A federal judge on Tuesday ruled the U.S. Bureau of Prisons must keep providing transgender inmates gender-affirming care, despite an executive order President Donald Trump signed on his first day back in office to halt funding for such care.
U.S. District Judge Royce Lamberth in Washington, D.C., allowed a group of more than 2,000 transgender inmates in federal prisons to pursue a lawsuit challenging the order as a class action. He ordered the Bureau of Prisons to provide them with hormone therapy and accommodations such as clothing and hair-removal devices while the lawsuit plays out.
The ruling does not require the bureau to provide surgical care related to gender transitions.
White House spokesperson Harrison Fields said the Trump administration expects to ultimately prevail in the legal dispute.
“The District Court’s decision allowing transgender women, aka MEN, in women’s prisons fundamentally makes women less safe and ignores the biological truth that there are only two genders,” Fields said in an email.
The American Civil Liberties Union, which represents the inmates, said the ruling was “a critical reminder to the Trump administration that trans people, like all people, have constitutional rights that don’t simply disappear because the president has decided to wage an ideological battle.”
About 2,230 transgender inmates are housed in federal custodial facilities and halfway houses, according to the U.S. Department of Justice. About two-thirds of them, 1,506, are transgender women, most of whom are housed in men’s prisons.
The named plaintiffs, two transgender men and one transgender woman, sued the Trump administration in March to challenge Trump’s January 20 executive order aimed at combating what the administration called “gender ideology extremism.”
The executive order directed the federal government to only recognize two, biologically distinct sexes, male and female; and house transgender women in men’s prisons. It also ordered the bureau to stop spending any money on “any medical procedure, treatment, or drug for the purpose of conforming an inmate’s appearance to that of the opposite sex.”
Lamberth, appointed by Republican President Ronald Reagan, said in Tuesday’s ruling that the plaintiffs were likely to succeed in their lawsuit because the bureau did not perform any analysis before cutting off treatment that its own medical staff had previously deemed to be medically appropriate for the inmates.
Even if it had extensively studied the issue before deciding to stop gender-affirming care, the decision might still violate the U.S. Constitution’s Eighth Amendment’s protections against “cruel and unusual” punishment, Lamberth wrote.
The Department of Justice had argued that the judge should defer to the policy decision of a democratically elected president, but Lamberth said a functioning democracy requires respect for “all duly enacted laws,” including those that blocked the executive branch from acting in an “arbitrary and capricious” manner.
Democratic self-governance “does not mean blind submission to the whims of the most recent election-victor,” Lamberth wrote.
The executive order said it was meant to promote the “dignity, safety, and wellbeing of women, and to stop the spread of “gender ideology” which denies “the immutable biological reality of sex.” But the inmates receiving hormone treatments had little interest in promoting any ideology, and were instead taking “measures to lessen the personal anguish caused by their gender dysphoria,” Lamberth wrote.
A federal judge in California has blocked the Trump administration from enforcing anti-diversity and anti-transgender executive orders in grant funding requirements that LGBTQ+ organizations say are unconstitutional.
U.S. District Judge Jon Tigar said Monday that the federal government cannot force recipients to halt programs that promote diversity, equity and inclusion or acknowledge the existence of transgender people in order to receive grant funding. The order will remain in effect while the legal case continues, although government lawyers will likely appeal.
The funding provisions “reflect an effort to censor constitutionally protected speech and services promoting DEI and recognizing the existence of transgender individuals,” Tigar wrote.
He went on to say that the executive branch must still be bound by the Constitution in shaping its agenda and that even in the context of federal subsidies, “it cannot weaponize Congressionally appropriated funds to single out protected communities for disfavored treatment or suppress ideas that it does not like or has deemed dangerous.”
The plaintiffs include health centers, LGBTQ+ services groups and the Gay Lesbian Bisexual Transgender Historical Society. All receive federal funding and say they cannot complete their missions by following the president’s executive orders.
The San Francisco AIDS Foundation, one of the plaintiffs, said in 2023 it received a five-year grant from the Centers for Disease Control and Prevention to expand and enhance sexual health services, including the prevention of sexually transmitted infections. The $1.3 million project specifically targets communities disproportionately affected by sexual health disparities.
But in April, the CDC informed the nonprofit that it must “immediately terminate all programs, personnel, activities, or contracts” that promote DEI or gender ideology.
President Donald Trump has signed a flurry of executive orders since taking office in January, including ones to roll back transgender protections and stop DEI programs. Lawyers for the government say that the president is permitted to “align government funding and enforcement strategies” with his policies.
Plaintiffs say that Congress — and not the president — has the power to condition how federal funds are used, and that the executive orders restrict free speech rights.
Marriage for same-sex couples has been legal across the United States since the Supreme Court’s Obergefell v. Hodges decision a decade ago. While Democratic support for gay nuptials has risen steadily since that landmark 2015 ruling, Republican support has tumbled 14 points since its record high of 55% in 2021 and 2022, according to a Gallup report released Thursday.
In the latest Gallup Poll, 41% of Republicans and 88% of Democrats said marriages between same-sex couples should be “recognized by the law as valid, with the same rights as traditional marriages.” This 47-point gap is the largest it has been since Gallup first started asking the question in 1996. The report found 76% of independents and 68% of all U.S. adults surveyed backed marriage rights for same-sex couples.
A separate question about whether “gay or lesbian relations” are “morally acceptable or morally wrong” found a similar political trend, with 86% of Democrats, 69% of independents and 38% of Republicans answering answering “morally acceptable.”
When broken down by nonpolitical subgroups, women, younger people and college graduates were more likely to support gay marriage and find same-sex relations morally acceptable than men, older people and those who did not graduate college.
The Gallup report’s authors noted that the “widening political divide suggests potential vulnerabilities in the durability of LGBTQ+ rights” in the country.
