws and policies in all 50 states, Washington D.C., and the five populated U.S. territories. For these policies, MAP assigns a score or point value, and then adds these scores to create a “policy tally” for each state. Policy scores are sorted into simple categories (Negative, Low, Fair, Medium, and High) to be able to quickly and easily compare the overall LGBTQ policy landscape in states across the country.

The major categories of laws covered by the policy score currently include:

Relationship and Parental Recognition
Nondiscrimination
Religious Exemptions
LGBTQ Youth
Health Care
Criminal Justice
Identity Documents

Harmful or discriminatory policies earn negative points or point deductions, while LGBTQ-inclusive or protective laws earn positive points. Fractions of a point may be awarded for states that have enacted a portion of a law, or in cases where local laws provide some protection but do not cover the entire state population. Quarter-points are the smallest increment.

Policies are evaluated and scored based on their relevance to sexual orientation and gender identity. As a result, each state has three scores: a Sexual Orientation score, a Gender Identity score, and then an Overall (combined) score. Having both the sexual orientation and gender identity scores illustrates how LGBQ-related versus transgender-related policies differ across the country.

States are also categorized as “Negative,” “Low,” “Fair,” “Medium,” or “High,” based on their tally score relative to the total tally points possible. This categorization allows for clear comparisons of the LGBTQ policy landscape across states. Categorizations are based on a percentile of the total positive points possible, as shown below.

Depending on a state’s score, the state could have the same categorization for all three scores or different categorizations for each. Table 1 shows the cut-offs for each categorization in each of the three measures.

Scoring Table

	Sexual Orientation Tally	Gender Identity Tally	Overall Tally
High (75-100% of total points possible)	17.25+	19.5+	36.75+
Medium (50-74.9% of total points possible)	11.5 to 17	13 to 19.25	24.5 to 36.5
Fair (25-49.9% of total points possible)	5.75 to 11.25	6 to 12.75	12.25 to 24.25
Low (0-24.9% of total points possible)	0 to 5.5	0 to 5.75	0 to 12
Negative (<0 points)	<0	<0	<0
Total points possible	23	26	49

Note: no updates to the scoring system’s thresholds have been required since October 2024.

Note that the scores look only at existing laws. They do not look at the social climate, nor do they take into account implementation of each state’s laws. The score also does not reflect the efforts of advocates and/or opportunities for future change. States with low scores might shift rapidly with an influx of resources, and states with higher scores might continue to expand equality for LGBTQ people in ways that can provide models for other states.

Description of Laws / Policies

Relationship and Parental Recognition

These laws pertain to relationship recognition and parental recognition rights, such as adoption and foster parenting, for LGBTQ people and parents. Historically, laws regarding relationship recognition are more directly related to sexual orientation than to gender identity.

