As a nation, we owe all youth, including transgender, nonbinary, and gender diverse (“TNGD”)¹ youth, the opportunity to thrive and exist in homes, schools, and communities, that support their healthy development. We must implement policies that reflect this commitment to youth and ensure it is not conditional on race, gender identity, sexual orientation, religion, immigration status, or any other element of identity

The research is clear: lesbian, gay, bisexual, transgender, and queer (LGBTQ+)²  youth thrive when their identities are respected, they are safe from emotional and physical victimization, they have access to programs and physical spaces consistent with their identity, and they receive love and support from their families and communities. Yet, recent federal and state attacks have threatened LGBTQ+ youth’s well-being, and data clearly highlights that as a nation we are failing TNGD youth in particular. In 2022 and 2023, state legislatures set records for pursuing anti-LGBTQ+ legislation³ and are on track to do the same in 2024;⁴ in 28 states, a majority of these attacks include laws and policies specifically targeting TNGD youth.⁵ TNGD youth face extreme barriers to their safety and well-being and in some places, daily assaults on their health – for example, with some states restricting access to affirming health care, including banning gender-affirming care. While in some communities, there may not be an explicit attack on the health, well-being, and safety of TNGD youth, data clearly highlights the gap in community-based supports for these youth and their families, seen through the significant overrepresentation of TNGD in child welfare, juvenile legal,⁶ and homeless systems.

When they become involved in these out-of-home systems, these youth experience physical and mental harm, exclusion from services, and instability that lead to poor outcomes when they leave these systems. Importantly, TNGD and lesbian, gay, bisexual, and queer (“LGBQ+”) youth do not experience worse outcomes or more system-involvement because they identify as TNGD or LGBQ+, but due to the compounding impact of stigma and societal inequities, racism, and misogyny.

We owe TNGD youth better. We owe youth and their families community-based supports that address dynamics that may lead to out-of-home systems; and when youth are in out-of-home systems, we have a responsibility – including a legal responsibility – to promote their safety, health, and well-being. Policymakers and system administrators must take action. They must work to create and implement policies and resources that support TNGD youth in their communities and eliminate harm for youth who are currently system-involved. These policies must center equity, reflect the experiences of TNGD youth, be based on research and science, and include structures that hold systems accountable to youth, thereby creating conditions for TNGD youth to thrive.

Public Systems Are Failing TNGD Youth

Too many youth and families are separated, experiencing homelessness, or involved with juvenile and criminal legal systems due to lack of affordable housing, living wages, and community supports. Much of the research since Safe Havens I confirms prior findings that LGBTQ+ youth are over-represented in child welfare, juvenile legal, and homeless systems compared to their non-LGBTQ+ peers; are predominately youth of color; and have worse experiences while in out-of-home systems. These experiences and outcomes are not inherent in being TNGD but are a result of systemic and societal failure to support TNGD youth. These failures demonstrate that TNGD youth need more supportive policies in place.

Once in these systems, TNGD youth are often failed yet again, and face enormous barriers to accessing support, care, and having their identities affirmed, despite systems’ legal requirements to support the well-being of the youth in their custody, promote their rehabilitation, or provide safe and supportive housing. Youth and families do not get the support they need and experience harm from the system itself. TNGD youth must navigate complex, underfunded, and disjointed social and economic support systems as they try to find family and community acceptance, secure safe and affordable housing, pursue their education, find employment, and access health care – all in the context of public policies that often deny their identities.

These systems and services, which should be robust and affirm and support TNGD youth, too often fail to meet their needs. Discriminatory policies not only marginalize TNGD youth and keep them from crucial supports, but also stigmatize and criminalize their identities and actions. Further, TNGD youth are also impacted by ongoing bias, prejudice, and discrimination in society, which causes elevated rates of suicidal ideation and substance use, among other negative health outcomes. For TNGD youth of color, these barriers are exacerbated by discrimination and systemic racism in public programs.⁷

Policy Must Affirm Youth Identities and Center Their Experiences

Latest research confirms what countless prior studies have found: for transgender, nonbinary, and gender diverse youth to thrive, they need more than safety from overt bigotry and exclusion; they need explicit affirmation. This means respect, love, and support from their families and communities, physical and emotional safety, and access to programs and facilities, such as restrooms and housing, consistent with their identity. For law and policy to meaningfully affirm and protect TNGD youth, policymakers and administrators must rely on the experiences of TNGD youth who have been in out-of-home systems. To support those youth who are currently in juvenile legal, child welfare, and youth homelessness systems, we must implement policies and practices that promote and affirm the identities of TNGD youth, meet young people where they are and in ways that are responsive to their needs, including by letting them define their own identities, address chronic challenges by aligning practice with professional standards, and support youth to thrive in today’s hostile political environment.

New and Continuing Challenges For TNGD Youth: An Update

During the last 20 years, research and information shared in our work with youth has documented overrepresentation of LGBQ+ and TNGD youth in out-of-home systems, but little concentrated effort has been made to safely prevent system-involvement and provide supports to families, who may be struggling, to accept youth. Policymakers should focus efforts on preventing system-involvement and supporting youth in their communities by 1) following the recommendations of TNGD youth with lived experience in these systems, 2) basing policies on science and research rather than stigma, 3) eliminating harm within public systems, and 4) implementing laws and policies that are supportive to TNGD youth.

As highlighted by Safe Havens II youth contributors, who share their lived experience and a call to action for systemic improvement in this report, since the publication of Safe Havens I in 2017, TNGD youth in particular face new challenges as a result of an onslaught of political attacks on their identities and well-being. In the wake of advances in the law for LGBTQ+ people and U.S. Supreme Court decisions establishing marriage equality for same-sex couples, the Trump Administration made multiple attempts to limit or erase LGBTQ+ rights, with many focused on TNGD people.⁸ In 2022 and 2023, state legislatures increased their attacks on LGBTQ+ youth. Specifically, 2023 eclipsed the record set in 2022 for most anti-LGBTQ+ bills, with over 500 anti-LGBTQ+ bills introduced in state legislatures and 84 becoming law.⁹ The first quarter of 2024 saw over 400 anti-LGBTQ+ bills introduced across the country.¹⁰ Tyler, a youth contributor, said, “It mentally affects me because . . . my community isn’t being protected. Other trans people . . . can’t get the support they need and . . . it makes me sad[.]”

Twenty-eight states now have harmful laws or policies in place specifically targeting TNGD youth¹¹ in health care access, school curricula, parental notification requirements, restroom and facility access, and sports participation. This government sanctioned discrimination harms not only TNGD youth, but also all youth who also face the systemic consequences of such hatred. For system-involved TNGD youth, these new laws and policies layer additional harm when youth are not able, for example, to travel to another state for necessary medical care without agency permission or lack the financial resources to do so. Rhetoric and misinformation have created a chilling effect on affirmation of youth. Professionals, including teachers, doctors, and social workers, are now fearful of being reported and having their licenses revoked.

Efforts To Affirm, Support, And Protect TNGD Youth: An Update

Despite these setbacks, efforts are underway to improve the circumstances for TNGD youth who are involved with child welfare, juvenile legal, and homeless systems. Since the release of Safe Havens I, nondiscrimination protections and affirming agency policy or practice guidance in these systems have increased. For example, 26 additional states have gender identity and sexual orientation nondiscrimination protections in statute, regulation, or agency policy;¹² across the child welfare and juvenile legal systems. 44 states now have gender identity nondiscrimination protections in statute, regulation, or agency policy;¹³ more LGBTQ+ specific practice guidance for agency staff has been developed by child welfare and juvenile legal agencies in collaboration with community stakeholders; more agencies require training for detention staff, probation officers, and child welfare caseworkers; and some states have mandates for prevention efforts and services that promote acceptance of youth by families.

These efforts are a result of strong advocacy and education, and the leadership and increased visibility of, and partnership with, TNGD youth. TNGD youth are engaging in advocacy and systemic improvement efforts, sharing their recommendations and experiences, and asserting their rights in the legislative process, litigation, and agency policymaking. As a result, since 2017:

• Twenty-six states have added gender identity as a protected class in law or policy related to youth in out-of-home systems,¹⁴ making the total number of states with nondiscrimination protections for youth on the basis of gender identity 34 in child welfare¹⁵ and 37 in the juvenile legal system.¹⁶
• Sixteen states and Washington, D.C. are providing additional affirmative protection for LGBTQ+ youth in a variety of ways, including protecting the right of transgender and nonbinary youth to access gender-affirming medical care.¹⁷
• Twenty states have statewide protections for school-aged TNGD youth.¹⁸
• Twenty-three states now allow people to choose an “X” gender marker to reflect nonbinary and/or intersex identities on their identity documents.¹⁹

While there has been some progress in law, policy, and practice guidance within child welfare, juvenile legal, and youth homeless systems, there is still more to do:

• Child welfare systems in 16 states²⁰ and juvenile legal systems in 13 states²¹ still do not have explicit protections from discrimination based on gender identity.
• A staggering 46 states have no explicit sexual orientation and gender identity (“SOGI”)-inclusive nondiscrimination law or policy protecting youth experiencing homelessness.²²
• Twenty-eight states have laws or policies in place that treat TNGD people differently under the law than their cisgender peers.²³
• Nineteen of the 28 states with harmful laws or policies are also states with no explicit protection from gender identity-based discrimination in child welfare or juvenile legal systems.²⁴
• Only four states have any requirement in law and policy to provide services that help prevent system-involvement or to provide services that promote acceptance of TNGD and LGBQ+ youth by their families.²⁵
• Only two states acknowledge the existence of nonbinary youth in child welfare or juvenile legal system law, policy, or practice guidance.²⁶
• Only 16 states have LGBTQ+-specific policy or practice guidance for agency and facility staff and contractors in their child welfare systems²⁷ and only 20 states in their juvenile legal systems.²⁸

As Kayden, one of the youth contributors, shared, agencies need clear policies so staff have step-by-step instructions to follow on how to support LGBTQ+ youth. Without explicit protection, clear policies, and a multi-faceted framework of support, TNGD youth remain at risk of serious physical and mental harm, including death – a risk that has grown even greater due to a marked increase in anti-LGBTQ+ laws and policies, which fuel the dehumanization of transgender, nonbinary, and gender diverse people.

Conclusion

Although some progress has been made, it is clear that we have a long way to go. Some states have taken active steps to dehumanize TNGD young people, while other states lack protections that could emphasize universal affirming values such as love, respect, and bodily autonomy. Safe Havens II: We Must Affirm and Protect Trans, Nonbinary, and Gender Diverse Youth in Out-of-Home Systems, includes a call to action from the youth contributors with lived experience; an update of current research about LGBQ+ and TNGD youth; a summary of supportive and harmful federal and state law and policy developments; a description of efforts to prevent system-involvement; and information on the needs of system-involved nonbinary youth. Additionally, we focus on ensuring that accessible, understandable, and safe accountability measures are in place; they are essential for the safety and well-being of TNGD youth.