The report cited Supreme Court Justice Clarence Thomas’ concurring opinion in the 2022 Dobbs v. Jackson Women’s Health Organization ruling — which overturned the landmark 1973 Roe v. Wade abortion rights decision — that stated the high court ”should reconsider” some of its past rulings, including the 2015 same-sex marriage decision.
And, as NBC News reported earlier this year, lawmakers in at least nine states have introduced measures to try to chip away at same-sex couples’ right to marry.
LGBTQ people in the U.S. see lower social acceptance for transgender people than those who are lesbian, gay or bisexual, a new Pew Research Center poll found.
Pew found that about 6 in 10 LGBTQ adults said there is “a great deal” or “a fair amount” of social acceptance in the U.S. for gay and lesbian people. Only about 1 in 10 said the same for nonbinary and transgender people — and about half said there was “not much” or no acceptance at all for transgender people.
Giovonni Santiago, a 39-year-old transgender man and Air Force veteran who lives in Northeast Ohio and was not a participant in the survey, said he feels that acceptance for transgender people has declined in the last few years – roughly in step with the rise of state laws banning gender-affirming care for transgender minors, regulating which school and public bathrooms transgender people can use and which sports they can play.
He said he’s seen acceptance get worse nationally, following the lead of some places that were early adopters of restrictions.
“They were like the anomaly for ignorance and in hatred, especially towards trans people,” Santiago said. “But now we see that it’s just kind of sweeping the nation, unfortunately.”
Still, Santiago said he doesn’t fear for his own personal safety — a contrast with most transgender people, who said they have feared for their safety at some point.
“I guess I don’t feel it as much because I live a life that most people don’t know that I’m trans unless I specifically tell them,” said Santiago, who runs a nonprofit dedicated to supporting transgender youth.
The survey of 3,959 LGBTQ adults was conducted in January, after President Donald Trump was elected but just before he returned to office and set into motion a series of policies that question the existence of transgender people.
A “Rise Up for Trans Youth” rally in New York against President Donald Trump’s executive actions targeting transgender people on Feb. 7.Stephanie Keith / Bloomberg via Getty Images file
On his first day, Trump signed an executive order calling on the government to recognize people as male or female based on the “biological truth” of their future cells at conception, rather than accept scientific evidence that gender is a spectrum. Since then, he’s begun ousting transgender service members from the military, and tried to bar transgender women and girls from sports competitions for females and block federal funding for gender-affirming care for transgender people under 19, among other orders.
A poll from The Associated Press-NORC Center for Public Affairs Research conducted in May found that about half of U.S. adults approve of how Trump is handling transgender issues, with a range of views on specific actions.
According to the Pew poll, about two-thirds of LGBTQ adults said the U.S. Supreme Court ruling that legalized same-sex marriage nationally 10 years ago boosted acceptance of same-sex couples “a lot more” or “somewhat more.” The Supreme Court is expected to rule in coming weeks on a major case regarding transgender people — deciding whether Tennessee can enforce a ban on gender-affirming care for minors.
Transgender people are less likely than gay or lesbian adults to say they’re accepted by all their family members. The majority of LGBTQ said their siblings and friends accepted them, though the rates were slightly higher among gay or lesbian people. About half of gay and lesbian people said their parents did, compared with about one-third of transgender people. Only about 1 in 10 transgender people reported feeling accepted by their extended family, compared with about 3 in 10 gay or lesbian people.
Transgender people are more likely than gay, lesbian or bisexual people to say they feel “extremely” or “very” connected to a broader LGBTQ+ community and to say that all or most of their friends are also LGBTQ.
Some elements of the experience are similar. About one-third of transgender and lesbian or gay adults said they first felt they might be LGBTQ by the time they were 10 and most did by age 13. About half waited until they were at least 18 to first tell someone.
Audrey Campos hosts a Loteria game night at Jackie O’s Cocktail Club in Fort Worth, Texas, on Tuesday.Ronaldo Bolaños / AP
Aubrey Campos, 41, runs a taco truck near a hub of LGBTQ bars in Fort Worth, Texas, and also serves as a community organizer. She says her parents were supportive when she came out as transgender at about age 12. But the younger trans people she works with often have very different experiences — including some who were kicked out of their homes.
“Now the times are a little bit dark,” she said. “This is a time that we to come together and make it brighter and make it known that we aren’t going to just disappear.”
The Centers for Medicare and Medicaid Services, headed by Mehmet Oz, has sent a letter to some hospitals demanding information on their provision of gender-affirming care to transgender youth.
The CMS, like all of Donald Trump’s administration, is opposed to this care, falsely claiming it is experimental and is not supported by evidence.
The letter, dated Wednesday, expresses “urgent concerns with both the quality standards adherence and profits related to these harmful procedures,” says a CMS press release. The release quotes Oz as saying, “These are irreversible, high-risk procedures being conducted on vulnerable children, often at taxpayer expense. Hospitals accepting federal funds are expected to meet rigorous quality standards and uphold the highest level of stewardship when it comes to public resources — we will not turn a blind eye to procedures that lack a solid foundation of evidence and may result in lifelong harm.”
“The United States government has serious concerns with medical interventions for gender dysphoria in children,” the letter reads. “These interventions include surgical procedures that attempt to transform an individual’s physical appearance to align with an identity that differs from his or her sex or that attempt, for purposes of treating gender dysphoria, to alter or remove an individual’s sexual organs to minimize or destroy their natural biological functions. These interventions also include, but are not limited to, the use of puberty blockers, including GnRH agonists and other procedures, approaches, or modalities, to delay the onset or progression of normally-timed puberty for purposes of treating gender dysphoria, as well as the use of sex hormones, such as estrogen, progesterone, or testosterone, and androgen blockers to align an individual’s physical appearance with an identity that differs from his or her sex. … CMS believes that these interventions were initiated with an underdeveloped body of evidence, lack reliable evidence of benefits for minors, and are now known to carry serious risks of long-term and irreparable harm.”