Marriage Recognition	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
As a result of the 2015 U.S. Supreme Court decision in Obergefell, same-sex couples can marry nationwide and states must extend all the rights and benefits of marriage to same-sex couples. As a result, the following benefits are available to all married same-sex couples on the same basis they are available to married different-sex couples: Marriage for Same-Sex Couples Medical Decision-Making Authority for Married Same-Sex Couples Stepparent Adoption for Married Same-Sex Couples Joint Adoption for Married Same-Sex Couples		1
Second-Parent Adoption for Unmarried Couples	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Second-parent adoption laws permit a parent in a relationship to adopt their partner's child and become a legal parent of that child, giving the child two legal parents and giving both parents legal rights. LGBTQ people often create families in diverse ways, including outside of legal marriage, so these laws help protect LGBTQ parents’ rights without requiring legal marriage.	Only parents in legally recognized relationships can petition to adopt their partner’s child.	0	These laws permit adoption of a child by a second parent who is not married to the child’s parent, irrespective of one’s gender identity. Therefore, enumerating gender identity is outside of the scope of these laws.
	Parents can petition for second-parent or stepparent adoption statewide irrespective of parents' marital status or legal recognition of their relationship.	1
Confirmatory Adoption	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
A confirmatory adoption is a streamlined process established by law to confirm a parent’s existing legal relationship to a child. The parent may have established parentage through other means, but completing the confirmatory adoption process results in a formal adoption decree. Other means of establishing parentage can include the marital presumption (the presumption that married parents are the parents of a child born during their marriage), the holding out presumption (the presumption that if a person acted as a parent to a child, such as by providing a home and raising them, then they are a parent), or as someone who intended to parent a child born through assisted reproduction. In the streamlined confirmatory adoption process, the home study or background check requirements associated with other types of adoptions are not required.	Confirmatory adoption is not available.	0
	Confirmatory adoption is available.	1
Voluntary Acknowledgment of Parentage	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
For most children born to unmarried parents, legal recognition of parentage is established through the “voluntary acknowledgment of parentage” (VAP), a legal document typically completed at the hospital at the time of the child’s birth. There are no costs associated with it, and once it takes effect, it is the legal equivalent of a court decree of parentage and, under federal law, must be respected across state lines and in all jurisdictions. However, in many states, only men who are believed to be the genetic father of the child in question are permitted to sign VAPs. As a result, many LGBTQ families face obstacles to this pathway to parental recognition. Now, a growing number of states are updating their parenting laws to ensure that any parent—regardless of their gender, sexual orientation, or genetic relationship to the child—can sign a VAP and have their parental relationship legally recognized and protected.	State has not yet expanded access of Voluntary Acknowledgment of Parentage (VAP)	0
	State has Voluntary Acknowledgment of Parentage (VAP) that is explicitly available to non-genetic and LGBTQ parents	1
Family Services Nondiscrimination Protections for LGBTQ Parents: Adoption	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Adoption nondiscrimination policies protect LGBTQ parents from discrimination by adoption agencies and officials. In combination with foster care nondiscrimination, this creates a full point for family services nondiscrimination policy.	Adoption nondiscrimination protections do not enumerate sexual orientation.	0	Adoption nondiscrimination protections do not enumerate gender identity.	0
	State law, regulation, or agency policy prohibits discrimination in adoption based on sexual orientation of parent(s).	0.5	State law, regulation, or agency policy prohibits discrimination in adoption based on gender identity of parent(s).	0.5
Family Services Nondiscrimination Protections for LGBTQ Parents: Foster Care	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Foster care nondiscrimination policies protect LGBTQ foster parents from discrimination by foster care agencies and officials. In combination with adoption nondiscrimination, this creates a full point for family services nondiscrimination policy.	Foster care nondiscrimination protections do not enumerate sexual orientation.	0	Foster care nondiscrimination protections do not enumerate gender identity.	0
	State law, regulation, or agency policy prohibits discrimination in foster care based on sexual orientation of parent(s).	0.5	State law, regulation, or agency policy prohibits discrimination in foster care based on gender identity of parent(s).	0.5
Legal Recognition for Parents Using Assisted Reproduction	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
These laws apply when a child is conceived through donor insemination and other forms of assisted reproduction. These laws grant legal parenting rights to the non-gestational, non-genetic parent (just as a woman’s husband would be a legal parent of a child they have using donor insemination even though he is not the biological father). In some states, being a married is not a legal requirement for parental recognition of a non-gestational, non-genetic parent. The process of “consenting to inseminate” allows parents in some states a way to establish a legal relationship to the child irrespective of the parents’ marital status.	State lacks clear mechanisms to create legal ties between a non-gestational, non-genetic parent and a child born via donor insemination.	0	Historically, parents using donor insemination are not denied legal recognition because they are transgender, but because they are part of (or perceived to be part of) a same-sex couple. Therefore, enumerating gender identity is outside of the scope of these laws.
	State law recognizes the non-gestational parent as a legal parent, regardless of marital status, if the non-gestational parent consents to the process by which a child is conceived via donor insemination or other assisted reproduction.	1
State Family Leave Laws: Definitions of Spouse/Partner	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
State family leave laws allow a person to take leave from work to care for their family members, including a spouse or partner. Some laws allow the worker to take leave for a partner only if they are in a legally recognized relationship (i.e. marriage) to the person who needs care. Other family leave laws use broader definitions of spouse or partner that better reflect the varied ways that LGBTQ people create family, including outside of legal marriage.	State lacks a family leave law entirely.	0	Although transgender people may be (or be considered to be) in a same-sex relationship and benefit from family leave, historically these laws’ definitions of family have the effect of recognizing or not recognizing a same-sex partner or spouse because both parties are the same sex, not because one of the parties is transgender. Therefore, enumerating gender identity is outside of the scope of these laws.
	State law grants workers leave to care for a partner, but only if the couple is in a legally recognized relationship.	0.25
	State law grants workers leave to care for a partner, even if the couple is not in a legally recognized relationship.	0.5
State Family Leave Laws: Definitions of Child/Parent	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
State family leave laws allow a person to take leave from work to care for a child. Barriers to parental recognition for LGBTQ people raising children often mean that one parent lacks legal ties to the child or children they are raising. Additionally, LGBTQ people create families in many ways, and some LGBTQ workers may not have legal or biological relationships to their children. Parents who are not legal or biological parents may be denied this leave unless the state law uses broader definitions of children or parenting that recognizes these varied ways of family building.	State lacks a family leave law entirely.	0	In the domain of family leave laws, LGBTQ parents’ struggles to gain legal ties to the children they are raising, and thus be recognized under state family leave laws, stem from lack of recognition of parents who are part of a same-sex couple, rather than because a parent is transgender. Therefore, enumerating gender identity is outside the scope of these laws.
	State law grants workers leave to care for a child for whom the worker is parenting, but only if the worker has a legal or biological relationship to the child.	0.25
	State law grants workers leave to care for a child for whom the worker is parenting, even if the worker lacks a legal or biological relationship to the child.	0.5
Relationship and Parental Recognition Subtotals (Tallies for Sexual Orientation and Gender Identity)	7		1
Relationship and Parental Recognition Total	8

Nondiscrimination Laws

These laws protect LGBTQ people from discrimination in various areas of life, including employment, housing, public accommodations, credit and lending, and more.