Endnotes

1. TNGD is used throughout the report, except where cited research uses other terms such as TGNC (transgender, gender nonconforming). Since cultural norms around gender still negatively impact youth who express themselves outside of those norms, the authors emphasize that every individual is unique and there is no one “correct” way to identify or express oneself.
2. LGBTQ+ emphasizes that there are a variety of ways people identify or describe themselves in addition to lesbian, gay, bisexual, transgender, queer or questioning. For example, youth from some indigenous communities may identify as Two Spirit.For more information about the concepts of sexual orientation, gender identity, and gender expression (“SOGIE”) or terms youth may use to describe or identify themselves, please see https://cssp.org/resource/key-equity-terms-concepts/. Because people use labels in different ways, or reject labels altogether, the authors recommend that best practice is to honor the language individuals use to describe themselves. Uses of other acronyms in the text are used to reflect research particular to that instance in the text.
3. Brooke Migdon, ACLU says states saw record number of anti-LGBTQ bills in 2023, The Hill (Dec. 2023) https://thehill.com/homenews/lgbtq/4380719-aclu-states-record-anti-lgbtq-bills-2023/; Mapping Attacks on LGBTQ Rights in U.S. State Legislatures in 2023, ACLU (Dec. 21, 2023), https://www.aclu.org/legislative-attacks-on-lgbtq-rights-2023.
4. Mapping Attacks on LGBTQ Rights in U.S. State Legislatures in 2024, ACLU (Updated June 28, 2024), https://www.aclu.org/legislative-attacks-on-lgbtq-rights-2024.
5. Alabama, Alaska, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, and Wyoming; LGBTQ Curricular Laws, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/curricular_laws; Forced Outing of Transgender Youth in Schools, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/youth/forced_outing; Bans on Transgender People using Bathrooms and Facilities According to their Gender Identity, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/youth/school_bathroom_bans; Bans on Transgender Youth Participation in Sports, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/youth/sports_participation_bans; Bans on Best Practice Medical Care for Transgender Youth, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/healthcare/youth_medical_care_bans.
6. The authors use “juvenile legal” to refer to the system where youth are charged with delinquencies and may face a range of interventions, requirements, and restrictions on their behavior and liberty including short and long-term incarceration or informal conduct conditions or formal probation requirements. Youth under 18 may be treated within juvenile systems or adult criminal systems depending on the jurisdiction and type and severity of delinquency or crime alleged. The authors do not use “juvenile justice” due to the system being profoundly unjust for youth for a variety or reason, including, the overrepresentation and disparately harmful treatment of youth of color, LGBTQ+ youth, and LGBTQ+ youth of color.
7. Alan J. Dettlaff and Reiko Boyd, Racial Disproportionality and Disparities in the Child Welfare System: Why Do They Exist, and What Can Be Done to Address Them? 692 The ANNALS of the American Academy of Political and Social Science 1, https://doi.org/10.1177/0002716220980329; Racial and Ethnic Disparity in Juvenile Justice Processing, Office of Juvenile Justice and Delinquency Prevention, March 2022, https://ojjdp.ojp.gov/model-programs-guide/literature-reviews/racial-and-ethnic-disparity.
8. The Discrimination Administration: Anti-Transgender and Anti-LGBTQ Actions, National Center for Transgender Equality, https://transequality.org/the-discrimination-administration; HRC Staff, The Real List of Trump’s “Unprecedented Steps” for the LGBTQ Community, Human Rights Campaign (June 11, 2020), https://www.hrc.org/news/the-list-of-trumps-unprecedented-steps-for-the-lgbtq-community.
9. See note 3.
10. See note 4.
11. See note 5.
12. CW 15 States: Arizona, Colorado, Delaware, Georgia, Hawaii, Mississippi, Missouri, New Mexico, North Dakota, Oklahoma, Oregon, South Carolina, Vermont, Washington, West Virginia JL 16 States: Alaska, Arkansas, Delaware, Idaho, Kansas, Maine, Maryland, Missouri, Nevada, New Mexico, North Carolina, North Dakota, Oregon, Pennsylvania, Utah, West Virginia. YH 2 States: Connecticut, Maine.
13. CW 34 States: Arizona, California, Connecticut, Colorado, Delaware, Georgia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Washington, West Virginia JL 37 States: Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Vermont, Washington, West Virginia.
14. See note 12.
15. Arizona, California, Connecticut, Colorado, Delaware, Georgia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Washington, West Virginia.
16. Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Vermont, Washington, West Virginia.
17. 17 States with ‘shield’ or ‘refuge’ legislation protecting access to transgender health care”: California, Colorado, Connecticut, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Mexico, New York, Oregon, Rhode Island, Vermont, Washington and D.C.”States with ‘shield’ or ‘refuge’ executive order only protecting access to transgender health care”: Arizona, New Jersey; Transgender Healthcare “Shield” Laws, Movement Advancement Project (MAP), http://www.mapresearch.org/equality-maps/healthcare/trans_shield_laws.
18. California, Colorado, Connecticut, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oregon, Vermont, Virginia, Washington, and DC. Safe Schools Law, Movement Advancement Project (MAP), https://www.lgbtmap.org/equality-maps/safe_school_laws/discrimination.
19. Driver’s License 22 States: California, Colorado, Connecticut, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Utah, Vermont, Virginia, Washington Birth Certificate 16 States: California, Colorado, Connecticut, Illinois, Maine, Michigan, Nevada, New Jersey, New Mexico, New York, Ohio, Oregon, Rhode Island, Utah, Vermont, Washington. Identity Document Laws and Policies, Movement Advancement Project (MAP), https://www.lgbtmap.org/equality-maps/identity_documents/.
20. Alabama, Alaska, Arkansas, Kansas, Kentucky, Louisiana, Montana, Nebraska, New Hampshire, North Carolina, Pennsylvania, Texas, Utah, Virginia, Wisconsin, Wyoming.
21. Alabama, Florida, Indiana, Minnesota, Mississippi, Montana, Nebraska, Oklahoma, South Carolina, South Dakota, Virginia, Wisconsin, Wyoming.
22. Only California, Connecticut, Maine, New York, and the District of Columbia have protections against discrimination on the basis of gender identity for youth served by runaway and homeless youth programs and shelters.
23. See note 5.
24. CW 13 States: Alabama, Alaska, Arkansas, Kansas, Kentucky, Louisiana, Montana, Nebraska, New Hampshire, North Carolina, Texas, Utah, Wyoming JL 10 States: Alabama, Florida, Indiana, Mississippi, Montana, Nebraska, Oklahoma, South Carolina, South Dakota, Wyoming.
25. Connecticut, Michigan, Rhode Island, Utah.
26. “Gender” or “gender identity” means a person’s internal identification or self-image as male or female. Gender identity may or may not correspond to the gender that is listed on the person’s birth certificate. The terms “male,” “female,” or “nonbinary” describe how a person identifies.” Fla. Admin. Code Ann. r. 65C-46.001 (2001); “W. “Gender” or “gender identity” means a person’s internal identification as male, female, or nonbinary. Gender identity may or may not correspond to the sex or gender marker that is listed on the person’s birth certificate.” N.M. Admin. Code 8.26.4.7 (2020).
27. Arizona, Connecticut, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Rhode Island, Tennessee, Vermont, Virginia, and Washington.
28. Colorado, Connecticut, Delaware, Georgia, Hawaii, Idaho, Illinois, Kentucky, Louisiana, Maine, Massachusetts, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Tennessee, Vermont, and Washington.

Safe Havens I chronicled significant advances in federal law and policy for transgender, nonbinary, and gender diverse (“TNGD”)¹ youth and adults, including federal civil rights jurisprudence. Other federal law and policy advances prior to April 2017 included the addition of gender identity and sexual orientation as protected classes in federal nondiscrimination law applicable to state child welfare system funding and to programs for youth experiencing homelessness, and the first ever recommendations from the Department of Justice on how best to support LGBTQ+² youth in juvenile legal³ systems.⁴

Safe Havens I summarized case law establishing that under the U.S. Constitution, youth in state custody, including TNGD youth, must be protected from unreasonable risk of harm and unequal treatment and have the right to freedom of speech and expression.⁵ Since then, these rights have been affirmed in decisions by the Fifth and Ninth Circuits.⁶ Specific to the juvenile legal system, R.G. v. Koller remains the only federal civil rights case brought on behalf of LGBTQ+ youth in a juvenile detention facility.⁷ Constitutional protections for these youth outlined in Safe Havens I remain in effect.⁸ As we also described in 2017, LGBTQ+ youth experiencing homelessness have Equal Protection rights to be treated the same way as their non-LGBTQ+ peers, First Amendment rights to freedom of speech and expression, and the right to be free from religious indoctrination under the Establishment Clause.⁹

Below we provide an update on major federal jurisprudence and federal agency action since 2017 specific to youth in child welfare and juvenile legal systems, and youth experiencing homelessness.

TNGD People and Federal Jurisprudence

In June 2020, the U.S. Supreme Court, in a 6-3 decision in Bostock v. Clayton County, held that Title VII of the Civil Rights Act of 1964 (“Title VII”) prohibits discrimination based on sexual orientation, gender identity, and transgender status as unlawful sex discrimination in the context of federal employment law.¹⁰ Title VII protects workers from discrimination “on the basis of sex.” The Court, relying on a textual reading of the statute, found that “it is impossible to discriminate against a person for being homosexual or transgender without discriminating against that individual based on sex.”¹¹ Because a textual reading applies with equal force to other statutory prohibitions of sex discrimination, federal courts have routinely relied on the scope of sex discrimination protection provided by Title VII to inform decisions regarding sex discrimination coverage under the Equal Credit Opportunity Act,¹² the Fair Labor Standards Act,¹³ the Fair Housing Act,¹⁴ Title IX of the Education Amendments of 1972,¹⁵ and many other statutes.

In the last five years, many lower federal courts have held that transgender individuals “meet the criteria for being deemed a suspect or quasi-suspect class, and thus discrimination against them must be subject to heightened scrutiny” under an Equal Protection analysis.¹⁶ Several Circuit Courts of Appeals have taken the stance that cases involving transgender individuals are subject to heightened scrutiny, “either because the community as a class warrants heightened scrutiny on its own, or because discrimination against the transgender community is sex discrimination.”¹⁷

Unfortunately, two Circuit Courts that heard cases about the rights of transgender students came down on opposite sides. In Grimm v. Gloucester County School Board, the Fourth Circuit found, in a case brought by a transgender boy who was denied access to facilities consistent with his gender identity, that discrimination based on transgender status is discrimination “on the basis of sex” under Title IX.¹⁸ The court explained that a transgender boy who was excluded from using the boys’ restrooms “was treated worse than students with whom he was similarly situated because he alone could not use the restroom corresponding with his gender.”¹⁹ The court also found that Grimm suffered harm as a result of this discrimination because being excluded from the same restrooms as other boys made him feel “stigmatized and isolated” and “invite[s] more scrutiny and attention from other students, ‘very publicly brand[ing] all transgender students with a scarlet ‘T’.”²⁰ By contrast, the en banc Eleventh Circuit Court of Appeals ruled in favor of the St. Johns County Florida School Board, reversing its own panel and the district court, which relied heavily on facts established at trial, finding that the county’s policy of excluding transgender students from restrooms consistent with their identity did not violate the U.S. Constitution and Title IX.²¹

In other significant cases involving TNGD people, federal courts uniformly rejected attempts to exclude transgender people from military service,²² enjoined some states’ attempts to limit or ban gender-affirming medical care for minors,²³ permitted transgender students to participate in school sports,²⁴ and recognized nonbinary identity.²⁵

In B.P.J. v. West Virginia State Board of Education, a federal court granted a preliminary injunction and ruled that an 11-year-old transgender girl must be allowed to try out for the girls’ cross-country and track teams at her school, blocking West Virginia from enforcing a law that bans transgender girls and women from participating in school sports in violation of Title IX and the Equal Protection Clause of the Fourteenth Amendment.²⁶ The same judge who, in issuing a preliminary injunction, found he had “been provided with scant evidence that [H.B. 3293] addresses any problem at all, let alone an important problem,”²⁷ then reversed course and  granted West Virginia’s motion for summary judgment and dismissed the case.²⁸ B.P.J. appealed and the Fourth Circuit Court of Appeals granted a stay permitting her to continue playing on the girls’ track team; the U.S. Supreme Court declined to intervene. In April 2024, the Fourth Circuit granted B.P.J.’s motion for summary judgment on her Title IX claim and held that H.B. 3293 is unconstitutional as applied to her.²⁹ Similar bans in other states have been enjoined by federal courts.³⁰

Relying on prior successful rulings on behalf of LGBTQ+ individuals, advocates have challenged recent discriminatory state laws against TNGD people in both state and federal courts under the Constitution’s Equal Protection and Due Process clauses, and under Title IX of the Education Amendments Act of 1972 (“Title IX”). For example, in Brandt v. Rutledge, a challenge to an Arkansas ban on gender-affirming medical for minors, a federal court ruled that the ban is unconstitutional and found that “[g]ender-affirming treatment is supported by medical evidence that has been subject to rigorous study,” and that “[p]arent plaintiffs have a fundamental right to seek medical care for their children and, in conjunction with their adolescent child’s consent and their doctor’s recommendation, make a judgment that medical care is necessary.”³¹