In reality, the procedures are not harmful and are often lifesaving. Studies by the Trevor Project, which assists LGBTQ+ youth in crisis, and other researchers have found that access to gender-affirming care reduces the risk of suicide among young trans people. Also, such care is endorsed by every major medical association, including the American Academy of Pediatrics, the American Medical Association, and the American Psychiatric Association.
Also, genital surgery is almost never performed on minors, although some undergo top surgery or facial surgery. The effects of puberty blockers are reversible, and the effects of cross-sex hormones usually are as well. Regret about transition is rare.
The letter goes on to ask about “the adequacy of informed consent protocols for children with gender dysphoria, including how children are deemed capable of making these potentially life-changing decisions and when parental consent is required.”
The answer about consent, from a Human Rights Campaigndocument: “If medications or surgery are part of their gender journey, they are only prescribed after further assessments to ensure they meet prescribing criteria. This can include but is not limited to documentation and referral letters, parental consent, and ongoing mental health support. At all stages, gender-affirming care is only delivered after patients and their families have been counseled, and informed consent has been given.”
The letter further asks for billing codes for gender-affirmation procedures, how much revenue these procedures generate, and what the profit margins for this care are — as if doctors and hospitals are providing it out of greed.
Dr. Kellan E. Baker, executive director of the Institute for Health Research and Policy at Whitman-Walker, an LGBTQ-focused clinic, issues a statement denouncing the letter. “This ‘request’ is a blatant attempt to intimidate providers into betraying their professional obligation to care for their patients,” Baker said. “It is vitally important that hospitals, states, elected officials, and courts stand up to these strong-arm tactics and protect patients’ right to care. And it is vital that providers recognize this document has no legal force or effect and that they continue to provide the care their patients need.”
A recent study from the Department of Health and Human Services, headed by Robert F. Kennedy Jr., who is anti-trans, went so far as to recommend conversion therapy for trans youth rather than gender-affirming care. Conversion therapy has been shown to cause harm to young people and has been repudiated by all major medical and mental health organizations. Many states have barred licensed professionals from subjecting minors to it.
The “Big Beautiful Bill” on the federal budget, which was passed narrowly by the House of Representatives and is pending in the Senate, would attack gender-affirming care even further. It would bar Medicaid and the Children’s Health Insurance Program from covering any gender-affirming services for people of any age. It also would no longer classify gender-affirming care as an “essential health benefit” under the Affordable Care Act, explicitly excluding transition-related care from private insurance plans regulated by federal standards.
Chase, a 9-year-old trans girl, sits with her parents, Candace and Brandon, as their family prepares for a life-changing move to New Zealand. Jimena Peck for NBC News
Denver parents Brandon and Candace are spending tens of thousands of dollars to move to New Zealand in July. The reason, they said, is to protect their 9-year-old transgender daughter, Chase, from the effects of the Trump administration’s policies and an increasingly hostile climate for trans people in the United States.
“You’re taught to believe, or indoctrinated, I suppose, in America that this is the land of the free and promise and all of that, and for my child’s rights to be stripped away for just being herself is gross,” Candace said, adding that she and her family feel like they have “no control over” their future in the United States.
Brandon and Candace, who agreed to speak on the condition that their last names not be used to protect their family from harassment and threats, are one of five families interviewed by NBC News who have either already left or plan to leave the country as a result of federal and state policies targeting transgender people and their health care. The families described fears of increased anti-trans violence and losing access to health care and identification documents that reflect their gender identities.
Chase shares a quiet moment in her bedroom with her mom, Candace, and the family cat, who will be joining them in New Zealand.Jimena Peck for NBC News
During Donald Trump’s first presidential term, many trans people talked about leaving the country, according to Sydney Duncan, a lawyer for Advocates for Trans Equality, the country’s largest transgender rights group. However, few people actually did.
Trump’s second term has had a more immediate effect on trans people and their rights because of several executive orders he issued this year. The orders, many of which are blocked in court or have faced lawsuits, have prohibited federal funds from going to hospitals that provide transition-related care to minors, barred trans women and girls from competing in female sportsin K-12 schools and colleges,blocked trans people from getting passports that reflect their gender identities and banned trans people from military service.
But while an increasing number of trans people are deciding to leave the United States, Duncan cautioned that it still isn’t a widespread trend.
“The reality is that a lot of people of trans experience don’t have the resources to travel or to escape the policies of this administration,” Duncan said.
Brandon and Candace said they will arrive in New Zealand with only their clothing, sentimental items and ski gear.Jimena Peck for NBC News
‘We were supposed to be safe here’
Brandon and Candace said their fears of having to leave the country were realized just 13 days into Trump’s second term. That is when Chase’s medical team at the Children’s Hospital Colorado told them it could no longer provide transition-related medical care to anyone under 19 because of an executive order Trump issued that barred research and education grants from going to hospitals that provide such care to minors.
The couple were shocked, in part because Colorado is among about a dozen states that have passed “shield” laws intended to protect access to trans health care, they said.
“Our reaction was we were supposed to be safe here until we left,” Candace said. “And immediately, we weren’t.”
Chase keeps what the family calls a “pillow library.” It’s a collection of four to five books under her pillow that she reads after her parents put her to bed. Jimena Peck for NBC News
Some parents told NBC News that if the court allows the law to stand, they fear Trump will try to declare all transition care for minors child abuse and directthe attorney general to investigate parents who have been vocal advocates for their trans kids, similar to what Republican officials in Texas did in 2022. Trump issued a proclamation in April for Child Abuse Prevention Month declaring “the sinister threat of gender ideology” one of “the most prevalent forms of child abuse facing our country today.”
So far, Chase hasn’t received any transition-related care other than therapy and regular checks at the hospital to monitor for when she starts puberty. However, she is likely to consider it in the near future, and Brandon and Candace said they don’t want to raise her in an environment in which she hears negative rhetoric about trans people from elected officials.