Employment Nondiscrimination Laws	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Employment nondiscrimination laws protect LGBTQ people from being unfairly fired, not hired, or discriminated against in the workplace by private employers. If state lacks a statewide law, this tally looks at local nondiscrimination ordinances and provides partial points based on the percent of the state's LGBTQ population covered by local laws that protect LGBTQ people from discrimination by private employers. No points are awarded for state policies or local laws that only protect government/public employees.	No state law prohibiting employment discrimination based on sexual orientation, and <25% of state population is protected from discrimination based on sexual orientation through local ordinances.	0	No state law prohibiting employment discrimination based on gender identity, and <25% of state population is protected from discrimination based on gender identity through local ordinances.	0
	No state law prohibiting employment discrimination based on sexual orientation, but 25-49% of state population is protected from discrimination based on sexual orientation through local ordinances.	0.25	No state law prohibiting employment discrimination based on gender identity, but 25-49% of state population is protected from discrimination based on gender identity through local ordinances.	0.25
	No state law prohibiting employment discrimination based on sexual orientation, but 50-99% of state population is protected from discrimination based on sexual orientation through local ordinances.	0.5	No state law prohibiting employment discrimination based on gender identity, but 50-99% of state population is protected from discrimination based on gender identity through local ordinances.	0.5
	State employment nondiscrimination law does not explicitly enumerate sexual orientation, but state explicitly interprets existing state prohibition on sex discrimination to include sexual orientation.	0.75	State employment nondiscrimination law does not explicitly enumerate gender identity, but state explicitly interprets existing state prohibition on sex discrimination to include gender identity.	0.75
	State law explicitly prohibits employment discrimination based on sexual orientation.	1	State law explicitly prohibits employment discrimination based on gender identity.	1
Housing Nondiscrimination Laws	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Housing nondiscrimination laws protect LGBTQ people from being unfairly evicted, denied housing, or refused the ability to rent or buy housing. If state lacks a statewide law, this tally looks at local nondiscrimination ordinances and provides partial points based on the percent of the state's LGBTQ population covered by local laws that protect LGBTQ people from housing discrimination.	No state law prohibiting housing discrimination based on sexual orientation, and <25% of state population is protected from housing discrimination based on sexual orientation through local ordinances.	0	No state law prohibiting housing discrimination based on gender identity, and <25% of state population is protected from housing discrimination based on gender identity through local ordinances.	0
	No state law prohibiting housing discrimination based on sexual orientation, but 25-49% of state population is protected from housing discrimination based on sexual orientation through local ordinances.	0.25	No state law prohibiting housing discrimination based on gender identity, but 25-49% of state population is protected from housing discrimination based on gender identity through local ordinances.	0.25
	No state law prohibiting housing discrimination based on sexual orientation, but 50-99% of state population is protected from housing discrimination based on sexual orientation through local ordinances.	0.5	No state law prohibiting housing discrimination based on gender identity, but 50-99% of state population is protected from housing discrimination based on gender identity through local ordinances.	0.5
	State housing nondiscrimination law does not explicitly enumerate sexual orientation, but state explicitly interprets existing state prohibition on sex discrimination to include sexual orientation.	0.75	State housing nondiscrimination law does not explicitly enumerate gender identity, but state explicitly interprets existing state prohibition on sex discrimination to include gender identity.	0.75
	State law explicitly prohibits housing discrimination based on sexual orientation.	1	State law explicitly prohibits housing discrimination based on gender identity.	1
Public Accommodations Nondiscrimination Laws	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Public accommodation nondiscrimination laws protect LGBTQ people from being unfairly refused service from or entry to places accessible to the general public. Public accommodations laws generally cover anywhere someone is when they are not at home, work, or school, including retail stores, restaurants, parks, hotels, doctors' offices, and banks. If state lacks a statewide law, this tally looks at local nondiscrimination ordinances and provides partial points based on the percent of the state's LGBTQ population covered by local laws that protect LGBTQ people from public accommodation discrimination.	No state law prohibiting public accommodation discrimination based on sexual orientation, and <25% of state population is protected from public accommodation discrimination based on sexual orientation through local ordinances.	0	No state law prohibiting public accommodation discrimination based on gender identity, and <25% of state population is protected from public accommodation discrimination based on gender identity through local ordinances.	0
	No state law prohibiting public accommodation discrimination based on sexual orientation, but 25-49% of state population is protected from public accommodation discrimination based on sexual orientation through local ordinances.	0.25	No state law prohibiting public accommodation discrimination based on gender identity, but 25-49% of state population is protected from public accommodation discrimination based on gender identity through local ordinances.	0.25
	No state law prohibiting public accommodation discrimination based on sexual orientation, but 50-99% of state population is protected from public accommodation discrimination based on sexual orientation through local ordinances.	0.5	No state law prohibiting public accommodation discrimination based on gender identity, but 50-99% of state population is protected from public accommodation discrimination based on gender identity through local ordinances.	0.5
	State public accommodations nondiscrimination law does not explicitly enumerate sexual orientation, but state explicitly interprets existing state prohibition on sex discrimination to include sexual orientation.	0.75	State public accommodations nondiscrimination law does not explicitly enumerate gender identity, but state explicitly interprets existing state prohibition on sex discrimination to include gender identity.	0.75
	State law explicitly prohibits public accommodation discrimination based on sexual orientation.	1	State law explicitly prohibits public accommodation discrimination based on gender identity.	1
Credit and Lending Nondiscrimination Laws	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Credit and lending nondiscrimination laws protect LGBTQ people from being unfairly denied credit and lending services. Local nondiscrimination ordinances typically do not apply to credit and lending practices, so the 0.25 and 0.5 scoring options seen in the employment, housing, or public accommodations nondiscrimination policies are not applicable here.	No state law prohibiting credit and lending discrimination based on sexual orientation.	0	No state law prohibiting credit and lending discrimination based on gender identity.	0
	State credit nondiscrimination law does not explicitly enumerate sexual orientation, but state explicitly interprets existing state prohibition on sex discrimination to include sexual orientation.	0.75	State credit nondiscrimination law does not explicitly enumerate gender identity, but state explicitly interprets existing state prohibition on sex discrimination to include gender identity.	0.75
	State law explicitly prohibits credit and lending discrimination based on sexual orientation.	1	State law explicitly prohibits credit and lending discrimination based on gender identity.	1
Nondiscrimination Policies for State Employees	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Nondiscrimination policies for state employees prohibit discrimination against state employees on the basis of sexual orientation and/or gender identity.	No state policy prohibiting discrimination in public employment based on sexual orientation.	0	No state policy prohibiting discrimination in public employment based on gender identity.	0
	State law or policy explicitly prohibits discrimination against public employees based on sexual orientation.	0.5	State law or policy explicitly prohibits discrimination against public employees based on gender identity.	0.5
Negative Law: State Bans Cities and Counties from Passing Nondiscrimination Laws	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
So-called "Commerce Protection Acts," or preemption laws, prohibit cities and counties from extending local nondiscrimination protections to classes not included in state law. They also render existing local nondiscrimination ordinances unenforceable if they extend protection to these classes. These laws have been used to prevent cities and counties from protecting LGBTQ people from discrimination, and to nullify local ordinances which extend these protections.	State does not ban cities and counties from passing nondiscrimination protections based on sexual orientation.	0	State does not ban cities and counties from passing nondiscrimination protections based on gender identity.	0
	State law bans cities and counties from passing nondiscrimination protections based on sexual orientation.	-1	State law bans cities and counties from passing nondiscrimination protections based on gender identity.	-1
Negative Law: State Bans Transgender People from Using Publicly-Owned Bathrooms and Facilities According to their Gender Identity	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
These laws prohibit transgender people from using bathrooms and facilities—such as locker rooms, shower rooms, changing rooms, and other sex-segregated spaces—according to their gender identity in certain circumstances or places. All of these policies apply to K-12 school settings, and some apply even more broadly to other government-owned buildings and spaces. This can include bathrooms and facilities in government buildings (e.g., city hall, courthouses, state legislative buildings, and more), colleges or universities, jails or prisons, and even in some cases airports, public parks, and much more. Please note that these bans do not apply to, for example, private businesses or other non-government-owned spaces, though these spaces may have their own discriminatory policies.			No bathroom ban, or no bathroom ban applying beyond K-12 settings. Note that a K-12 bathroom ban may still apply; see LGBTQ youth category.	0
			State bans transgender people from using bathrooms and facilities consistent with their gender identity in K-12 schools and at least some government-owned buildings (e.g., public colleges/universities, prisons or jails, etc).	-0.5
			State bans transgender people from using bathrooms and facilities consistent with their gender identity in all government-owned buildings and spaces, including K-12 schools, colleges, and more.	-1
Negative Law: State Explicitly Regulates Gender by Defining "Sex" Throughout State Law	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
These laws explicitly regulate gender by defining "sex" throughout all state law to effectively allow discrimination against transgender and nonbinary people. These laws regulate gender and define sex as only male or female, typically based on a person's presumed reproductive anatomy, chromosomes, hormones, or other physical characteristics at birth. These laws also define sex as a permanent category, implying that transgender people's gender identity would never be legally recognized under state law. They may also have dangerous implications for transgender people when it comes to bathrooms, identity documents, and other areas of law or policy.			State has no law or executive order regulating gender by defining "sex" throughout state law	0
			State law regulates gender by defining "sex" throughout state law	-1
Nondiscrimination Subtotals (Tallies for Sexual Orientation and Gender Identity)	4.5		4.5
Nondiscrimination Total	9