Similarly, a federal court blocked the majority of Alabama’s law prohibiting gender-affirming medical care for minors in Boe v. Marshall, finding that the law seeks to ban established, effective medical care and that doing so would cause severe harm.³² The court found that Alabama presented no credible evidence to contradict testimony from doctors and medical experts on the safety and efficacy of medical care for transgender youth who experience gender dysphoria, including that over 22 major medical organizations recognize the established standard of care for transgender youth.³³ Despite these findings, the Eleventh Circuit Court of Appeals allowed Alabama’s ban to take effect.³⁴ A majority of district courts that have heard evidence in support of requests to enjoin gender-affirming medical care bans have done so, but some appellate courts have overturned those decisions and let bans take effect.³⁵ The U.S. Supreme Court is considering whether to hear an appeal of Tennessee’s and Kentucky’s bans after plaintiffs appealed a decision by the Sixth Circuit Court of Appeals overturning a district court decision enjoining Tennessee’s ban and allowing it and another one in neighboring Kentucky to proceed.³⁶ As of May 2024, bans on gender-affirming care are in effect in 19 of 24 states.³⁷

In 2021, Dana Zzyym, an intersex and nonbinary U.S. Navy veteran, became the first U.S. citizen to receive an official U.S. passport with an “X” sex/gender marker, the culmination of their six-year legal battle to get an accurate passport that did not force them to identify as male or female.³⁸ The U.S. State Department announced it would change its policy to add a gender marker on U.S. passports for nonbinary, intersex, and gender nonconforming persons.³⁹ That announcement came thirteen months after the Tenth Circuit Court of Appeals ordered the Department to reconsider its prior decisions denying Zzyym an accurate passport.⁴⁰ The court noted that forcing intersex individuals to pick a male or female sex/gender marker in the passport application “injects inaccuracy into the data.”⁴¹

While these cases do not involve TNGD youth in government systems, most federal court rulings show that despite political rhetoric and attacks associated with anti-TNGD bills and policies, courts regard government actions that exclude TNGD people or treat them differently than non-TNGD people under the law as unconstitutional or contrary to statutory prohibitions against sex discrimination. These principles should also apply to TNGD youth in government custody or who benefit from or participate in government programs.

In addition to cases about laws or policies directly targeting youth, in 2021, the U.S. Supreme Court in Fulton v. City of Philadelphia, decided a case about the ability of same-sex couples to be protected from discrimination when seeking to become foster parents.⁴² The Court found that Catholic Social Services (“CSS,”) a child placing agency with a government contract to provide child welfare services, including foster parent recruitment and screening, for the City of Philadelphia) could use religious criteria to refuse to work with married, same-sex couples seeking to foster. ⁴³ The Court held that because Philadelphia’s contracts allowed some exemptions to nondiscrimination requirements and so its fair practice ordinance that forbade sexual orientation discrimination was not “generally applicable” or “neutrally applied.”⁴⁴ On a positive note, the Court rejected CSS’s request to grant agencies a broad religious exemption from nondiscrimination requirements like Philadelphia’s and to overturn the court’s decision in Employment Division v. Smith. ⁴⁵

Federal Agency Action

From 2017 to early 2021, the Trump Administration took numerous steps to eliminate nondiscrimination protections for LGBTQ+ people, limit their participation in and equal access to government or government-funded programs, and to keep them statistically invisible. Most of these actions were blocked by courts, but some harmful policies remain in place with litigation pending. These developments specific to TNGD youth in government systems are summarized below.

1. Child Welfare

A. Statutory and Regulatory Law

In Safe Havens I, the authors collected various federal laws and regulations that provide protection applicable to all children, including lesbian, gay, bisexual, and queer (“LGBQ+”) and TNGD youth in care, and those that provide explicit protection from sexual orientation and gender identity-based discrimination. Summarized below is existing federal law and, where applicable, attempts by the Trump Administration to remove protections and subsequent steps by the Biden Administration to reverse some of those changes, promulgate new protective regulations, and provide additional policy guidance and resources.

Family First Prevention Services Act (“FFPSA”) was signed into law in 2018.⁴⁶ States and tribes now have the option of using Title IV-E funding for time-limited, “evidence-based” prevention services for mental health, substance abuse, and in-home parent skill-based programs for children who are considered at risk of removal into the foster system, pregnant or parenting youth in the foster system, and the parents or kin caregivers of those children. These services and programs are focused on preventing the removal of children so they may safely remain at home and do not enter the foster system, supporting placement with kin if remaining at home is not possible, and reducing congregate placement for children who have been removed. However, funding is only available for services that have been approved by the Title IV-E Clearinghouse and, despite overrepresentation of LGBTQ+ youth and youth of color in the child welfare system, approved services do not need to address needs related to either SOGIE or race and cultural identity.⁴⁷ Moreover, the Clearinghouse’s restrictive evidence requirements continue to create barriers for affirming services to receive funding.⁴⁸ There are currently no approved services developed by and/or for LGBTQ+ youth. These limitations are cause for concern, as research shows that services that affirm youth SOGIE⁴⁹ and racial identity are protective, while non-affirming services can cause harm.⁵⁰ Forty-six states, the District of Columbia and Puerto Rico have submitted Title IV-E prevention plans to the Children’s Bureau for approval.⁵¹ As of February 2024, 42 plans have been approved and four are awaiting approval.⁵²

Titles IV-E and IV-B of the Social Security Act require agencies receiving federal child welfare dollars to place children in a safe, least restrictive setting close to the children’s homes and consistent with their best interest and needs; show that their foster family homes and childcare institutions meet national standards, including standards related to admission policies, safety, and protection of civil rights; and ensure case plans require that children receive safe and proper care.⁵³

The Foster Care Independence Act (John H. Chafee Foster Care Independence Program) provides services and support to youth aging out of the foster system to make the transition to self-sufficiency.⁵⁴ States and tribes must ensure beneficiaries receive equitable treatment, but does not explicitly include or reference sexual orientation or gender identity, and must use federal training funds to help foster and adoptive parents, group home workers, and case managers understand and address the issues confronting adolescents.⁵⁵ The requirements of these federal statutes remain unchanged since 2017.

Health and Human Services (“HHS”) Grants (Final Rule). As we summarized in Safe Havens I, regulation 45 CFR Part 75, the 2016 HHS Grants Rule required state child welfare agencies that receive federal funds through the Administration for Children and Families (“ACF”) to ensure beneficiaries of and participants in grant-funded programs are not discriminated against based on sexual orientation and gender identity, among other protected classes.⁵⁶ In 2019, the Trump Administration announced it would not enforce the HHS Grants Rule (the “Nonenforcement Decision”).⁵⁷ In 2020, the Trump  Administration proposed a new HHS Grants Rule (“2020 Grants Rule”) removing sexual orientation, gender identity, religion, sex, and other protected classes from the Rule and reverted to only those protections explicitly delineated in each program’s underlying statutory authority.⁵⁸

In January 2021, Facing Foster Care in Alaska, Alaska’s foster youth and alumni member organization, along with three other plaintiffs, challenged the 2020 Grants Rule and requested a stay of the effective date.⁵⁹ The Biden Administration agreed to a stay and, in 2022, HHS conceded error.⁶⁰ The court vacated the 2020 Rule, which thanks to the stay never became law.⁶¹ The 2019 Nonenforcement Decision was challenged in Family Equality v. Beccera; ⁶² the federal district court found the plaintiffs lacked standing and dismissed the case.⁶³ Inexplicably, the Biden Administration did not pull the Nonenforcement Decision.⁶⁴ In May 2024, the Biden Administration finalized a new HHS Grants Rule that includes sexual orientation and gender identity nondiscrimination protections only where underlying federal statute included sex as a protected class.⁶⁵ Sex does not appear as a protected class in federal child welfare statute so the reasoning in the U.S. Supreme Court’s decision in Bostock v. Clayton County that Title VII’s prohibition on sex discrimination includes discrimination on the basis of sexual orientation could not be applied in the child welfare system context.

Safe and Appropriate Foster Care Placements for Title IV-E and Title IV-B (Proposed Rule) and Designated Placement Requirements Under Titles I-E and I-B for LGBTQI+ Children (Final Rule). In September 2023, ACF issued a notice of proposed rulemaking for a new rule establishing protections for LGBTQI+ youth from harm in the context of placement while in the foster system.⁶⁶ The rule summarized much of the existing research on the prevalence, experiences, and outcomes of LGBTQI+ youth in the child welfare system.⁶⁷ The proposed rule did not cover all aspects of the child welfare system, including involvement with child welfare systems prior to removal or while at home under supervision and does not protect families, including prospective foster and adoptive families.⁶⁸ In addition, the proposed rule only required a certain subset of providers to meet criteria to be consider safe and appropriate placements and set out a process for faith-based providers to be granted an exemption to the rule’s requirement.⁶⁹ The rule also only provides notice to LGBTQI+ youth who are out or those known to the agency and places the burden on youth to notify the agency if they want a safe and appropriate placement.⁷⁰ In April 2024, ACF finalized the rule under a new name, “Designated Placement Requirements Under Titles IV-E and IV-B for LGBTQI+ Children” and included some changes, but does not include comprehensive protection from discrimination for children and families. ⁷¹ The new rule clarified that Title IV-E/IV-B agencies must ensure that placements for all children, including LGBTQI+ children, must be “free from harassment, mistreatment, or abuse” and that LGBTQI+ must have a “Designated Placement” if they “request or would benefit” from one.⁷² While the rule does not require any provider to become or offer a “Designated Placement,” such placements must receive training and support the child’s access to services that “are supportive of their sexual orientation and gender identity or expression, including clinically appropriate mental and behavioral health supports.”⁷³ The rule requires notice of the right to a “Designated Placement” for youth 14 and over, to youth who have disclosed their identity to the agency, and to youth or were removed from home “in whole or part” to familial conflict related to their sexual orientation, gender identity and gender expression or sex characteristics.⁷⁴ The agency must give substantial weight to an LGBTQI+ child’s concerns or requests regarding placement or service decisions or changes and before initiating placement changes, “consider whether additional services and training would allow the current provider to meet the conditions for a Designated Placement.”⁷⁵

Section 1557 of the Affordable Care Act (ACA) (Final Rule) prohibits discrimination on the basis of sex and other protected classes by health programs and activities⁷⁶ that receive federal financial assistance or are administered by an executive agency, including many child welfare programs, such as those involving therapeutic foster care or residential treatment. In 2020, the HHS Office for Civil Rights issued a final rule removing “gender identity” from the group of protections covered under the umbrella of “on the basis of sex” from a 2016 regulation implementing Section 1557 that prohibited discrimination on account of gender identity or sex stereotyping.⁷⁷ Only three days later, the Supreme Court issued the Bostock⁷⁸ decision. Considering the decision, a federal district court temporarily prevented the 2020 rule from removing “gender identity” from the definition of “on the basis of sex” from Section 1557 of the ACA.⁷⁹ In April 2024, HHS issued a final rule for Section 1557 solidifying that protection against discrimination based on sex include sexual orientation and gender identity, consistent with the U.S. Supreme Court’s holding in Bostock and apply to all federally-funded health programs.⁸⁰

Title IX of the Education Amendments of 1972 (Final Rule) protects people from discrimination based on sex, among other protected classes, in education programs or activities that receive federal financial assistance.⁸¹ In response to the Bostock decision, the U.S. Department of Education (“DoEd”) issued guidance interpreting Title IX’s “prohibition ‘on discrimination on the basis of sex’ to encompass discrimination on the basis of sexual orientation and gender identity.”⁸² This guidance was enjoined by a federal district court.⁸³ In April 2023, DoEd issued an updated Notice of Proposed Rulemaking (“NPRM”) focused on transgender students’ rights to play on sports teams consistent with their gender identity.⁸⁴ At the time of publication, DoEd has yet to issue final rule regarding sports participation, but in April 2024, issued a final rule clarifying that the rule protects students form discrimination based on sex stereotypes, sex characteristics, sexual orientation, and gender identity, mirroring prior guidance and the language from the Bostock opinion.⁸⁵