Chase loves playing soccer and skiing, and she keeps what the family calls a “pillow library” — a collection of four to five books under her pillow that she reads after they put her to bed. Chase said she feels both happy and sad about moving, because she doesn’t want to leave her friends, but she does want to try living somewhere new.
Chase, who is in fourth grade, looks at pictures of Taylor Swift in her bedroom.Jimena Peck for NBC News
Asked in an interview with her parents whether she is aware of Trump’s policies regarding trans people, Chase, who is in the fourth grade, said, “I am very aware about what he has been doing to people like me, and how I feel about it is I hate it, because I think everybody deserves to have that care.”
Brandon and Candace said they chose New Zealand because Brandon loved it when he visited a few years ago, it is very LGBTQ-friendly, their kids will be able to speak the language, and its way of life is similar to Denver’s.
They began planning the move while they applied for jobs in New Zealand. On Tuesday, Brandon officially accepted a job as a sales manager at a winery in Queenstown. He should have an accredited employer visa in about four weeks, while visas for the rest of the family will take an additional two. Accredited employer visas allow people to stay for up to five years if they have received job offers from accredited employers, and they provide a path to permanent residence. It will also provide Candace with a partner visa that will allow her to work in New Zealand.
The family will leave the United States and begin 35 hours of travel to their new home on July 23. The winery offered a house on the vineyard for the family to stay for six weeks until they find a home to rent.
When Chase found out that Brandon had gotten the job at the winery, she burst into “tears of happiness,” Candace said.
Chase and her family look at a map of Queenstown, New Zealand, where they’ll be moving in July.Jimena Peck for NBC News
“School’s ending next week, and then everything kind of gets real,” she said, adding that the entire family feels a mix of excitement and sadness about having to start saying goodbye to their lives in the United States.
They estimated that the total cost of moving their family — which also includes Chase’s older brother, a 90-pound dog and two cats — will be $65,000 to $80,000. That total includes one-way plane tickets for the family of four ($6,000); relocation services for their three pets, if they can afford to take all of them ($25,000); visa applications ($3,000); lawyer fees ($2,000); and required medical tests for the move that aren’t covered by insurance.
Candace organized a GoFundMe fundraiser with a goal of $50,000, in part because, she said, she felt bad asking for anything more. The money will go toward the expenses they’ve paid with their savings so far and to whatever they need when they arrive with only their clothing, sentimental items and ski gear. They’ve raised just over $6,500 and have already taken money out of one of their 401(k) retirement plans to cover some moving costs.
Chase and her mom share an embrace in their Denver living room. Jimena Peck for NBC News
A pre-emptive departure
The Jackson family of Missouri left more than a year before the 2024 election. Debi Jackson’s child Avery, who uses they/them pronouns and is about to turn 18, became a prominent face in trans advocacy after they were featured on the cover of National Geographic in January 2017, when they were 9 years old.
The family lived in Kansas City for 15 years and often traveled to the State Capitol to testify against legislation targeting trans people. She said that after a series of difficult events — the Supreme Court’s overturning Roe v. Wade; a shooting at a school in Uvalde, Texas, that killed 19 people; and Missouri’s enacting a ban on gender-affirming care for minors — her kids asked her why they were still in the United States.
“In that moment, I realized they were just saying they wanted out completely,” Jackson said. “A big part of it was their fear over the escalation of violence that we could all tell was going to come, because for years they had been listening to the language about trans people become more and more dehumanizing and become more and more violent in the way it was presented.”
Jackson said she also knew trans issues would be important for Republicans in the 2024 election, and she feared that photos of Avery — which she said prominent right-wing figures in Brazil, France and Poland were already using in speeches and online — could be featured in Republican attack ads.
She said she also knew the family couldn’t afford to move to another state first and then leave the country if Trump won.
Just a few months later, in September 2023, Jackson packed up her family and moved them to a country in the European Union, which for safety reasons she declined to name. She said it took her two months to raise $15,000 online to pay to transport their four dogs to Europe and for an initial deposit to rent a home.
Jackson does consulting and freelance writing remotely and was able to get a digital nomad visa, which in some countries can provide permanent residency. Now settled in her new home, Jackson said she spends time each day answering some of the hundreds of direct messages she gets on social media from parents with trans children who want to move either to other states or out of the country entirely.
Jackson said many Americans don’t know, for example, that they can’t move to other countries, particularly in Europe, and apply for asylum because of their or their children’s trans status. No countries that provide asylum to LGBTQ peoplebecause of fears of persecution accept U.S. citizens through those programs. When people are denied asylum by one of the more than two dozen member countries in the European Union, they are also banned from re-entering all other countries in the E.U. except Ireland and Switzerland for two years if they are from what are considered “safe countries.”
“I spend a lot of time researching and replying to people,” Jackson said. “That’s really the way that I deal with stress and trauma, is by trying to actually be proactive rather than reactive.”
Chase in her bedroom as she prepares for a move to New Zealand.Jimena Peck for NBC News
‘Life is starting again’
It’s not only trans minors and their parents who are making the move. Ohio couple Marina, 30, and Faye, 23 — who are both trans and requested that only their first names be used because of fears of being publicly targeted — are leaving the United States behind for Australia. Faye saidone of the turning points for her was the Trump administration’s detaining and trying to deport people with valid visas and revoking the visas of foreign-born college students. Faye is an Australian citizen on a student visa, and Marina is a U.S. citizen.
The couple have to move before Marina turns 31 in August, because they plan to get work holiday visas, which are available only to those 30 and younger and would allow them to stay and work in Australia for up to a year. It costs $600 to apply, and applicants also have to show that they have at least $5,000 in their bank accounts. After that year is up, the couple have to decide whether they want to get married.
Marina said they’re looking forward to the stress of the move’s being over.