Religious Exemptions

Negative Law: Broad "RFRA" Religious Exemption Law	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Broad "RFRAs", or Religious Freedom Restoration Acts, are religious exemption laws that permit people, churches, non-profit organizations, and sometimes corporations to seek exemptions from state laws if they argue the laws burden their religious beliefs. The individual or organization must proactively seek out this exemption, such as through a court proceeding.	State has no broad RFRA religious exemption law.	0	State has no broad RFRA religious exemption law.	0
	State has broad RFRA religious exemption law.	-0.5	State has broad RFRA religious exemption law.	-0.5
Negative Law: Targeted Religious Exemption for Child Welfare Services	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Targeted religious exemptions for child welfare service providers permit state-licensed child welfare agencies to refuse to place and provide services to children and families, if doing so would conflict with their religious beliefs. These laws can harm many communities, as they can allow agencies to refuse to work with people from different or minority faith backgrounds, interracial or unmarried couples, single women, and LGBTQ people and same-sex couples, among others.	State has no targeted religious exemption law for child welfare providers.	0	State has no targeted religious exemption law for child welfare providers.	0
	State has targeted religious exemption law that permits state-licensed child welfare agencies to refuse to place and provide services to children and families, including LGBTQ people and same-sex couples, if doing so conflicts with their religious beliefs.	-1	State has targeted religious exemption law that permits state-licensed child welfare agencies to refuse to place and provide services to children and families, including LGBTQ people and same-sex couples, if doing so conflicts with their religious beliefs.	-1
Negative Law: Targeted Religious Exemption for Medical Professionals	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Targeted religious exemptions for medical professionals allow healthcare providers (such as doctors, nurses, pharmacists, and other medical professionals) to refuse to provide medical care to or otherwise serve LGBTQ clients.	State has no targeted religious exemption law for medical professionals.	0	State has no targeted religious exemption law for medical professionals.	0
	State has targeted religious exemption law allowing medical professionals to refuse to serve LGBTQ clients.	-1	State has targeted religious exemption law allowing medical professionals to refuse to serve LGBTQ clients.	-1
Negative Law: Targeted Religious Exemption for Private Wedding Services	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Targeted religious exemptions for private wedding services permit private for-profit businesses to deny services to married same-sex couples.	State has no targeted religious exemption law for private wedding services.	0	Although transgender people may often be (or be considered to be) in a same-sex relationship and would be harmed by laws denying services to same-sex couples, these laws have the effect of recognizing or not recognizing a same-sex partner or spouse because both parties are the same sex, not because one of the parties is transgender. Therefore, enumerating “gender identity” is outside of the scope of these laws.
	State permits services permits private for-profit businesses to deny wedding-related services to LGBTQ people/couples.	-0.5
Negative Law: Targeted Religious Exemption for Public Officials Providing Marriage Licenses	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Targeted religious exemptions for public officials (i.e., state and local government employees) permit those officials to decline to marry couples of whose marriage they disapprove, including same-sex couples.	State has no targeted religious exemption law for state and local officials providing marriage licenses.	0	Although transgender people may often be (or be considered to be) in a same-sex relationship and would be harmed by laws denying marriage licenses to same-sex couples, these laws have the effect of recognizing or not recognizing a same-sex partner or spouse because both parties are the same sex, not because one of the parties is transgender. Therefore, enumerating “gender identity” is outside of the scope of these laws.
	State permits state and local officials to decline to marry couples of whose marriage they disapprove.	-0.5
Religious Exemptions Subtotals (Tallies for Sexual Orientation and Gender Identity)	-3.5		-2.5
Religious Exemptions Total	-6

Religious exemption laws allow individuals, organizations, businesses, and others to opt out of existing laws and instead refuse to serve or work with people (including, but not limited to, LGBTQ people), if doing so would burden their religious beliefs.

LGBTQ Youth Laws and Policies

These laws and school regulations protect LGBTQ students from discrimination and bullying in schools, from the harmful and dangerous practice of conversion “therapy,” from discrimination in the child welfare system, and more..