The Adoption and Foster Care Analysis and Reporting System (AFCARS) (Final and Proposed Rule). States are required by the Social Security Act to collect demographic information about the youth in their care.⁸⁶ In 2016, the Obama Administration promulgated an updated Adoption and Foster Care Analysis and Reporting System (“AFCARS”) Rule, which set out the type of demographic information states must collect.⁸⁷ The 2016 AFCARS Rule required states to include sexual orientation data elements for youth 14 and over and for foster and adoptive parents and guardians, and to capture whether conflict at the time of a child’s removal from home was related to the child’s sexual orientation, gender identity, or gender expression.⁸⁸ The Trump Administration delayed implementation of that rule and, in 2020 issued a new rule eliminating the sexual orientation data elements along with host of others, including numerous elements related to implementation of the Indian Child Welfare Act (“ICWA”).⁸⁹ A group of tribes, tribal advocates, LGBTQ+ youth serving organizations, and a foster youth and alumni group sued HHS in California Tribal Families Coalition v. Beccera for violations of the Administrative Procedure Act (“APA”).⁹⁰ The federal district court found HHS did not violate the APA. ⁹¹ In the context of an appeal by plaintiffs, ACF stated its intent to engage in new rulemaking and in February 2024 ACF issued an NPRM restoring many of the ICWA-related data elements, including, among others, requirements to document how and when inquiries were made about whether the child is an Indian child, whether the court determined ICWA applies, whether placement preference under ICWA were followed, and whether active efforts were made to keep the children with their parents.⁹² A separate rule restoring sexual orientation elements and proposing the addition of gender identity is expected.⁹³

B. Policy Memoranda and Information

On March 2, 2022, the Administration on Children, Youth and Families (“ACYF”) published Administration for Children and Families Information Memorandum 22-01 (“IM 22-01”) to state child welfare agencies regarding LGBTQI+ youth in the foster system.⁹⁴ IM 22-01 provides additional guidance and information to states and builds off ACYF’s first LGBTQI+-focused 2011 memo, confirming that “[r]esearch and best child welfare practices clearly demonstrate that every child and youth in foster care should be affirmed and supported, including children and youth who are LGBTQI+ or who have a non-conforming gender identity or expression.”⁹⁵ ACYF noted that transgender youth are often unable to access necessary medical care due in part to “intentionally erected systemic barriers,” such as polices that limit or ban access to gender-affirming care and attempt to characterize such care falsely.⁹⁶ Importantly, the agency clarified that HHS and “all leading national medical and pediatric associations confirm that providing gender-affirming medical care is in the best interest of children and youth who need it.”⁹⁷ Title IV-B and IV-E agencies must comply with IV-B and IV-E plan as well as all applicable federal law, including considering and addressing the needs of children in their care, “placing them in safe, permanent placements that support the whole of each child and youth’s well-being” and addressing needs that a child may have because of their SOGIE.⁹⁸ In addition, youth age 14 and older must be consulted about their case plans and receive services appropriate for older youth and young adults.⁹⁹

In February 2023, ACYF’s Children’s Bureau issued a Program Instruction with specific guidance on how state child welfare systems could use federal funding from the John H. Chafee Foster Care Program for Successful Transition to Adulthood to meet the needs of LGBTQI+ youth.¹⁰⁰ For example, Chafee funding can be used to “to facilitate a young person’s participation in a community-based support group for LGBTQI+ youth and . . . to purchase items related to supporting a youth’s expression of their gender identity and/or sexual orientation.”¹⁰¹ The Children’s Bureau also stated “agencies, facilities and caregivers should not condition or restrict access to support groups or provision of gender identify-affirming items as part of a reward and punishment system for LGBTQI+ youth/young adults. Removing or denying access to such activities and personal items as a form of punishment can negatively affect their mental health, safety, and well-being.”¹⁰²

Substance Abuse and Mental Health Services Administration (“SAMHSA”) released a 2023 report “Moving Beyond Change Efforts:  Evidence and Action to Support and Affirm LGBTQI+ Youth” detailing “helpful and harmful interventions . . . in clinical, community, family, and school settings” and “evidence-informed policy options that could improve the overall health and well-being of LGBTQI+ youth.”¹⁰³ The report also summarizes professional consensus that “attempts to change an individual’s sexual orientation and gender identity . . . are harmful and should not be provided[,]” echoing similar reminder from the Children’s Bureau to child welfare agencies and providers in its 2023 publication, “Protecting the Rights and Providing Appropriate Services to LGBTQIA2S+ Youth in Out-of-Home Care.”¹⁰⁴

2. Juvenile Legal

A. Statutory and Regulatory Law

As set out in Safe Havens I, two critical statutes include “sex” as a protected class in their nondiscrimination provisions. The Omnibus Crime Control and Safe Streets Act of 1968 (“Safe Streets Act”) was designed to assist state and local governments in reducing crime and improving law enforcement and criminal legal systems.¹⁰⁵  The Juvenile Justice and Delinquency Prevention Act (“JJDPA”) is the principal federal statute governing functioning of state juvenile legal systems.¹⁰⁶  In March 2022, in the wake of the Bostock decision, the Department of Justice, Office of Civil Rights, issued guidance that in the context of the Safe Streets Act and the JJDPA, sex as a protected class includes protection from discrimination on the basis of sexual orientation and gender identity.¹⁰⁷ This prohibition protects LGBTQ+ youth from discrimination in connection with any programs or activity funded in whole or in part through these federal programs, including grants to state juvenile agencies, mentoring programs, prevention initiatives, and a host of other grants administered by the Office of Justice Programs (“OJP”) and Office of Juvenile Justice and Delinquency Prevention (“OJJDP”).

B. Policy

In addition to the Bostock guidance, in June 2022, OJJDP released a Pride Month statement announcing it had “developed a new framework to guide its approach to [LGBTQI+ or Two Spirit youth], including a policy statement with recommendations for their treatment within the juvenile justice system.”¹⁰⁸  OJJDP “has also committed to incorporating the voices of LGBTQI+ and Two-Spirit youth in presentations and webinars; building relationships with advocates and organizations that serve youth; expanding research on issues such as sexual orientation, gender identity, and gender expression; and sharing best practices, such as providing gender-affirming care in youth facilities and community-based programs.”¹⁰⁹ Administrator Liz Ryan stated, “OJJDP programs are tackling urgent issues encountered by youth in the juvenile justice system, schools, and communities nationwide … We envision a country where all youth feel safe to be themselves.”¹¹⁰

a. Training and Technical Assistance

In 2023, OJJDP awarded a one-million-dollar grant to the National Council of Juvenile and Family Court Judges (“NCJFCJ”) for a “36-month collaborative project to provide training and technical assistance [] to juvenile justice system practitioners to support the identification, promotion, and implementation of system reforms that address the needs of justice-involved LGBTQ+ and Two-Spirit youth.”¹¹¹ NCJFCJ will collaborate with the University of Connecticut National SOGIE Center, the Coalition for Juvenile Justice, the Gault Center, and the Tribal Law and Policy Institute.¹¹² The project will promote policies, programs, services, and practices that serve the needs of LGBTQ+ and Two-Spirit youth so that the juvenile legal and child welfare systems that affect them do so in ways that produce equitable outcomes, promote positive youth development, empower youth to have productive lives, and create safer and inclusive communities.¹¹³ The Pride Center is accepting requests for training and technical assistance, including, for example SOGIE-inclusive nondiscrimination policy and LGBTQ+-specific practice guidance.¹¹⁴

In 2019, the Prison Rape Elimination Act (“PREA”) Resource Center published a first-of-its kind model policy outlining how detention facilities and other treatment facilities subject to PREA should support and affirming transgender and gender nonconforming youth.¹¹⁵ The model policy was informed by transgender youth with lived experience in the juvenile legal system as well as juvenile defenders, LGBTQ+ civil rights lawyers, detention facility administrators, and probation officers.¹¹⁶ The guidance accompanying the model policy is designed to assist policymakers with creating policy that augments the legal requirements of PREA to ensure transgender and gender nonconforming youth are affirmed and supported.¹¹⁷

3. Systems Serving Runaway and Youth Experiencing Homelessness

A. Statutory and Regulatory Law

The Runaway and Homeless Youth Act authorizes community-based projects to provide temporary shelter and care to runaway or otherwise homeless youth in need of temporary shelter, counseling, and aftercare services.¹¹⁸ The Act requires that services be provided using a “positive youth development approach” and should ensure youth have a sense of “safety and structure[,] belonging and membership[,] self-worth and social contribution[,] independence and control over their life[, as well as] closeness in interpersonal relationships.¹¹⁹ The Runaway and Homeless Youth Rule,¹²⁰ which explicitly prohibits discrimination on account of sexual orientation and gender identity by runaway and homeless youth programs receiving federal funds, remains in effect.¹²¹

Equal Access to Housing in the Department of Housing and Urban Development (“HUD”) Programs Regardless of Sexual Orientation or Gender Identity. The HUD Equal Access Rule ensures that its core programs, including runaway and homeless youth shelters, are open to all eligible individuals and families regardless of sexual orientation, gender identity, or marital status.¹²² The rule prohibits discrimination on account of sexual orientation or gender identity in all programs receiving federal assistance through HUD, including all providers who operate shelters for runaway and homeless youth across the country.¹²³  Subsequent to the Equal Access Rule, HUD issued the Equal Access in Accordance with an Individual’s Gender Identity in Community Planning and Development Programs Rule to clarify that gender identity should be affirmed in all programs, including housing.¹²⁴ The Gender Identity Rule also applies to all programs receiving federal financial assistance from HUD.¹²⁵

B. Information

Information and resources regarding affirming programs and services for LGBTQ+ youth experiencing homelessness may be found on ACF’s and HUD’s websites, including the Family and Youth Services Bureau’s Runaway and Homeless Youth Training and Technical Assistance Center’s “Supporting and Affirming LGBTQIA2S+ Youth and Young Adults: Tip Sheet”¹²⁶ and HUD’s guide “Equal Access for Transgender People: Supporting Inclusive Housing and Shelters.¹²⁷