“Every time I look at my cat, I’m about to cry,” Marina said of their 10-year-old pet, which they have to leave behind until Marina’s sister can, they hope, bring her over after having completed Australia’s rigorous process to move animals into the country. “It’s really overwhelming. I feel like once we actually have our feet down on the ground in Australia, it’s definitely going to be sad and still a lot of emotion, but part of it’s definitely going to feel like life is starting again.”
As for Duncan, the Advocates for Trans Equality lawyer, she that said she and her wife, a college professor in Alabama, have talked about leaving the country but that one of the problems they’ve run into is whether there is a safer place to go.
“What does Canada look like in 10 years? Do they get to where we are now? Or do they learn from our mistakes here?” she said. “It just becomes a Rubik’s Cube of decisions to solve, and that’s exhausting.”
There were 932 anti-LGBTQ incidents across the United States over the past year — from hate speech and bomb threats to fatal violence — with more than half of these acts targeting transgender and gender-nonconforming people, according to a new report from the LGBTQ advocacy group GLAAD.
The report found a year-over-year increase in incidents targeting transgender and gender-nonconforming people, state and local governments, and educators and librarians. It also found a decrease in incidents targeting drag performers and pride symbols.
“This really goes toward showing these kinds of shifting tides in hate and what extremists like to focus on at the moment,” Sarah Moore, an analyst of anti-LGBTQ extremism at GLAAD, told NBC News. “They really are kind of beholden to the new cycle of the day.”
This is the third year GLAAD has published an annual report based on its Anti-LGBTQ Extremism Reporting Tracker. The 932 incidents tracked in this latest report occurred between May 1, 2024, and May 1, 2025. This is a 20% drop from last year’s 1,173 incidents and an 80% increase from the 521 incidents tracked in its inaugural report in 2023.
GLAAD defines anti-LGBTQ incidents as both criminal and noncriminal “acts of harassment, threats, vandalism, and assault motivated by anti-LGBTQ hate and extremism.” Incidents are tracked through self-reports, media reports, social media posts and data sharing from partner organizations and law enforcement and then validated by a team at GLAAD.
Moore cautions that the incidents tracked in the report are “just a drop in the bucket in terms of what is actually happening when it comes to anti-LGBTQ hate.”
“This is more of a snapshot of what the lived experience of LGBTQ people is, as opposed to being an exact accurate representation of every incident of hate in the U.S.,” she said.
One of the most surprising findings from this year’s report, Moore said, was the sharp decrease in incidents targeting drag performers, which dropped to 83 tracked incidents from 185 the year prior.
“This really goes to show the resilience of the drag community, and that we’ve seen them take all of these amazing steps toward protecting their own personal safety, protecting the safety of their audiences and working with community security organizations,” she said.
Coinciding with this decrease in anti-drag incidents is an increase in incidents targeting local and state governments and educators and librarians.
“We saw a number of our incidents, actually, going after city council officials, going after political candidates who are either LGBTQ or who support the community, going after legislators at the state level who are trying to protect or enshrine LGBTQ rights and going after educators and librarians that are offering safe spaces for LGBTQ youth in their classrooms and in their libraries as well,” Moore said.
Anti-LGBTQ incidents take place more frequently in June, according to the past two years of reporting by GLAAD’s Anti-LGBTQ Extremism Reporting Tracker.
“That is most likely attributed to the fact that June is Pride Month, and that’s when we’re going to have the biggest number of LGBTQ events and the most visible events,” Moore said. “This June, for example, D.C. is holding WorldPride, which is going to be a really massive event and really massive showing of support for the LGBTQ community in the U.S. and globally.”
When asked if GLAAD has safety tips for those planning to attend Pride Month events this year, Moore noted that one of the hallmarks of the LGBTQ community is its “resilience and strength.”
“This hate, unfortunately, is not new to us. We have been dealing with persecution, with oppression, with these acts of hate against our community for centuries,” she said, adding that the first Pride marches were protests held on the first anniversary of the 1969 Stonewall uprising.
“So I think just really carrying on those legacies of pride as a form of protest, pride as a form of resistance, pride as a refusal to allow others to define us and to legislate our bodies and tell us that we have to be kept in private spaces and not display our true authentic selves to the rest of the world.”
More than a tax bill, the legislation, passed 215-214 in the early morning hours Thursday, couples tax cuts for corporations and the wealthy with profound structural changes to Medicaid and the Affordable Care Act, including provisions that would strip transgender people of access to transition-related care — even when privately insured. It’s a vision of health policy that experts told The Advocate weaponizes bureaucracy and budgetary authority to target one of the most marginalized groups in the country.
What Trump’s budget bill does to trans health
At the heart of the bill are two key provisions targeting transgenderhealth care. The first prohibits Medicaid and the Children’s Health Insurance Program from covering any gender-affirming services — puberty blockers, hormone therapy, surgeries — for people of any age. The second redefines what counts as an “essential health benefit” under the ACA, explicitly excluding transition-related care from private insurance plans regulated by federal standards.
Katie Keith, a scholar and director of the Center for Health Policy and the Law at the O’Neill Institute for National and Global Health Law at Georgetown University Law Center, told The Advocate the bill would “certainly increase health care costs for transgender people, both on those who have Medicaid coverage, but also those who have marketplace coverage as well.”
“By stripping federal funding for treatment for gender dysphoria, you’re imposing a whole set of barriers,” she said. “A primary one is cost. But I think it will also have the unintended — or maybe intended — consequence of deterring providers from offering this care at all.”
Keith, who previously served as deputy assistant to the president and deputy director of the White House Gender Policy Council under President Joe Biden, added that the essential health benefits provision could destabilize health coverage even for those outside ACA marketplaces.