Nondiscrimination Laws and Policies Covering LGBTQ Students	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
School nondiscrimination laws and statewide regulations protect LGBTQ students from discrimination in school, including being unfairly denied access to facilities, sports teams, or clubs.	No state law, regulation, or teacher code prohibits discrimination in schools based on sexual orientation.	0	No state law, regulation, or teacher code prohibits discrimination in schools based on gender identity.	0
	Statewide regulation or teacher code prohibits discrimination in schools based on sexual orientation.	0.5	Statewide regulation or teacher code prohibits discrimination in schools based on gender identity.	0.5
	State’s school nondiscrimination law does not explicitly enumerate sexual orientation, but state explicitly interprets existing prohibition on sex discrimination to include sexual orientation.	0.75	State’s school nondiscrimination law does not explicitly enumerate gender identity, but state explicitly interprets existing prohibition on sex discrimination to include gender identity.	0.75
	State law explicitly prohibits discrimination in schools based on sexual orientation.	1	State law explicitly prohibits discrimination in schools based on gender identity.	1
Anti-Bullying Laws and Policies Covering LGBTQ Students	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Anti-bullying laws and statewide regulations protect LGBTQ students from bullying by other students, teachers, and school staff.	No state law or regulation prohibits bullying in schools based on sexual orientation.	0	No state law or regulation prohibits bullying in schools based on gender identity.	0
	State regulation, but not law, prohibits bullying in schools based on sexual orientation.	0.5	State regulation, but not law, prohibits bullying in schools based on gender identity.	0.5
	State law prohibits bullying in schools based on sexual orientation.	1	State law prohibits bullying in schools based on gender identity.	1
Negative Law: Anti-Enumeration Laws Banning Local Schools and Districts from Passing LGBTQ-Inclusive Nondiscrimination and/or Anti-Bullying Policies	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
These "anti-enumeration" laws prohibit schools and districts from adding (enumerating) sexual orientation or gender identity protections in the school/district's own anti-bullying and anti-discrimination policies.	State does not ban schools and districts from passing nondiscrimination and/or anti-bullying protections that include sexual orientation.	0	State does not ban schools and districts from passing nondiscrimination and/or anti-bullying protections that include gender identity.	0
	State law prohibits schools and districts from passing nondiscrimination and/or anti-bullying protections that include sexual orientation.	-1	State law prohibits schools and districts from passing nondiscrimination and/or anti-bullying protections that include gender identity.	-1
LGBTQ Inclusive Curricular Standards	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
LGBTQ-inclusive curricular laws explicitly require the state’s curricular standards to include LGBTQ people and history, such as in subjects like history, civics, or social studies. Often, laws requiring LGBTQ-inclusive curricular standards also require inclusive representation of other communities like people of color, people with disabilities, and religious minorities.	No state law requiring state's curricular standards to be LGBTQ-inclusive.	0	No state law requiring state's curricular standards to be LGBTQ-inclusive.	0
	State law requires the state's department of education to create LGBTQ-inclusive curriculum, but does not require schools to adopt it.	0.5	State law requires the state's department of education to create LGBTQ-inclusive curriculum, but does not require schools to adopt it.	0.5
	State law requires state's curricular standards to be LGBTQ-inclusive.	1	State law requires state's curricular standards to be LGBTQ-inclusive.	1
Negative Law: “Don't Say Gay” Laws Explicitly Restricting Educators From Discussing LGBTQ People or Issues in Schools	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
“Don't Say Gay” laws restrict teachers and staff from talking about LGBTQ issues and people. Most of these laws are written to bar any discussion of same-sex relationships within sex education programming, but the laws are often vague and can be misapplied by schools to limit discussion and inclusion of LGBTQ people and issues in other parts of the curriculum, school events and programs, and even extracurricular activities (for example, by being seen as prohibiting Gay-Straight Alliances).	State does not prohibit or explicitly restrict teachers and staff from talking about LGBTQ issues and people.	0	State does not prohibit or explicitly restrict teachers and staff from talking about LGBTQ issues and people.	0
	State has "Don't Say Gay" regulation prohibiting or explicitly restricting teachers and staff from talking about LGBTQ issues and people.	-1	State has "Don't Say Gay" regulation prohibiting or explicitly restricting teachers and staff from talking about LGBTQ issues and people.	-1
Negative Law: Laws Requiring Parental Notification And Allowing Parents to Opt Children Out of LGBTQ-Inclusive Curricula	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Parental opt-out laws require parents to be notified in advance of LGBTQ-inclusive curricula, and allow parents to opt their children out of those classes. "LGBTQ-inclusive curricula" can refer to any curricula about sexual orientation, gender identity, and/or LGBTQ people in general. Some states' parental opt-out laws apply to sex education or human sexuality instruction, but they have defined these to inherently include anything about sexual orientation or gender identity.	State does not have this law.	0	State does not have this law.	0
	State has law requiring parental notification of LGBTQ-inclusive curricula and allowing parents to opt children out.	-1	State has law requiring parental notification of LGBTQ-inclusive curricula and allowing parents to opt children out.	-1
Negative Law: Restricting Discussions of "Homosexuality" in Specific School Subjects	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
In the late 1980s, amidst the HIV/AIDS crisis, states began to enact censorship laws restricting how schools could discuss "homosexuality" in specific subjects like sex or health education. In some states, these laws remain on the books. These laws are distinct from the more recent wave of “Don’t Say LGBTQ” laws that explicitly censor teachers and staff from discussing LGBTQ people and issues in general (not only homosexuality), and throughout all curricula (not only in specific subjects).	State has no older-style law censoring discussions of "homosexuality" in specific subjects	0