Endnotes

1.  TNGD—transgender (or trans), nonbinary, gender diverse. Used throughout the report, except where cited research uses other terms such as TGNC (transgender, gender nonconforming). Since, cultural norms around gender still negatively impact youth who express themselves outside of those norms, the authors emphasize that every individual is unique and there is no one “correct” way to identify or express oneself.
2.  LGBTQ+ emphasizes that there are a variety of ways people identify or describe themselves in addition to lesbian, gay, bisexual, transgender, queer or questioning. For example, youth from some indigenous communities may identify as Two Spirit. For more information about the concepts of sexual orientation, gender identity, and gender expression (“SOGIE”) or terms youth may use to describe or identify themselves, please see https://cssp.org/resource/key-equity-terms-concepts/. Because people use labels in different ways, or reject labels altogether, the authors recommend that best practice is to honor the language individuals use to describe themselves. Uses of other acronyms in the text are used to reflect research particular to that instance in the text.
3.  The authors use “juvenile legal” to refer to the system where youth are charged with delinquencies and may face a range of interventions, requirements, and restrictions on their behavior and liberty including short and long-term incarceration or informal conduct conditions or formal probation requirements. Youth under 18 may be treated within juvenile systems or adult criminal systems depending on the jurisdiction and type and severity of delinquency or crime alleged. The authors do not use “juvenile justice” due to the system being profoundly unjust for youth for a variety or reason, including, the overrepresentation and disparately harmful treatment of youth of color, LGBTQ+ youth, and LGBTQ+ youth of color.
4.  Christina Wilson Remlin et al., Safe Havens: Closing the Gap Between Recommended Practice and Reality for Transgender and Gender-Expansive Youth in Out-of-Home Care, Children’s Rights, Lambda Legal, and Center for Social Policy, 7-11 (April 2017), https://legacy.lambdalegal.org/sites/default/files/publications/downloads/tgnc-policy-report_2017_final-web_05-02-17.pdf.
5.  Remlin et al., Safe Havens, 7, 9, 11.
6.  M.D. by Stukenberg v. Abbott, 907 F.3d 237 (5th Cir. 2018); B.K. by next friend Tinsley v. Snyder, 922 F.3d 957 (9th Cir. 2019).
7.  R.G. v. Koller, 415 F. Supp. 2d 1129 (D. Haw. 2006).
8.  Remlin et al., Safe Havens, 7-11.
9.  Remlin et al., Safe Havens, 11.
10.  Bostock v. Clayton Cnty., Georgia, 140 S.Ct. 1731 (2020).
11.  Bostock, 140 S.Ct. at 1741.
12.  Rosa v. Park W. Bank & Tr. Co., 214 F.3d 213, 215-16 (1st Cir. 2000).
13.  Hall v. BNSF Ry. Co., Case No. C13-2160 RSM, 2014 WL 4719007 (W.D. Wash. Sept. 22, 2014).
14.  Wetzel v. Glen St. Andrew Living Cmty., LLC, 901 F.3d 856 (7th Cir. 2018); Smith v. Avanti, 249 F. Supp. 3d 1194 (D. Colo. 2017).
15.  Whitaker by Whitaker v. Kenosha Unified Sch. Dist. No. 1 Bd. Of Educ., 858 F.3d 1034 (7th Cir. 2017); Videckis v. Pepperdine Univ., 150 F. Supp. 3d 1151 (C.D. Cal. 2015); Miles v. New York Univ., 979 F. Supp. 248, 250 n.4 (S.D.N.Y. 1997).
16.  Katie R. Eyer, Transgender Constitutional Law, 171 University of Pennsylvania Law Review, Rutgers Law School Research Paper 1405, 1408 (July 26, 2022), https://ssrn.com/abstract=4173202 or http://dx.doi.org/10.2139/ssrn.4173202.
17.  Eyer, Transgender Constitutional Law, 1415; See Whitaker, 858 F.3d at 1050-1054 (sex discrimination rationale); Karnoski v. Trump, 926 F.3d 1180, 1200-1201 (9th Cir. 2019) (transgender people as a class should receive heightened scrutiny); Grimm v. Gloucester Cnty. Sch. Bd., 972 F.3d 586, 610-613 (4th Cir. 2020), as amended (Aug. 28, 2020), cert denied 141 S. Ct. 2878 (2021) (transgender people should be deemed a quasi-suspect class, and discrimination against them is sex discrimination); Adams v. Sch. Bd. of St. Johns Cnty., Fla., 3 F.4th 1299 (11th Cir. 2021), reh’g en banc granted, opinion vacated, 9 F.4th 1369 (11th Cir. 2021), and on reh’g en banc sub nom. Adams by & through Kasper v. Sch. Bd. of St. Johns Cnty., 57 F.4th 791 (11th Cir. 2022) (sex discrimination rationale); Smith v. City of Salem, Ohio, 378 F.3d 566 (6th Cir.2004); Glenn v. Brumby, 663 F.3d 1312, 1315-1321 (11th Cir. 2011).
18.  Grimm, 972 F.3d at 616-617.
19.  Grimm, 972 F.3d at 618.
20.  Grimm, 972 F.3d at 617–18.
21.  Adams by & through Kasper v. Sch. Bd. of St. Johns Cnty., 57 F.4th 791 (11th Cir. 2022).
22.  Memorandum Opinion, Doe v. Trump, 275 F.Supp.3d 167, No. 17-cv-01587-CKK (D.D.C October 30, 2017), ECF 61, https://glad-org-wpom.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2017/10/doe-v-trump-memorandum-opinion-10-30-17.pdf; Memorandum and Order Re: Motions, Stone v. Trump, 280 F.Supp.3d 747, No. 17-cv-02459-MJG (D. Md. Nov. 21, 2017), ECF 85, https://www.aclu.org/cases/stone-v-trump?document=stone-v-trump-memorandum-and-order; Order Granting in Part and Denying in Part Defendants’ Motion to Dismiss, Order Granting Plaintiffs’ Motion for Preliminary Injunction, Karnoski v. Trump, No. 2:17-cv-01297-MJP (W.D. Wa. Dec. 11, 2017), ECF 103, https://legacy.lambdalegal.org/sites/default/files/legal-docs/downloads/karnoski_pi_order.pdf; Proceedings: Order (1) DENYING Defendants’ Motion to Dismiss Pursuant to Rule 12(b)(1) of the Federal Rules of Civil Procedure (Dkt. No. 36); and (2) GRANTING Plaintiffs’ Motion for Preliminary Injunction (Dkt. No. 15), Stockman v. Trump, No. 17-cv-01799-JGB-KK (C.D. Ca Dec. 22, 2017), ECF 79, https://glad-org-wpom.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2017/10/stockman-order-granting-pi-12-22.pdf.
23.  Opinion & Order, Eknes-Tucker v. Marshall, 603 F.Supp3d 1131, No. 22-cv-184, (M.D. Ala. May 13, 2022), ECF 107, https://glad-org-wpom.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2022/05/eknes-tucker-ruling-on-pi-5-13-22.pdf;  Order, Brandt v. Rutledge, 47 F.4th 661, No. 21-2875 (8th Cir. August 25, 2022), https://www.aclu.org/cases/brandt-et-al-v-rutledge-et-al?document=Order-Upholding-District-Courts-Preliminary-Injunction-Ruling; Preliminary Injunction, Doe v. Ladapo, No. 23-cv-00114-RH-MAF, (N.D. Fla. June 6, 2023), ECF 90, https://glad-org-wpom.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2023/06/doe-v-ladapo-order-granting-pi.pdf; Order, Koe v. Noggle, No. 23-cv-2904-SEG (N.D. Ga. August 20, 2023), ECF 106, https://www.splcenter.org/sites/default/files/documents/koe-v-noggle-injunction-order.pdf; Memorandum Decision and Order, Poe v. Labrador, No. 1:23-CV-00269-BLW (D. Idaho, Dec. 26, 2023), ECF 78, https://www.aclu.org/cases/poe-v-labrador?document=Order-Denying-Defendant-Bennetts-Motion-to-Dismiss-Granting-in-Part-and-Denying-in-Part-State-Defendants-Motion-to-Dismiss-and-Granting-Plaintiffs-Motion-for-Preliminary-Injunction; Order Granting in Part Plaintiffs’ Motion for a Preliminary Injunction, K.C. v. Individual Members of Medical Licensing Board of Indiana, 677 F.Supp3d 802, No . 23-cv-00595-JPH-KMB (S.D. Ind. June 16, 2023), ECF 67, https://www.aclu.org/cases/k-c-v-medical-licensing-board-of-indiana?document=Order-Granting-in-Part-Plaintiffs-Motion-for-Preliminary-Injunction–; Memorandum Opinion and Order, Doe v. Thornbury, No. 23-cv-00230-DJH (W.D. Ky June 28, 2023), ECF 61, https://www.aclu-ky.org/sites/default/files/field_documents/pi_opinion.pdf; Memorandum Opinion, L.W. v. Skrmetti, No. 23-cv-00376 (M.D. Tenn. June 28, 2023), https://lambdalegal.org/wp-content/uploads/2023/06/LI_20230629_PI.pdf
24.  Doe v. Horne, No. CV-23-00185-TUC-JGZ (D. Ariz. 2023); Hecox v. Little, 79 F.4th 1009 (9th Cir. 2023); A.M. v. Indianapolis Public Schools, 617 F. Supp. 3d 950 (S.D. Ind. 2022), appeal dismissed sub nom. A.M. by E.M. v. Indianapolis Pub. Schools and Superintendent, No. 22-2332 (7th Cir. 2023); L.E. v. Lee, No. 3:21-cv-00835 (M.D. Tenn. 2021); B.P.J. v. W. Virginia State Bd. of Educ., No. 23-1078 (4th Cir. Feb. 2023).
25.  Zzyym v. Pompeo, 958 F.3d 1014, 1018, 1024, No. 18-1453, (10th Cir. 2020), https://legacy.lambdalegal.org/sites/default/files/legal-docs/downloads/zzyym_co_20200512_opinion.pdf.
26.  Preliminary Injunction Ruling, B.P.J. v. W. Virginia State Bd. of Educ., 550 F. Supp. 3d 347 (S.D.W. Va. 2021) (No. 2:21-cv-00316), https://www.lambdalegal.org/sites/default/files/legal-docs/downloads/067._memorandum_opinion_order_2021-07-21.pdf.
27.  B.P.J., 550 F. Supp. 3d at 350
28.  B.P.J. v. W. Virginia State Bd. of Educ., 2023 WL 111875 (S.D.W. Va. Jan. 5, 2023) (No. 2:21-CV-00316).
29.  B.P.J. v. W. Virginia State Bd. of Educ., 2023 WL 2803113 (4th Cir. Feb. 22, 2023) (No. 23-1078); W. Virginia., v. B.P.J., 143 S. Ct. 889 (2023).
30.  See note 24.
31.   Brandt v. Rutledge, 551 F. Supp. 3d 882, 891, 892 (E.D. Ark. 2021), (No. 4:21CV00450JM), aff’d sub nom. Brandt by & through Brandt v. Rutledge, 47 F.4th 661 (8th Cir. 2022).
32.  Eknes-Tucker v. Marshall, 603 F. Supp. 3d 1131 (M.D. Ala. 2022).
33.  Eknes-Tucker v. Marshall, 603 F. Supp. 3d at 1141-1142 ,1145.
34.  Opinion of the Court, Eknes-Tucker v. Governor of Alabama, 80 F.4th 1205, No. 22-11707 (11th Cir. August 21, 2023), ECF 125-1, https://media.ca11.uscourts.gov/opinions/pub/files/202211707.pdf.
35.  Order, K.C. v. Individual Members of Medical Licensing Board of Indiana, No. 23-2366, (7th Cir. Feb 27, 2024), ECF 124,  https://wp.api.aclu.org/wp-content/uploads/2024/02/KC-decsiion.pdf; Opinion, L.W. v. Skrmetti, 83 F.4th 460, No. 23-5600 (6th Cir. Sept. 28, 2023), ECF 166-2, https://lambdalegal.org/wp-content/uploads/2023/09/CA6-Opinion.pdf.
36.  U.S. v. Skrmetti, 83 F.4th 460 (6th Cir. 2023), cert. granted, No. 23-477 (June 24, 2024), https://www.supremecourt.gov/qp/23-00477qp.pdf.
37.  In effect: Alabama, Arizona (surgery only), Georgia, Iowa, Idaho, Indiana, Kentucky, Louisiana, Missouri, Mississippi, North Carolina, North Dakota, Nebraska, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wyoming;Permanently Blocked: Arkansas, Florida;Temporarily Blocked: Montana, Ohio (legislative ban is blocked, the executive order that bans surgical care still remains in effect);Passed, not in effect until 01/01/2025: New Hampshire (surgery only);Lindsey Dawson & Jennifer Kates, Policy Tracker: Youth Access to Gender Affirming Care and State Policy Restrictions, KFF (Apr. 22, 2024),  https://www.kff.org/other/dashboard/gender-affirming-care-policy-tracker/; See also Bans on Best Practice Medical Care for Transgender Youth, Movement Advancement Project (MAP), https://www.lgbtmap.org/equality-maps/healthcare/youth_medical_care_bans.
38.  Lambda Legal, Lambda Legal Client Dana Zzyym Receives First ‘X’ U.S. Passport (Oct. 27, 2021), https://legacy.lambdalegal.org/blog/co_20211027_dana-zzyym-receives-first-us-passport-with-x-gender-marker.