“By proposing to exclude treatment for gender dysphoria from essential health benefits, this care would not be subject to cost-sharing limitations that apply to essential health benefits under the Affordable Care Act,” she explained. “If treatment for gender dysphoria is not considered an essential health benefit, transgender people — including those in job-based private health insurance — could face higher out-of-pocket costs for care that would otherwise be covered.”
Medicaid cuts and their fallout
The bill’s language goes beyond cost containment; it reengineers Medicaid to eliminate federal support for gender-affirming care, even in states that affirmatively cover it. As Adrian Shanker, a former Biden administration LGBTQ+ health adviser in the Department of Health and Human Services, told The Advocate, this would deliver a disproportionate blow to low-income trans people who rely on Medicaid
“Medicaid is the payer for low-income Americans, and it’s an essential safety net program,” Shanker said. “We know that trans people are disproportionately lower income and benefit from Medicaid in a higher percentage than the majority population. We know that’s even more pronounced among trans people of color and trans people who are from rural communities.”
A new study from the Williams Institute at UCLA underscores the scale of what’s at stake. Drawing on federal health data, the May report finds that approximately 1.8 million LGBTQ+ adults — nearly twice the rate of non-LGBTQ+ adults — rely on Medicaid as their primary source of health insurance. The burden is especially acute among transgender people, more than 185,000 of whom depend on Medicaid. These disparities, the authors note, are driven by intersecting inequalities — including disability, parenting responsibilities, and systemic economic disadvantage — that make Medicaid a lifeline for some of the most vulnerable in the LGBTQ+ community.
The legislation’s ripple effects would be especially catastrophic in states like Colorado, where budget constraints enshrined in the state constitution limit how leaders can respond to sudden federal funding shortfalls. Mardi Moore, executive director of Rocky Mountain Equality, told The Advocate that Colorado’s unique combination of a balanced budget requirement and the Taxpayer’s Bill of Rights (TABOR) would make it nearly impossible for the state to backfill the $10 billion the state receives annually in federal Medicaid funding.
TABOR, adopted by voters in 1992, is one of the most restrictive fiscal policies in the country. It caps state spending increases to a formula based on population growth and inflation — but inflation as experienced by government services, not consumers, Moore explained. TABOR also requires voter approval for any new taxes or tax increases, which means Colorado’s legislature cannot simply raise revenue or allocate extra funds to offset lost federal support without a ballot measure.
“The service gaps are going to widen, especially for LGBT communities, people of color, rural communities, low-income folks, and young people,” Moore said.
Why the bill targets trans health
The bill’s framing — slashing Medicaid to “pay” for tax cuts while targeting trans care — represents what critics have called a cruel calculus: appealing to a political base through culture war flashpoints. “This administration seems obsessed with the idea that their political goals are more important than the health and wellbeing of the American people,” Shanker said.
Moore, a longtime LGBTQ+ advocate, echoed that sentiment. “They know this is a winning issue for their base,” she said of the bill’s anti-trans provisions. “Our movement has not done a great job of getting information out about trans folks. The narrative that gender-affirming care is a choice and not medically necessary has taken hold. ‘Why should my tax dollars pay for your choice?’” she said. “That’s what we’re fighting.”
Even if the bill dies in the Senate, Moore argued that the damage has already been done. “The national narrative is starting to take hold in Colorado,” she warned. “There’s just not enough of us who care about others to make the community well.”
A broader strategy of erasure
Advocates for Trans Equality, the largest trans-led policy organization in the U.S., called the bill a calculated political attack. “This budget proposal is a direct, calculated attack on the lives and dignity of people across the country,” Sinead Murano-Kinney, the group’s health policy analyst, said in a statement. “These cuts clearly aim to make trans people and their healthcare into political scapegoats.”
Murano-Kinney pointed to a 2022 Williams Institute report showing that 21 percent of trans adults rely on Medicaid, likely due to high rates of employment discrimination and economic instability. “Denying access to this care would not only worsen physical and mental health outcomes but would deepen housing insecurity, exacerbate mental health crises, and increase rates of depression and suicidality among trans people.
“This is no accident — it is part of a broader political agenda driven by anti-trans extremists determined to force trans, nonbinary, and intersex people out of public life,” she added.
Insurance industry raises alarm
Notably, even the health insurance industry has balked at the logistical and financial burdens of carving out gender dysphoria care from essential health benefits. In public comments reviewed by the Center on Health Insurance Reforms at Georgetown, insurers such as the Blue Cross Blue Shield Association warned that banning care for gender dysphoria would create “significant operational burdens” and could inadvertently disrupt access to services used for other conditions, including cancer treatment, menopause care, and birth control procedures like vasectomies.
“This is just health care,” said Keith. “Many of these procedures are medically necessary for cisgender people, too. The only difference is who’s receiving the care.”
What comes next?
Keith said legal challenges are inevitable, but the immediate policy impact is clear: health care for most transgender Americans is at risk.
The Congressional Equality Caucus has condemned the bill, with Chair Rep. Mark Takano of California warning that 13.7 million Americans will lose their health insurance if it becomes law. “Attacks on the trans community are just the cherry on top,” Takano said. “Congress should be working to make healthcare more affordable — not banning medically necessary care or pulling the rug out from underneath millions who rely on Medicaid.”
The stakes are no longer hypothetical as the bill heads to the Senate.
“The word I just use over and over is cruel,” Moore said. “How much more cruel can you be, and what’s the point of this? Is the point really cruelty?”
In 2022, Utah Gov. Spencer Cox was the rare Republican governor who seemed to truly care about the well-being of transgender kids. “I don’t understand what they are going through or why they feel the way they do. But I want them to live,” he wrote in a letter that year, explaining why he was vetoing a bill that would have banned four trans middle- and high schoolers in Utah from playing on sports teams with classmates who shared their gender identity. “All the research shows that even a little acceptance and connection can reduce suicidality significantly.”