	State law censors discussions of "homosexuality" in specific subjects	-0.5
Negative Law: Laws Banning Transgender Youth from Participating in Sports	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
These laws explicitly prevent transgender student athletes from participating in sports according to their gender identity. Independent of state laws, state high school athletic associations may have developed their own policies, which also vary widely from state to state.	These laws explicitly target transgender youth only. While transgender people may be of any sexual orientation, these laws are focused on gender identity.		State has no law (though state high school athletic associations may have their own policies).	0
			State has law banning transgender youth from participating in sports according to their gender identity.	-1
Negative Law: Laws Banning Transgender Students From Using School Facilities	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
These laws explicitly prevent transgender students from using K-12 school facilities, such as bathrooms or locker rooms, according to their gender identity.	These laws explicitly target transgender youth only. While transgender people may be of any sexual orientation, these laws are focused on gender identity.		State has no law banning transgender students from using school facilities according to their gender identity.	0
			State law bans transgender students from using school facilities according to their gender identity.	-1
Negative Law: Forced Outing of Transgender Youth in Schools	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
These laws explicitly require school staff—and in some cases, any government or public employee—to out transgender youth to their families, often without regard for whether doing so might put the child at risk of harm. Importantly, however, these laws vary in their actual requirements.	While students can also be outed about their sexual orientation, these laws specifically address and refer to students' gender identity.		State has no forced outing or related law	0
			State law requires forced outing of transgender youth before school staff can use a student’s preferred name/pronouns, but a student’s mere request to use a different name or pronouns does not itself require forced outing	-0.25
			State law requires forced outing of transgender youth, but only if parents ask school staff for the information	-0.5
			State law forces the outing of transgender youth if they make specific disclosures or requests about their gender identity (such as asking to be addressed by different name or pronouns, to access different bathrooms, etc) to school staff	-1
Conversion "Therapy" Laws	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Protective versions of these laws prohibit licensed mental health practitioners from subjecting minors to harmful conversion "therapy" practices that attempt to change their sexual orientation or gender identity. More recently, new and harmful versions of conversion "therapy" related state laws instead attempt to prevent municipalities from being able to enact local-level protections against conversion "therapy."	State law explicitly prevents municipalities from enacting local-level protections against conversion "therapy"	-1	State law explicitly prevents municipalities from enacting local-level protections against conversion "therapy"	-1
	No state law protecting youth from conversion "therapy," and <25% of state population is protected from conversion "therapy" through local ordinances.	0	No state law protecting youth from conversion "therapy," and <25% of state population is protected from conversion "therapy" through local ordinances.	0
	No state law protecting youth from conversion "therapy," but 25-49% of state population is protected from conversion "therapy" through local ordinances.	0.25	No state law protecting youth from conversion "therapy," but 25-49% of state population is protected from conversion "therapy" through local ordinances.	0.25
	No state law protecting youth from conversion "therapy," but 50-99% of state population is protected from conversion "therapy" through local ordinances.	0.5	No state law protecting youth from conversion "therapy," but 50-99% of state population is protected from conversion "therapy" through local ordinances.	0.5
	State law or executive order partially restricts conversion "therapy" for minors, but does not fully prohibit the practice	0.75	State law or executive order partially restricts conversion "therapy" for minors, but does not fully prohibit the practice	0.75
	State law prohibits licensed mental health care providers from subjecting minors to conversion "therapy"	1	State law prohibits licensed mental health care providers from subjecting minors to conversion "therapy"	1
Protections for LGBTQ Youth in the Child Welfare System	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Protections for LGBTQ youth in the child welfare system can stem from state laws, regulations, or agency policies that prohibit discrimination against youth based on sexual orientation and/or gender identity. Some states also require current and prospective foster parents and child welfare staff to receive training about LGBTQ youth in areas like cultural competency and legal requirements, and some states require that transgender youth be placed in accordance with their gender identity. These laws and regulations are designed to improve the safety of and outcomes for LGBTQ youth in the child welfare system.	No explicit state protections against discrimination based on sexual orientation for youth in the child welfare system, nor requirements of LGB cultural competency training.	0	No explicit state protections against discrimination based on gender identity for youth in the child welfare system, nor guidance about transgender youth being placed in accordance with their gender identity.	0
	State law, regulation, or agency policy prohibits discrimination against youth in the child welfare system based on sexual orientation.	1	State law, regulation, or agency policy prohibits discrimination against youth in the child welfare system based on gender identity.	1
LGBTQ Youth Laws and Policies Subtotals (Tallies for Sexual Orientation and Gender Identity)	5		5
LGBTQ Youth Laws and Policies Total	10