39.  Anthony J. Blinken, Secretary of State, Press Release: Proposing Changes to the Department’s Policies on Gender on U.S. Passports and Consular Reports of Birth Abroad, U.S. Dept. of State (June 30, 2021), https://www.state.gov/proposing-changes-to-the-departments-policies-on-gender-on-u-s-passports-and-consular-reports-of-birth-abroad/
40.  Zzyym v. Pompeo, 958 F.3d 1014, No. 18-1453, (10th Cir. 2020), https://legacy.lambdalegal.org/sites/default/files/legal-docs/downloads/zzyym_co_20200512_opinion.pdf.
41.  Zzyym, 958 F.3d at 1024.
42.  Fulton v. City of Philadelphia, Pennsylvania, 593 U.S. 522 (2021).
43.  Fulton, 593 U.S. at 523.
44.  Fulton, 593 U.S. at 523-526.
45.  Fulton, 593 U.S. at 523.
46.  Bipartisan Budget Act of 2018, Pub. L. No. 115-123, 132 Stat 64 (2018), https://www.congress.gov/bill/115th-congress/house-bill/1892.
47.  Title IV-E Prevention Program, Children’s Bureau, https://www.acf.hhs.gov/cb/title-iv-e-prevention-program.
48.  Esi Hutchful, Culture is Healing: Removing the Barriers Facing Providers of Culturally Responsive Services, Center for the Study of Social Policy (Jan. 2024), https://cssp.org/resource/culture-is-healing/.
49.  Brief of Amici Curiae Medical, Public Health, and Mental Health Organizations in Support of Plaintiff-Appellee, Grimm v. Gloucester County School Board, 972 F.3d 586 (4th Cir. 2020) (No.19-1952), https://www.aclu.org/cases/grimm-v-gloucester-county-school-board?document=grimm-v-gloucester-county-brief-medical-public-health-and-mental-health-organizations; Brief of Amici Curiae American Academy of Pediatrics and Additional National and State Medical and Mental Health Organizations in Support of Plaintiffs-Appellees and Affirmance, Brandt v. Rutledge, (8th Circ, 2023) (No. 23-2681) https://www.aclu.org/cases/brandt-et-al-v-rutledge-et-al?document=Amicus-Brief-of-American-Academy-of-Pediatrics-et-al-in-Support-of-Plaintiffs-Appellees; Medical Organization Statements, TLDEF, https://transhealthproject.org/resources/medical-organization-statements/; Farnan M. Clarke et al., Gender-Affirming Care Is Trauma-Informed Care, National Center for Child Traumatic Stress (2022), https://www.nctsn.org/sites/default/files/resources/fact-sheet/gender-affirming-care-is-trauma-informed-care.pdf; American Academy of Pediatrics et al., Major Health, Education, and Child Welfare Organizations Oppose Anti-LGBTQ State-Based Legislation (March 5, 2021), https://www.aap.org/en/news-room/news-releases/aap/2021/major-health-education-and-child-welfare-organizations-oppose-anti-lgbtq-state-based-legislation/; Medical Organization Statements, TLDF’s Trans Health Project, https://transhealthproject.org/resources/medical-organization-statements/; Susan D. Boulware et al, Biased Science: The Texas and Alabama Measures Criminalizing Medical Treatment for Transgender Children and Adolescents Rely on Inaccurate and Misleading Scientific Claims, Yale School of Medicine (April 28, 2022), https://medicine.yale.edu/lgbtqi/research/gender-affirming-care/report%20on%20the%20science%20of%20gender-affirming%20care%20final%20april%2028%202022_442952_55174_v1.pdf; AMA strengthens its policy on protecting access to gender-affirming care, Endocrine Society (June 12, 2023), https://www.endocrine.org/news-and-advocacy/news-room/2023/ama-gender-affirming-care
50.  Aprile D. Benner et al., Racial/ethnic discrimination and well-being during adolescence: A meta-analytic review, 73 American Psychologist 7, 855 (2018), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6172152/; Deborah Rivas-Drake et al., Ethnic and racial identity in adolescence: Implications for psychosocial, academic, and health outcomes, 85 Child Development 1, 40-57 (2014), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6673646/; Karol L. Kumpfer et al., Impact of family structure, functioning, culture, and family-based interventions on children’s health, Health promotion for children and adolescents, 57-81 (2016), https://psycnet.apa.org/record/2016-42813-004; Center for Native Child and Family Resilience, Center for Native Child and Family Resilience: Literature Review, Children’s Bureau, Administration for Children and Families, U.S. Department of Health and Human Services (Oct. 2018), https://cncfr.jbsinternational.com/sites/default/files/downloads/CNCFR_Lit_Review.pdf
51.  Status of Submitted Title IV-E Prevention Program Five-Year Plans, Children’s Bureau,  https://www.acf.hhs.gov/cb/data/status-submitted-title-iv-e-prevention-program-five-year-plans
52.  Status of Submitted Title IV-E Prevention Program Five-Year Plans.
53.  42 U.S.C. § 675(5)(a); 42 U.S.C. § 671(a)(10).
54.  Foster Care Independence Act of 1999, 42 U.S.C.A. § 677, Pub. L. No. 106-169, 113 Stat. 1182 (1999).
55.  Foster Care Independence Act of 1999, 42 U.S.C.A. § 677 (b)(3)(D).
56.  Health and Human Services Grants Regulation, 45 C.F.R. § 75.300, 81 Fed. Reg. 89393 (Dec. 12, 2016), www.federalregister.gov/documents/2016/12/12/2016-29752/healthand-human-services-grants-regulation.
57.  Notice of Nonenforcement of Health and Human Services Grants Regulation, 45 C.F.R. § 75, 84 Fed. Reg. 63809 (Nov. 19, 2019), www.federalregister.gov/documents/2019/11/19/2019-24384/notification-of-nonenforcement-of-health-and-human-services-grants-regulation.
58.  Health and Human Services Grants Regulation, 45 C.F.R. § 75.300, 86 Fed. Reg. 2257 (Jan. 12, 2021). https://www.federalregister.gov/documents/2021/01/12/2021-00207/health-and-human-services-grants-regulation.
59.  Complaint for Declaratory and Injunctive Relief, Facing Foster Care in Alaska v. U.S. Dept. of Health & Hum. Servs., No. 21-cv-00308, (D.D.C. Feb. 2, 2021), https://lambdalegal.org/wp-content/uploads/2021/02/ffca_v_hhs.pdf; Facing Foster Care in Alaska v. U.S. Dept. of Health & Hum. Servs., Lambda Legal, https://lambdalegal.org/case/facing-foster-care-in-alaska-v-hhs/#:~:text=Plaintiffs%20Facing%20Foster%20Care%20in,a%20regulation%20finalized%20in%202016%2C
60.  Order, Facing Foster Care in Alaska v. U.S. Dept. of Health & Hum. Servs., No. 21-cv-00308, (D.D.C. Feb. 9, 2022), https://lambdalegal.org/wp-content/uploads/2021/02/18_-_stay_order.pdf.
61.  Order, Facing Foster Care in Alaska v. U.S. Dept. of Health & Hum. Servs., No. 21-cv-00308, (D.D.C. June 29, 2022), https://lambdalegal.org/wp-content/uploads/2022/06/facing_foster_care_in_alaska_v_hhs_-_44_-_vacatur_order.pdf.
62.  Corrected Complaint for Declaratory and Injunctive Relief, Family Equality v. Azar, No. 20-cv-02403 (S.D.N.Y. April 1, 2020), https://lambdalegal.org/wp-content/uploads/2020/04/family_ny_20200319_complaint-corrected.pdf; Family Equality v. Becerra, Lambda Legal, https://lambdalegal.org/case/family-equality-v-azar/.
63.  Order and Opinion Granting Motion to Dismiss, Family Equality v. Becerra, No. 20-cv-02403 (S.D.N.Y. March 30, 2022).
64.  Notice of Nonenforcement of Health and Human Services Grants Regulation, 45 C.F.R. § 75, 84 Fed. Reg. 63809 (Nov. 19, 2019), https://www.federalregister.gov/documents/2019/11/19/2019-24384/notification-of-nonenforcement-of-health-and-human-services-grants-regulation.
65.  Health and Human Services Grants Regulation, 45 C.F.R. § 75, 89 Fed. Reg. 36684 (May 3, 2024), https://www.federalregister.gov/documents/2024/05/03/2024-08880/health-and-human-services-grants-regulation.
66.  ACYF-CB-IM-23-08 Notice of Proposed Rulemaking (NPRM) on safe and appropriate foster care placement requirements under titles IV-E and IV-B for children who identify as lesbian, gay, bisexual, transgender, queer, questioning, intersex, as well as children who are non-binary, or have non-conforming gender identity or expression (LGBTQI+), Administration for Children and Families, Children’s Bureau (Sept. 28, 2023), https://www.acf.hhs.gov/sites/default/files/documents/cb/ACYF-CB-IM-23-08.pdf.
67.  Safe and Appropriate Foster Care Placement Requirements for Titles IV-E and IV-B, 88 Fed. Reg. 66752 (proposed Sept. 28, 2023) (to be codified at 45 C.F.R. § 1355), https://www.federalregister.gov/documents/2023/09/28/2023-21274/safe-and-appropriate-foster-care-placement-requirements-for-titles-iv-e-and-iv-b.
68.  Lambda Legal, Family Equality, et al., ACF-2023-0007-4397, Comment Letter Re: Safe and Appropriate Foster Care Placement Requirements for Titles IV–E and IV–B Notice of Proposed Rulemaking (RIN 0970–AD03), 2-3 (Nov. 27, 2013), https://www.regulations.gov/comment/ACF-2023-0007-4397.
69. Lambda Legal, Family Equality, et al., ACF-2023-0007-4397, Comment Letter Re: Safe and Appropriate Foster Care Placement Requirements for Titles IV–E and IV–B Notice of Proposed Rulemaking (RIN 0970–AD03) 2-3; Center for the Study of Social Policy, ACF-2023-0007-2162, Comment Letter Re: Children’s Bureau (ACF/HHS) Notice of Proposed Rulemaking (RIN-0970- AD03), 3, 9-10 (Nov. 20, 2023), https://www.regulations.gov/comment/ACF-2023-0007-2162. 
70.  Lambda Legal, Family Equality, et al., ACF-2023-0007-4397, Comment Letter Re: Safe and Appropriate Foster Care Placement Requirements for Titles IV–E and IV–B Notice of Proposed Rulemaking (RIN 0970–AD03), 2; Center for the Study of Social Policy, ACF-2023-0007-2162, Comment Letter Re: Children’s Bureau (ACF/HHS) Notice of Proposed Rulemaking (RIN-0970- AD03), 3.
71.  Designated Placement Requirements Under Titles IV-E and IV-B for LGBTQI+ Children, 45 C.F.R. § 1355, 89 Fed. Reg. 34818 (Apr. 30, 2024), https://www.federalregister.gov/documents/2024/04/30/2024-08982/designated-placement-requirements-under-titles-iv-e-and-iv-b-for-lgbtqi-children#:~:text=This%20final%20rule%20specifies%20that,including%20related%20to%20a%20child’s.
72.  Designated Placement Requirements Under Titles IV-E and IV-B for LGBTQI+ Children, 45 C.F.R. § 1355.22(a), 1355.22(b)(1), https://www.govinfo.gov/content/pkg/FR-2024-04-30/pdf/2024-08982.pdf.
73.  Designated Placement Requirements Under Titles IV-E and IV-B for LGBTQI+ Children, 45 C.F.R. § 1355.22(e).
74.  Designated Placement Requirements Under Titles IV-E and IV-B for LGBTQI+ Children, 45 C.F.R. § 1355.22(b)(2)(i)(A-B).
75.  Designated Placement Requirements Under Titles IV-E and IV-B for LGBTQI+ Children, 45 C.F.R. § 1355.22(b)(3).
76.  42 U.S.C. § 18116 (2010); Section 1557 of the Patient Protection and Affordable Care Act, 45 C.F.R. § 92, 81 Fed. Reg. 31375 (August 18, 2020).
77.  Nondiscrimination in Health and Health Education Programs or Activities, Delegation of Authority, 85 Fed. Reg. 37160 (June 19, 2020), https://www.federalregister.gov/documents/2020/06/19/2020-11758/nondiscrimination-in-health-and-health-education-programs-or-activities-delegation-of-authority.
78.  Bostock v. Clayton Cnty., Georgia, 140 S. Ct. 1731 (2020).
79.  Walker v. Azar, 480 F. Supp. 3d 417, 430 (E.D.N.Y. 2020).
80.  Nondiscrimination in Health Programs and Activities, 42 C.F.R. §§ 438, 440, 457, and 460, 45 C.F.R §§ 80, 84, 92, 147, 155, and 156, 89 Fed. Reg. 37522 (May 6, 2024), https://www.federalregister.gov/documents/2024/05/06/2024-08711/nondiscrimination-in-health-programs-and-activities.