Meanwhile, nationally, Republican politicians were making opposition to trans rights a core tenet of their platforms, filing hundreds of bills attacking trans kids at the doctor’s office, at school, and on the field. Early in the 2023 legislative session, Cox capitulated, signing a bill that placed an indefinite “moratorium” on doctors providing puberty blockers and hormone therapy to trans kids with gender dysphoria. The bill ordered the Utah health department to commission a systematic review of medical evidence around the treatments, with the goal of producing recommendations for the legislature on whether to lift the moratorium. “We sincerely hope that we can treat our transgender families with more love and respect as we work to better understand the science and consequences behind these procedures,” Cox said at the time.
Now, more than two years later, that review is here, and its conclusions unambiguously support gender-affirming medical care for trans youth. “The conventional wisdom among non-experts has long been that there are limited data” on gender-affirming pediatric care, the authors wrote. “However, results from our exhaustive literature searches have lead us to the opposite conclusion.”
The medical evidence review, published on Wednesday, was compiled over a two-year period by the Drug Regimen Review Center at the University of Utah. Unlike the federal government’s recent report on the same subject, which was produced in three months and criticized gender-affirming pediatric treatments, the names of the Utah report’s contributors are actually disclosed on the more than thousand-page document.
The authors write:
The consensus of the evidence supports that the treatments are effective in terms of mental health, psychosocial outcomes, and the induction of body changes consistent with the affirmed gender in pediatric [gender dysphoria] patients. The evidence also supports that the treatments are safe in terms of changes to bone density, cardiovascular risk factors, metabolic changes, and cancer…
It is our expert opinion that policies to prevent access to and use of [gender-affirming hormone therapy] for treatment of [gender dysphoria] in pediatric patients cannot be justified based on the quantity or quality of medical science findings or concerns about potential regret in the future, and that high-quality guidelines are available to guide qualified providers in treating pediatric patients who meet diagnostic criteria.
In a second part of their review, the authors looked specifically at long-term outcomes of patients who started treatment for gender dysphoria as minors:
Overall, there were positive mental health and psychosocial functioning outcomes. While gender affirming treatment showed a possibly protective effect in prostate cancer in transgender men and breast cancer in transgender women, there was an increase in some specific types of benign brain tumors. There were increased mortality risks in both transgender men and women treated with hormonal therapy, but more so in transgender women. Increase risk of mortality was consistently due to increase in suicide, non-natural causes, and HIV/AIDS. Patients that were seen at the gender clinic before the age of 18 had a lower risk of suicide compared to those referred as an adult.
Submitted with the review was a set of recommendations—compiled by advisers from the state’s medical and professional licensing boards, the University of Utah, and a Utah non-profit hospital system—on steps the state legislature could take to ensure proper training among gender-affirming care providers, in the event it decides to lift the moratorium.
But according to the Salt Lake Tribune, legislators behind the ban are already dismissing the findings they asked for. In response to questions from the Tribune, Rep. Katy Hall, who co-sponsored the 2023 ban, issued a joint statement with fellow Republican state Rep. Bridger Bolinder, the chair of the legislature’s Health and Human Services Interim Committee, that dismissed the study’s findings. “We intend to keep the moratorium in place,” they told the Tribune. “Young kids and teenagers should not be making life-altering medical decisions based on weak evidence.”
Why ignore their own review? Polling, the legislators’ statement suggests. “Utah was right to lead on this issue, and the public agrees—polls show clear majority support both statewide and nationally,” Hall and Bolinder added in their statement. “Simply put, the science isn’t there, the risks are real, and the public is with us.”
Others, like former state Rep. Mike Kennedy, a co-sponsor of the 2023 ban who now represents Utah’s 3rd district in Congress, have so far been silent on the state review’s findings—as has Gov. Cox, who did not respond to the Salt Lake Tribune‘s request for comment.
In Trump’s new America, bathrooms have become politicized battlegrounds.
What may have seemed like an issue resolved in 2017 following the repeal of North Carolina’s infamous HB 2, bathroom bans targeting the trans community have once again made national headlines alongside a spate of new bills.
Nineteen states already have active laws that restrict transgender people from using restrooms that match their gender identity. Many of these bills are more extreme than those in previous years, with Florida and Utah—two states that have banned trans folks from using all government building restrooms that match their gender identity—threatening criminal penalties against violators. Florida’s law classifies the offense of using the bathroom and not leaving when asked as a first-degree misdemeanor, punishable by up to a year in prison and a $1,000 fine.
Photo on left by Whitney Brewer for Uncloseted Media.
To understand what these bans look like in practice, Uncloseted Media documented Briden Schueren, a trans man, legally using the women’s bathroom at the University of Cincinnati and Ashley Brundage, a trans woman, legally using the men’s bathroom at Tampa International Airport.
Whitney Brewer for Uncloseted Media.
Schueren, a 37-year-old art studio owner from Columbus, Ohio, walks across the University of Cincinnati’s campus, uncertain of where he can and can’t use the men’s restroom in his home state.
“What are the bills, what is getting passed in the House,” he told Uncloseted Media. “[Keeping up] is just exhausting.”
Ohio is one of seven states that ban transgender people from using bathrooms and facilities consistent with their gender identity in K-12 schools and specific government-owned buildings, including the University of Cincinnati.
Provided by a University of Cincinnati student.
The public research university made headlines and sparked outrage from LGBTQ advocates when it implemented restroom signs labeled “biological men” and “biological women” to enforce Ohio’s Senate Bill 104. They took the signs down after just one month of protests, with college administrators apologizing to students in an email, saying that the “biological” bathroom signs will be replaced and that they made an “error.”
But even with the removal of the signs, it’s still illegal for Schueren to use the men’s bathroom anywhere on the school’s campus, meaning if he wants to follow the law, he has to use the women’s bathroom or a gender neutral option that is “out of the way,” according to students.