Health Care Laws and Policies

These laws pertain to the health and well-being of LGBTQ people, including their ability to access health care free from discrimination.

Private Health Insurance Nondiscrimination Laws	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Insurance nondiscrimination laws protect LGBTQ people from being unfairly denied health insurance coverage or from being unfairly excluded from coverage for certain health care procedures.	No state law prohibiting private health insurance discrimination based on sexual orientation.	0	No state law prohibiting private health insurance discrimination based on gender identity.	0
	State law prohibits private health insurance discrimination based on sexual orientation.	1	State law prohibits private health insurance discrimination based on gender identity.	1
Negative Law: Laws Banning Best Practice Medical Care For Transgender Youth	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Bans on best practice medical care represent one of the most extreme—and coordinated—political attacks on transgender people in recent years. These bills target transgender youth by blocking their access to medically necessary health care, care that is backed by years of rigorous research and endorsed by the American Academy of Pediatrics, the American Medical Association, and other leading health authorities. These bills not only display a fundamental lack of understanding of transgender children, but they also ban access to medical care often by criminalizing either the doctors or even the parents of transgender youth seeking to provide best practice medicine for children in their care.			State law does not ban medically necessary care for transgender youth	0
			State law bans medically necessary surgical care only for transgender youth	-0.5
			State law bans medically necessary medication and surgical care for transgender youth	-1
"Shield" Laws Protecting Access to Transgender Health Care	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
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.			No state "shield" law or executive order protecting access to transgender health care	0
			State has "shield" executive order protecting access to transgender health care	0.75
			State has "shield" law protecting access to transgender health care	1
Health Insurance Providers Banned from Excluding Coverage for Transgender People	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Prohibitions on transgender exclusions in health insurance bar health insurance issuers from denying or limiting coverage based on gender identity and require the removal of “transgender exclusions” from health plans. They prevent insurers from explicitly refusing to cover medically necessary care for transgender people.	These laws are specific to “transgender exclusions” as insurance companies have not specifically banned care based on sexual orientation.		State policy is silent on transgender health insurance service coverage.	0
			State policy prohibits transgender-specific exclusions in health insurance service coverage.	1
State Medicaid Policy Related to Coverage for Transgender People	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
While federal healthcare regulations currently prohibit discrimination based on gender identity, state Medicaid policies reflect varying interpretations of those federal regulations. Some state Medicaid policies explicitly include medically necessary health care for transgender people, whereas other state policies explicitly exclude transgender health coverage and care. Still others have no explicit policy, often leading to inconsistent or difficult experiences in accessing health care for transgender people receiving Medicaid in that state.	These policies are specific to providing Medicaid coverage for medically necessary care for transgender people. Enumeration based on sexual orientation is outside the scope of these policies.		State Medicaid policy explicitly excludes transgender-related health care, despite medical necessity and federal regulations to the contrary.	-1
			State Medicaid policy has no explicit policy regarding transgender health coverage and care.	0
			State Medicaid policy explicitly includes medically necessary transgender-related health care.	1
Transgender Inclusive Health Benefits for State Employees	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
These state policies address whether the healthcare benefits provided to state employees explicitly include or exclude medically necessary health care for transgender state employees. Some states have no explicit policy either way, often leading to inconsistent or difficult experiences for transgender state employees attempting to access medically necessary care.	These policies are specific to providing healthcare for transgender people. Scoring based on sexual orientation is outside the scope of these policies.		State explicitly excludes transgender-related healthcare in their state employee health benefits.	-0.5
			State has no explicit policy regarding transgender-related healthcare in their state employee health benefits.	0
			State explicitly includes transgender-related healthcare in their state employee health benefits.	0.5
Data Collection for LGBTQ Adults	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
The Behavioral Risk Factor Surveillance System (BRFSS) is the largest continuously conducted health survey in the world. It is run by the Centers for Disease Control and Prevention (CDC). States can opt to include a number of modules with added questions, including questions about sexual orientation and gender identity. We update our scores as each year's survey participation is publicly released.	State does not include sexual orientation module in its state-based BRFSS survey of adults, or does not participate in BRFSS.	0	State does not include gender identity module in its state-based BRFSS survey of adults, or does not participate in BRFSS.	0
	State includes questions about sexual orientation in state-based BRFSS survey of adults.	0.5	State includes questions about gender identity in state-based BRFSS survey of adults.	0.5
Data Collection for LGBTQ Youth	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
The Youth Risk Behavior Surveillance System (YRBSS) is a school-based survey of youth and young adults. The national survey is conducted by the Centers for Disease Control and Prevention (CDC) in schools across the country. States can opt to include a number of modules with added questions, including questions about sexual orientation and gender identity. We update our scores as each year's survey participation is publicly released. Note that YRBSS is conducted every other year, not annually.	State does not include sexual orientation module in its state-based YRBS survey of youth, or does not participate in YRBS.	0	State does not include gender identity module in its state-based YRBS survey of youth, or does not participate in YRBS.	0
	State includes questions about sexual orientation in state-based YRBS survey of youth.	0.5	State includes questions about gender identity in state-based YRBS survey of youth.	0.5
Fertility Treatment Coverage in Private Insurance	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Fertility-related health care is diverse and can include fertility treatment services such as medications to assist in conception, in vitro fertilization (IVF), and other health care. It may also include fertility preservation services, such as egg retrieval and storage. In the United States, however, fertility-related healthcare is often not covered by insurance. As a result, some states have passed laws that require insurers to cover fertility treatment and/or preservation care. But, even when fertility health care is covered by insurance, many states still have definitions of “infertility” or other terms that exclude single people and many LGBTQ people from otherwise covered services. As a result, LGBTQ people may have to spend thousands of dollars in out-of-pocket costs to grow their families, even when these services are covered for other people.	State has requirements or language that may exclude some LGBTQ people or couples. Note this -0.25 point deduction would be applied in combination with the positive points listed below, leading to a net score.	-0.25	State has requirements or language that may exclude some LGBTQ people or couples. Note this -0.25 point deduction would be applied in combination with the positive points listed below, leading to a net score.	-0.25
	State does not require private insurers to cover fertility treatment care	0	State does not require private insurers to cover fertility treatment care	0
	State requires private insurers to offer coverage, but employers may still choose not to include that coverage	0.25	State requires private insurers to offer coverage, but employers may still choose not to include that coverage	0.25
	State requires coverage by at least some private insurers or of at least some fertility care, but requirements differ across states	0.5	State requires coverage by at least some private insurers or of at least some fertility care, but requirements differ across states	0.5
	State requires private insurers to cover fertility treatment care, but is not explicitly inclusive of LGBTQ people	0.75	State requires private insurers to cover fertility treatment care, but is not explicitly inclusive of LGBTQ people	0.75
	State requires private insurers to cover fertility treatment care and is explicitly inclusive of LGBTQ people	1	State requires private insurers to cover fertility treatment care and is explicitly inclusive of LGBTQ people	1
Fertility Treatment Coverage in Medicaid	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
See above.	State does not require Medicaid to cover any fertility treatment services	0	State does not require Medicaid to cover any fertility treatment services	0
See above.	State requires Medicaid to cover at least some fertility treatment care, though coverage differs across states	0.5	State requires Medicaid to cover at least some fertility treatment care, though coverage differs across states	0.5
Fertility Preservation Coverage in Private Insurance	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Fertility-related health care is diverse and can include fertility treatment services such as medications to assist in conception, in vitro fertilization (IVF), and other health care. It may also include fertility preservation services, such as egg retrieval and storage. In the United States, however, fertility-related healthcare is often not covered by insurance. As a result, some states have passed laws that require insurers to cover fertility treatment and/or preservation care.			State does not require private insurers to cover fertility preservation	0
			State requires private insurers to cover fertility preservation, but only for cancer patients	0.25
			State requires private insurers to cover fertility preservation, but not storage	0.5
			State requires private insurers to cover fertility preservation, including storage	1
Fertility Preservation Coverage in Medicaid	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
See above.			State does not require Medicaid to cover fertility preservation services	0
See above.			State requires Medicaid to cover at least some fertility preservation services, or for at least some (i.e., cancer) patients	0.5
Health Care Subtotals (Tallies for Sexual Orientation and Gender Identity)	3.5		8.5
Health Care Total	12