81.  Title IX of the Education Amendments of 1972, 20 U.S.C. §§ 1681-1688.
82.  Enforcement of Title IX of the Education Amendments of 1972 With Respect to Discrimination Based on Sexual Orientation and Gender Identity in Light of Bostock v. Clayton County, 86 Fed. Reg. 32637 (June 22, 2021), https://www.federalregister.gov/documents/2021/06/22/2021-13058/enforcement-of-title-ix-of-the-education-amendments-of-1972-with-respect-to-discrimination-based-on; Suzanne B. Goldberg, Acting Assistant Secretary for Civil Rights, Letter to Educators on the Title IX’s 49th Anniversary, U.S. Department of Education (June 23, 2021), https://www2.ed.gov/about/offices/list/ocr/correspondence/stakeholders/educator-202106-tix.pdf; U.S. Department of Justice & U.S. Department of Education, Confronting Anti-LGBTQI+ Harassment in Schools: A Resource for Students and Families (June 2021), https://www2.ed.gov/about/offices/list/ocr/docs/ocr-factsheet-tix-202106.pdf.
83.  Memorandum Opinion and Order, Tennessee v. U.S. Dept. of Educ., 615 F.Supp.3d 807, No. 21-cv-00308 (E.D. Tenn. July 15, 2022), https://www.tn.gov/content/dam/tn/attorneygeneral/documents/pr/2022/pr22-23-order.pdf.
84.  Notice of Proposed Rulemaking Title IX of the Education Amendments of 1972, RIN 1870-AA19, Nondiscrimination on the Basis of Sex in Education Programs or Activities Receiving Federal Financial Assistance: Sex-Related Eligibility Criteria for Male and Female Athletic Teams, (April 6, 2023) (to be codified at 34 C.F.R. § 106), https://www2.ed.gov/about/offices/list/ocr/docs/t9-ath-nprm.pdf; see also Fact Sheet: U.S. Department of Education’s Proposed Change to its Title IX Regulations on Students’ Eligibility for Athletic Teams, U.S. Department of Education (April 6, 2023), https://www.ed.gov/news/press-releases/fact-sheet-us-department-educations-proposed-change-its-title-ix-regulations-students-eligibility-athletic-teams.
85.  Nondiscrimination on the Basis of Sex in Education Programs or Activities Receiving Federal Financial Assistance, 34 C.F.R. 106, 89 Fed. Reg. 33474 (April 29, 204), https://www.govinfo.gov/content/pkg/FR-2024-04-29/pdf/2024-07915.pdf; See also U.S. Department of Education Releases Final Title IX Regulations, Providing Vital Protections Against Sex Discrimination, U.S. Department of Education (April 19, 2024), https://www.ed.gov/news/press-releases/us-department-education-releases-final-title-ix-regulations-providing-vital-protections-against-sex-discrimination.
86.  Social Security Act § 479, 42 U.S.C. 679 (1986).
87. Adoption and Foster Care Analysis and Reporting System, 45 C.F.R. § 1355, 81 Fed. Reg. 90524 (Dec.14, 2016), https://www.federalregister.gov/documents/2016/12/14/2016-29366/adoption-and-foster-care-analysis-and-reporting-system.
88.  Adoption and Foster Care Analysis and Reporting System, 45 C.F.R. §§ 1355.44(b)(2)(ii), 1355.44 (d)(6)(xxx), 1355.44(e)(19), 1355.44(e)(25), 81 Fed. Reg. 90524 (Dec. 14, 2016), https://www.govinfo.gov/content/pkg/FR-2016-12-14/pdf/2016-29366.pdf.
89.  Complaint for Declaratory and Injunctive Relief at 36-38, California Tribal Families Coalition v. Azar, 20-cv-06018, 2020 WL 5074028 (N.D. Cal. August 27, 2020) https://lambdalegal.org/wp-content/uploads/2020/08/california_ca_20200827_complaint.pdf; Adoption and Foster Care Analysis and Reporting System, 45 C.F.R. 1355, 85 Fed. Reg. 28,410 (May 12, 2020), https://www.federalregister.gov/documents/2020/05/12/2020-09817/adoption-and-foster-care-analysis-and-reporting-system.
90.  California Tribal Families Coalition v. Becerra, 20-cv-06018 (N.D. Cal. 2020), https://lambdalegal.org/case/california-tribal-families-coalition-v-azar/.
91.  Order Denying Plaintiffs’ Motion for Summary Judgement; Granting Defendants’ Motion for Summary Judgement; Denying as Moot Defendants’ Motion for Voluntary Remand, California Tribal Families Coalition v. Becerra, 20-cv-06018 (N.D. Cal. Nov. 4, 2022), ECF No. 117.
92.  ACYF-CB-IM-24-02 Notice of Proposed Rulemaking (NPRM) on Adoption and Foster Care Analysis and Reporting System (AFCARS), Administration for Children and Families, Children’s Bureau (Feb. 2024), https://www.acf.hhs.gov/sites/default/files/documents/cb/IM-24-02.pdf; Adoption and Foster Care Analysis and Reporting System, 89 Fed. Reg. 13652 (proposed April, 2024) (to be codified at 45 C.F.R. § 1355), https://www.federalregister.gov/documents/2024/02/23/2024-03373/adoption-and-foster-care-analysis-and-reporting-system/.
93.  Status Report, California Tribal Families Coalition v. Becerra, No. 23-15010 (9th Cir. Jan. 17, 2024), ECF No. 18.
94.  U.S. Department of Health and Human Services, Administration on Children, Youth and Families, ACYF-CB-IM-22-01, Information Memorandum: Guidance for Title IV-B and IV-E Agencies When Serving LGBTQI+ Children and Youth (2022), https://www.acf.hhs.gov/sites/default/files/documents/cb/im2201.pdf
95.  U.S. Department of Health and Human Services, ACYF-CB-IM-22-01, 1.
96.  Id. at 2.
97.  Id.
98.  Id.
99.  Id.
100.  U.S. Department of Health and Human Services, Administration on Children, Youth and Families, ACYF-CB-PI-23-01 Program Instruction (Feb. 9, 2023), https://www.acf.hhs.gov/sites/default/files/documents/cb/pi2301.pdf
101.  U.S. Department of Health and Human Services, ACYF-CB-PI-23-01 Program Instruction, 30 -31.
102.  Id. at 31.
103.  Substance Abuse and Mental Health Services Administration (SAMHSA), Moving Beyond Change Efforts: Evidence and Action to Support and Affirm LGBTQI+ Youth, SAMHSA Publication No. PEP22 03-12-001, Center for Substance Abuse Prevention, 7 (2023), https://store.samhsa.gov/sites/default/files/pep22-03-12-001.pdf.
104.  SAMHSA, Moving Beyond Change Efforts, 7; Child Welfare Information Gateway, Protecting the Rights and Providing Appropriate Services to LGBTQIA2S+ Youth in out-of-Home Care, U.S. Department of Health and Human Services, Administration for Children and Families, Children’s Bureau, 3 (Jan. 2023), https://www.childwelfare.gov/resources/protecting-rights-and-providing-appropriate-services-lgbtqia2s-youth-out-home-care/.
105.  Omnibus Crime Control and Safe Streets Act of 1968, 34 U.S.C. § 10101 et seq., Pub. L. No. 90-351 (1968, effective 2017).
106.  Juvenile Justice and Delinquency Prevention Act (JJDPA), 42 U.S.C. § 5601 et seq., Pub. L. No. 93-415 (1974); The Juvenile Justice Reform Act (JJRA) of 2018, 34 U.S.C. § 11101 et seq., Pub. L. No. 115-385 (2018), note in December 2018, JJRA was signed into law, reauthorizing and substantially amending the JJDPA while maintaining the OJJDP.
107.  Kristen Clarke, Assistant Attorney General, Memorandum: Interpretation of Bostock v. Clayton County regarding the nondiscrimination provisions of the Safe Streets Act, the Juvenile Justice and Delinquency Prevention Act, the Victims of Crime Act, and the Violence Against Women Act, U.S. Department of Justice, Civil Rights Division (March 10, 2022), https://www.justice.gov/crt/page/file/1481776/download.
108.  Kristen Clarke, Assistant Attorney General, Memorandum: Interpretation of Bostock v. Clayton County regarding the nondiscrimination provisions of the Safe Streets Act, the Juvenile Justice and Delinquency Prevention Act, the Victims of Crime Act, and the Violence Against Women Act, U.S. Department of Justice, Civil Rights Division (March 10, 2022), https://www.justice.gov/crt/page/file/1481776/download.
109.  OJJDP Expands Efforts To Protect Youth Who Identify as LGBTQI+ and Two Spirit, Office of Juvenile Justice and Delinquency Prevention.
110.  Id. 
111.  An Initiative to Develop a National Resource Center for Justice-Involved LGBTQ+ and Two-Spirit Youth, Office of Juvenile Justice and Delinquency Prevention (Sept. 27, 2022), https://ojjdp.ojp.gov/funding/awards/15pjdp-22-gk-03104-titl.
112.  An Initiative to Develop a National Resource Center for Justice-Involved LGBTQ+ and Two-Spirit Youth, Office of Juvenile Justice and Delinquency Prevention.
113. Id.
114.  Request Technical Assistance, Pride Justice Resource Center, https://pjrc.ncjfcj.org/contact/.
115.  Shannan Wilber & Jason Szanyi, Model Policy: Transgender, Gender Nonconforming, and Intersex Youth in Confinement Facilities, National PREA Resource Center, National Center for Lesbian Rights and Center for Children’s Law and Policy (2019), https://www.nclrights.org/wp-content/uploads/2019/05/TGNCI-Model-Policy.pdf.
116.  Wilber & Jason Szanyi, Model Policy: Transgender, Gender Nonconforming, and Intersex Youth in Confinement Facilities, 6.
117.  Id. at 5-6.
118.  The Runaway and Homeless Youth Act, 34 U.S.C. §§ 11201-11281 (1974, effective 2017).
119.  34 U.S.C. § 11201 (1974, effective 2017).
120.  Runaway and Homeless Youth, 45 C.F.R. § 1351, 81 Fed. Reg. 93030 (Dec. 20, 2016), https://www.federalregister.gov/documents/2016/12/20/2016-30241/runaway-and-homeless-youth.
121.  Runaway and Homeless Youth, 45 C.F.R. § 1351.22(a), 81 Fed. Reg. 93062 (Dec. 20, 2016), https://www.govinfo.gov/content/pkg/FR-2016-12-20/pdf/2016-30241.pdf.
122.  Equal Access to Housing in HUD Programs Regardless of Sexual Orientation or Gender Identity, 24 C.F.R. §§ 5, 200, 203, 236, 400, 570, 574, 882, 891, and 982, 77 Fed. Reg. 5661 (Feb. 3, 2012), https://www.federalregister.gov/documents/2012/02/03/2012-2343/equal-access-to-housing-in-hud-programs-regardless-of-sexual-orientation-or-gender-identity.
123.  Equal Access to Housing in HUD Programs Regardless of Sexual Orientation or Gender Identity, 24 C.F.R. §§ 5.105(a)(2),  200.300(a), 77 Fed. Reg. 5674, 5675  (Feb. 3, 2012), https://www.govinfo.gov/content/pkg/FR-2012-02-03/pdf/2012-2343.pdf.
124.  Equal Access in Accordance with an Individual’s Gender Identity in Community Planning and Development Programs, 24 C.F.R. § 5, 81 Fed. Reg. 64763 (Sept. 21, 2016), https://www.federalregister.gov/documents/2016/09/21/2016-22589/equal-access-in-accordance-with-an-individuals-gender-identity-in-community-planning-and-development.
125.  Equal Access in Accordance with an Individual’s Gender Identity in Community Planning and Development Programs, 24 C.F.R. § 5.106, 81 Fed. Reg. 64782, https://www.govinfo.gov/content/pkg/FR-2016-09-21/pdf/2016-22589.pdf.
126.  Family and Youth Services Bureau, Runaway and Homeless Youth Training and Technical Assistance Center, Supporting and Affirming LGBTQIA2S+ Youth and Young Adults: Tip Sheet (Feb. 2024), https://www.rhyttac.net/assets/docs/Resources/Supporting%20and%20Affirming%20LGBTQIA2S%2B%20Youth%20and%20Young%20Adults%20TIP%20SHEET.pdf.
127.  U.S. Department of Housing and Urban Development, Equal Access for Transgender People: Supporting Inclusive Housing and Shelters (Apr. 2021), https://files.hudexchange.info/resources/documents/Equal-Access-for-Transgender-People-Supporting-Inclusive-Housing-and-Shelters.pdf.