Schueren says he felt uncomfortable entering a space where he knows he doesn’t belong. “I now have to be in this bathroom [even though] that’s not how I identify anymore socially and mentally,” he says. “I don’t belong there. As a masculine person with a very obvious beard, I feel like my bathroom is the men’s restroom.”
Brundage, a 44-year-old transgender woman from Tampa, Florida, has not used men’s restrooms for 16 years since she came out.
“It felt weird,” says Brundage, describing the moments before being forced by law to use the men’s restroom at the airport. “It was a little awkward, right? We wanted to make sure that we weren’t making anybody feel uncomfortable.”
Schueren says that being back in a bathroom that doesn’t align with his identity was painful.
Research from the International Journal of Transgender Health shows that 49% of transgender youth reported sometimes avoiding public bathrooms and 22% always avoided them. Youth who avoided bathrooms were nearly twice as likely to attempt suicide in the past year compared to those who never avoided public bathrooms. And a 2020 survey found that 85% of transgender youth who faced bathroom restrictions reported a persistent depressive mood.
“We already know that the suicide rates for trans individuals are highest amongst everybody, so it just could cause more,” says Schueren.
Whitney Brewer for Uncloseted Media.
Bathroom bans are not only emotionally taxing; they can be dangerous.
A 2025 report by the Williams Institute found that transgender people face increased risks when they are required to use bathrooms according to their sex assigned at birth. Transgender men were more likely to experience harassment when using the women’s restroom.
Schueren has faced harassment in both the men’s and women’s restrooms. In the early stages of his transition, he remembers entering a bathroom on his college campus and being followed by a man who knew he was trans. “He was making aggressive movements,” says Schueren.
The man stood outside the stall, punching his hand against the wall. “He was just so angry. … [H]e was much bigger than I was. He was making threats, saying I would ‘be injured.’”
For nearly 45 minutes, Schueren sat on the toilet and watched through the crack in the stall door as the man paced back and forth before finally departing. “I was just sitting in the bathroom shaking hysterically, waiting patiently for him to leave.”
Brundage, who ran for office for the Florida House of Representatives in 2024, sees a massive irony when far-right lawmakers claim these bans will keep women and girls safer.
“I also want to make sure that my kids are safe in bathrooms,” Brundage says. “The people who actually do harm in spaces … are typically cisgender men. And it’s like, ‘Who is the actual villain?’ We should be doing something to address the issue, not scapegoating transgender people.”
Congresswoman Nancy Mace, who has been vocal and accusatory on this issue, has used transgender slurs in press conferences and has framed her stance as a defense of “biological reality” against what she calls “radical gender-bending experimentation.”
In November 2024, she introduced a resolution to ban transgender women from using female facilities on federal property. When asked if the resolution was targeted toward Sarah McBride, the first openly transgender member of Congress, Mace said, “Absolutely.”
Even though McBride said she would follow House rules by using a private bathroom on Capitol Hill, Republican Congresswoman Lauren Boebert mistakenly confronted a cisgender woman in a Capitol bathroom, believing she was Rep. McBride.
Boebert reportedly said, “You shouldn’t be here,” before realizing her error and later apologizing.
In addition, earlier this month, two cisgender women were ordered to leave a Boston hotel after a security officer demanded one of them show identification to “prove” her sex while using the women’s restroom.
“We have to do a better job in the world linking bathroom hypocrisy to [discrimination],” Brundage says, drawing a line from today’s debates to Jim Crow laws from the 1960s, where Black Americans were banned from white-only bathrooms—part of a racist system that falsely promised “separate but equal.”
Whitney Brewer for Uncloseted Media.
Far-right media has created a narrative that allowing trans folks to use the bathroom that matches their gender identity is dangerous and unsafe, especially for young girls.
In 2021, Fox News aired 88 segments over a three-week period about a sexual assault at a Virginia high school, repeatedly suggesting that the incident was related to trans-inclusive bathroom policies. Fox host Will Cain claimed that the school’s “transgender policies led to [a father’s] teenage daughter being allegedly raped in the school bathroom by a man in a skirt.” These claims were false, as the school’s policy was implemented months after the assault.
In addition, transgender men are frequently indistinguishable from cisgender men. This means a male predator wouldn’t need to disguise himself to enter a women’s restroom in a state with a bathroom ban; he could simply claim to be trans.
“A law’s not gonna stop a gross, deranged perpetrator,” says Schueren. “They’re already breaking the law by being a person that wants to be a predator. So it’s not trans people that are doing this, it’s people that just break the law in general, and those tend to be cis [men].”
There is no empirical evidence that allowing trans individuals to use a bathroom of their choosing increases the risk of sexual assault.
Brundage says that beyond the misinformed narratives surrounding anti-trans legislation lies something far more practical and frustrating: a massive amount of wasted taxpayer dollars.
“We’re talking about this wasteful spending issue of trans people,” she says. “Meanwhile, do I have a realistic way to make a living? Am I paying too much for insurance? Do the roads have potholes where I live? All of these things that could actually really affect you on a day-to-day basis aren’t being discussed and aren’t being solved.”
Brundage notes the more than $215 million the Trump campaign and the GOP spent on anti-trans ads during the last election cycle.
She says the constant political targeting of trans people has psychological and social consequences.
“Could you imagine if someone was going to be the president … and every time they got on the microphone, they talked about all the people named Steve in the world, how awful they are, how crappy they are?” she says. “If your name is Steve, you’re going to feel really crappy eventually. You’re going to feel like the whole weight of the largest economy in the world is against you.”
Whitney Brewer for Uncloseted Media.
While using a bathroom isn’t something cis people have to think about, Schueren says it’s often on his mind, especially when crossing state lines. “I recently went on a road trip with a trans person and we both are at different stages of our transition,” he says.
Beyond the emotional toll and stress of planning where to use the bathroom, holding in urine can increase the risk of urinary tract infections, cause bladder discomfort, and—in the long-run—contribute to bladder dysfunction from overstretching.