Criminal Justice Laws and Policies

Hate Crime Law Covering LGBTQ People	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Hate crime laws require law enforcement agencies to investigate and prosecute crimes committed with bias against LGBTQ people. Some state laws require collection of data on anti-LGBTQ hate crimes.	No state hate crime law, or existing state hate crime law does not enumerate sexual orientation.	0	No state hate crime law, or existing state hate crime law does not enumerate gender identity.	0
	State hate crime law enumerates sexual orientation.	1	State hate crime law enumerates gender identity.	1
Bans on Panic Defense	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
So-called “gay and trans panic defenses” allow defendants to claim a victim’s sexual orientation or gender identity provoked or caused the defendant’s actions. State bans prohibit the use of such defenses.	No state law prohibiting the use of so-called “gay panic” defense.	0	No state law prohibiting the use of so-called “trans panic” defense.	0
	State law prohibits the use of so-called “gay panic” defense.	1	State law prohibits the use of so-called “trans panic” defense.	1
Jury Service Nondiscrimination	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Jury service is an important civic responsibility, and the U.S. Constitution guarantees the right to a jury of one’s peers. Nondiscrimination protections are an important tool in ensuring that juries are representative of the broader community and to help ensure fairer and more equitable outcomes in the legal system. Currently, federal law prohibits discrimination against jurors based on their race, religion, sex, and other characteristics, but this law does not explicitly cover such discrimination based on sexual orientation or gender identity. This policy tracks whether state-level jury nondiscrimination protections across the country include sexual orientation and/or gender identity.	No state law or relevant court case that prohibits discrimination in jury service based on sexual orientation.	0	No state law or relevant court case that prohibits discrimination in jury service based on gender identity.	0
	State law or relevant court case prohibits discrimination in jury service based on sexual orientation.	1	State law or relevant court case prohibits discrimination in jury service based on gender identity.	1
Negative Law: HIV Criminalization Laws	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
HIV criminalization laws criminalize the transmission of, or perceived exposure to, HIV and other infectious diseases. The laws create a strong disincentive for being tested for HIV, and result in adverse public health outcomes. Some laws also criminalize behaviors, such as spitting, that have no risk of HIV transmission. Importantly, states may also have general STI or communicable disease laws that do not enumerate HIV but could still be used to prosecute people living with HIV. Additionally, there are no legal frameworks in place to prevent prosecutors in any state from prosecuting people living with HIV under general criminal codes.	State has no HIV-specific criminal law or policy.	0	State has no HIV-specific criminal law or policy.	0
	State has no HIV criminalization law, but does have HIV-specific sentencing enhancements (i.e., additional penalties) for sex-related convictions.	-0.25	State has no HIV criminalization law, but does have HIV-specific sentencing enhancements (i.e., additional penalties) for sex-related convictions.	-0.25
	State has HIV criminalization law only (including general STI laws that enumerate HIV).	-0.5	State has HIV criminalization law only (including general STI laws that enumerate HIV).	-0.5
	State has HIV criminalization law and either HIV-specific sentencing enhancements or may require sex offender registration (or both).	-1	State has HIV criminalization law and either HIV-specific sentencing enhancements or may require sex offender registration (or both).	-1
Negative Law: Restrictions on Drag Performances	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Drag is an art form dating back centuries and is a vital part of LGBTQ culture and history. While state laws restricting gender-based dress also date back to at least the 1800s, 2023 brought a resurgence of efforts to limit free speech and expression in the form of drag performances.	No state law explicitly restricting drag performances, though other related laws about "adult" performances may implicitly target drag	0	No state law explicitly restricting drag performances, though other related laws about "adult" performances may implicitly target drag	0
	State law explicitly restricts drag performances	-1	State law explicitly restricts drag performances	-1
Criminal Justice Subtotals (Tallies for Sexual Orientation and Gender Identity)	3		3
Criminal Justice Total	6

These laws pertain to the criminal justice system as it relates to LGBTQ people.

Identity Documents

These laws and policies allow transgender and nonbinary people to update the gender markers on their identity documents so that their identity documents reflect their gender identity. This can reduce the likelihood that they will experience harassment, discrimination, or even violence when asked to show an ID. These laws also govern what gender options are available to people updating their gender marker, and the processes by which people can legally change their name.

Driver's Licenses: Process	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Driver's license policies govern the process by which a state changes a gender marker on a person's driver's license. Many transgender people choose to update the gender marker on their identity documents so that it matches their gender identity, also reducing the likelihood they may experience harassment, discrimination, or violence when asked to show their ID.			State does not allow for updating the gender marker on driver's licenses.	-1
			State requires proof of surgery, court order, or amended birth certificate.	-0.75
			State has unclear, unknown or unwritten policy regarding gender marker changes.	0
			State has no form. State does not require court order or proof of surgery, but does have burdensome process requirements and/or provider certification requirements accepted only from a limited range of professionals.	0.25
			State uses easy to understand form and requires provider certification (accepted only from limited range of professionals).	0.5
			State uses easy to understand form and requires provider certification (accepted from wide range of professionals).	0.75
			State uses easy to understand form and does not require provider certification.	1
Birth Certificates	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Birth certificate laws govern the process by which a state changes a gender marker on a person's birth certificate. Many transgender people choose to update the gender marker on their identity documents so that it matches their gender identity, also reducing the likelihood they may experience harassment, discrimination, or violence when asked to show their ID.			State does not allow gender marker on birth certificate to be changed	-1
			State requires court order and proof of surgery	-0.75
			State uses administrative process but requires proof of surgery	-0.5
			State has unclear process regarding gender marker changes and/or unclear medical requirements	0
			State uses administrative process and requires documentation of "appropriate treatment" (or similar language) only	0.75
			State uses administrative process and does not require private medical documentation	1
Name Change Laws	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Name change laws govern the process by which a state changes the legal name on a person's identity documents. Many transgender people choose to legally change their name so that it better matches their gender identity, also reducing the likelihood they may experience harassment, discrimination, or violence when asked to show their ID or use their legal name. While state laws generally allow individuals to change their legal name for any non-criminal purpose, many states still have outdated and burdensome requirements that create substantial barriers to achieving a legal name change. One of the most common and problematic requirements is that a person must publicly post or publish their legal name change request, often in a local newspaper. This not only poses a financial obstacle (as the publication typically must be paid for), but also puts the person at risk of potential harm, harassment, or discrimination.			State law requires public announcement of name change, and/or includes only a narrow option to waive this requirement (e.g., only if in a witness protection program).	-1
			State law has unclear publication requirement, or requires publication but allows individual court discretion and/or broad option to waive requirement (e.g., "for good cause" or general safety).	0
			State law explicitly states that there is no publication of name change required.	1
Gender Neutral Options: Driver's Licenses	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Some states provide the option for people to select a gender neutral or non-binary "X" on their driver's license, in addition to the typical options of male or female. The options available for gender markers are independent of the difficulty (or ease) of the process of changing the gender marker.			State only allows residents to identify as male or female on driver's licenses.	0
			State allows residents to identify as male, female, or "X" on driver's licenses.	0.5
Gender Neutral Options: Birth Certificates	Sexual Orientation		Gender Identity
Definition	Level of State Law	Corresponding Point Value	Level of State Law	Corresponding Point Value
Some states provide the option for people to select a gender neutral or non-binary "X" on their birth certificate, in addition to the typical options of male or female. The options available for gender markers are independent of the difficulty (or ease) of the process of changing the gender marker.			State only allows residents to identify as male or female on birth certificates.	0
			State allows residents to identify as male, female, or "X" on birth certificates.	0.5
Identity Documents Subtotals (Tallies for Sexual Orientation and Gender Identity)	0		4
Identity Documents Total	4

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