As we noted in Safe Havens I, child welfare and juvenile legal¹ systems and housing and services for youth experiencing homelessness are administered through a complicated array of state, county, and municipal government agencies and their contractors and grantees.² In addition to federal law and policy protections that may apply to system administration, states have an array of system-specific statutes, regulations, and agency policy that guide care for youth, including, in most states, nondiscrimination requirements.³ Generally applicable laws, such as state and local public accommodation, human rights, and fair housing laws, may also offer protection from discrimination.⁴

For this report, the authors updated the child welfare and juvenile legal interactive maps contained in Safe Havens I that capture whether each state, Washington, D.C., Puerto Rico, or Guam includes gender identity, as well as sexual orientation and other protected classes, in its nondiscrimination statutes, regulations, or agency policies. In addition, we have updated the complete list of state regulations guiding care, including, for example, facility licensing and staff training requirements, provided to youth in child welfare and juvenile legal systems and to youth experiencing homelessness. The complete list can be found here and is linked with each state map entry. Implications of changes to state regulations for transgender, nonbinary, and gender diverse (“TNGD”)⁵ youth apart from nondiscrimination requirements are discussed fully in State-Based Licensing, Training and Other Requirements Section below.

In addition to information contained in the maps, in Safe Havens II we focus on notable changes in state law and policy since 2017 in child welfare, juvenile legal, and systems that serve homeless youth that support or harm TNGD youth. To do this, we separate states into three categories under each system based on: 1) Promising law, policy, and practice guidance, 2) Improvement in law, policy, and practice guidance; and 3) Lack of protections and/or actively harmful law and policy.

This categorization rests principally on whether gender identity is included as a protected class in nondiscrimination law or policy in each system, and whether the relevant state agency has LGBTQ+-⁶ specific practice guidance that provides more direction to practitioners on how to ensure TNGD youth are supported. In addition, we considered whether other mandates exist to place TNGD youth consistent with identity and provide medically necessary medical care, as well as whether there are measures that promote accountability, such as training requirements to support a youth’s whole identity, including race, culture, and spirituality. We also considered if a system-specific ombudsman exists.

State Law and Policy Findings Summary 

The past five years have seen significant law and policy progress for TNGD youth in certain child welfare, juvenile legal, and homeless systems. There has been an increase in both explicit protection from discrimination based on gender identity, as well as related requirements, for example, that youth receive gender-affirming medical care when recommended by qualified medical professionals or can express their gender through clothing choices.

The marked progress within some systems stands in sharp contrast to the unprecedented rhetorical and legal assault on the lives and well-being of TNGD youth around the country and significant regression within other systems. These include attempts to legislate TNGD youth out of legal existence by narrowly and inaccurately defining the term sex,⁷ to deny them medically necessary care,⁸ to limit their ability to access facilities and participate in sports consistent with identity,⁹ to limit information they receive about identity and history,¹⁰ to investigate their parents for “child abuse,”¹¹ and to inhibit their self-determination and freedom of expression.¹² Many of these attempts, fortunately, have been blocked by courts.

Proponents of the recent wave of anti-LGBTQ+ laws and policies focused on youth have attempted to justify discrimination in the name of “protecting” children.¹³ This harmful and categorically incorrect mantra flies in the face of what every major medical, social science, and child welfare organization and association has found: family and community acceptance and support, access to facilities and activities consistent with identity, and affirming and supportive medical and mental health care are what truly promote the safety and well-being of LGBTQ+ youth.¹⁴  In addition to the psychological harm of laws that stigmatize youth by categorizing them as second-class citizens,¹⁵ laws banning care essential to the well-being of TNGD youth are diametrically opposed to state law and agency policy prohibiting discrimination on the basis of gender identity,¹⁶ not to mention the core obligations of state governments to ensure the well-being and safety of youth placed in their care and custody.¹⁷

Fortunately, a significant number of states have, guided by professional standards set by the entities referenced above, improved their laws and policies specific to TNGD youth in out-of-home systems. The agencies and entities charged under state law with centering their policies and practices to promote youth’s well-being have, in significant measure, followed professionally recommended practices to prohibit discrimination. Political actors in other states, however, have not only ignored that guidance, but also proffered junk science and blatant misinformation to justify actively harmful laws and policies. In some states, like Texas and Florida, governors used their executive branch authority to promulgate harmful regulations, actively remove supportive resources, and weaponize youth-serving systems, like child welfare, for political advantage.¹⁸

While nearly all states provide publicly available information or mechanism to file a complaint or grievance, 17 states do not have a foster system or child welfare specific ombudsman¹⁹ office and 28 states do not have a youth specific ombudsman in juvenile legal systems.²⁰ Because services for youth experiencing homelessness do not, at the state level, have a dedicated agency specific to those services in most states, it is challenging to categorize states in terms of options for youth to understand who to complain to or how if they are receiving temporary housing or services related to homelessness.

Improvement of Protection from Discrimination and Active Harm

Notwithstanding the ongoing assault on LGBTQ+ youth in some states, in the past five years, 23 states have added further nondiscrimination protections for youth in their child welfare systems.²¹ Eleven states added sex, gender identity, or sexual orientation to their nondiscrimination requirements in statutes or regulations²² and 15 added protections in agency policy.²³ Fifteen states added nondiscrimination protection for youth on the basis of gender identity in their child welfare system in law or policy;²⁴ there are now a total of 34 states with these protections.²⁵ Seven states have added LGBTQ+ specific agency policy or practice guidance,²⁶ making the total states with LGBTQ+ specific policies, 16.²⁷ Sixteen states added supportive requirements around training, access to medical care, placement consistent with identity, or prevention efforts.²⁸ In juvenile legal systems, 22 states added sex, gender identity, or sexual orientation to their nondiscrimination requirements.²⁹ Nine of those states added nondiscrimination requirements in statute or regulation.³⁰ Nineteen states added protected classes to agency policy.³¹ Nine states added LGBTQ+ specific policies;³² there are now a total of 20 states with LGBTQ+ specific policies.³³ Sixteen states have added nondiscrimination protection for youth on the basis of gender identity in their juvenile legal systems;³⁴ a total of 37 states now have these protections.³⁵ Two states, Connecticut and Maine, added explicit nondiscrimination protection for youth experiencing homelessness.³⁶

In a major victory since 2017, 18 states³⁷ joined five others³⁸ in banning so-called conversion therapy for minors.³⁹
In 2023, in response to bans on gender-affirming care for minors, 14 states and D.C. passed “shield laws”⁴⁰ creating safe havens for youth accessing medical necessary care and two others put in place such protection via executive order.⁴¹ 26 states, Puerto Rico, and D.C. explicitly permit Medicaid coverage for transgender-related health care, including coverage for minors.⁴²

Ten states have clarified, in the wake of the Supreme Court’s Bostock decision, that, in their employment, public accommodation, or fair housing statues, protection against discrimination on the basis of sex includes discrimination on the basis of gender identity.⁴³  Some of these laws may also apply to youth in out-of-home systems, but, at the least, offer general protection in other aspects of daily life.⁴⁴

Ongoing Lack of Protection from Discrimination and Active Harm

No Explicit Protection from Discrimination

Two states — Alabama and Alaska — still offer no express protection from discrimination based on gender identity, sex, or any other protected class in their child welfare statutes, regulations, or agency policy and in 2024 Utah has listed its LGBTQ+-specific policy as “being revised.”⁴⁵ In the juvenile legal system, Oklahoma and Puerto Rico remain the only jurisdictions where no nondiscrimination provisions exist in law or agency policy. 16 states in the child welfare system still do not have gender identity as a protected class in nondiscrimination provisions⁴⁶ and in the juvenile legal system, 13 states do not include gender identity in such requirements.⁴⁷ Most states fail to provide explicit law or policy protection for youth experiencing homelessness as they access housing or services.⁴⁸ This is largely due to (a) the small number of statutes and regulations specific to services and programming for youth experiencing homelessness and (b) such services and programming not falling squarely under the purview of a single agency as they do for youth in the child welfare and juvenile legal systems.

Actively Harmful

Health Care. Since 2017, 26 states have enacted statutes that prohibit medical providers from providing gender-affirming medical care to minors to varying degrees.⁴⁹ Twelve of these states also prohibit Medicaid or other state funds to be used towards medical care or otherwise have language that may limit state action that assists youth obtain medically necessary care.⁵⁰ As noted above, in addition to harmful legislation, governors have taken executive action to limit health care access for TNGD minors. In 2022, Texas Governor Greg Abbott declared, without legal authority, that gender-affirming medical care for minors is “child abuse.”⁵¹ He directed the state child welfare agency to investigate parents assisting their adolescent transgender children in accessing medical care. The governor and the agency effectively turned the child welfare system’s mission on its head, by actively investigating parents who were supporting the safety and well-being of their children by seeking life-saving care from qualified medical professionals.⁵² The Florida state public health agency  published misinformation in the guise of a public health advisory that declared “social gender transition should not be a treatment option for children and adolescents [and] anyone under 18 should not be prescribed puberty blockers or hormone therapy.”^{53 54}   In late 2022, the agency promulgated a rule prohibiting Medicaid coverage for treatment of gender dysphoria for minors and adults,⁵⁵ effectively eliminating such care for thousands of Floridians.⁵⁶ Following suit, Missouri Attorney General Andrew Bailey filed an “emergency” regulation that effectively prohibits gender-affirming medical care for not only transgender minors but also some adults as well.⁵⁷

Definitions of Sex. Eighteen states have joined Tennessee in defining the term sex in statute in a way that denies the existence of TNGD people.⁵⁸ Idaho, Kansas, Louisiana, Mississippi, Montana, North Dakota, Oklahoma, Tennessee, and Utah’s laws define for the purposes of the entire code, while other statutes are limited to specific sections or chapters. For example, Iowa now, in the context of its gender affirming care and use of facilities in accordance with gender identity bans defines sex as “the biological indication of male and female, including sex chromosomes, naturally occurring sex hormones, gonads, and non-ambiguous internal and external genitalia present at birth without regard to an individual’s psychological, chosen, or subjective experience of gender”⁵⁹ and “a person’s biological sex as female or male, as listed on a person’s official birth certificate issued at or near the time of the person’s birth.”⁶⁰ As we noted in Safe Havens I, Illinois also defines sex as “the status of being male or female,” excluding nonbinary people.⁶¹

School Curriculum or Policy. Seven states have passed so-called “opt out” laws since 2017, allowing parents to decide whether they want their children to hear instruction about sexual orientation or gender identity in the classroom.⁶²  In 2022, Florida passed the infamous “Don’t Say Gay” law prohibiting instruction about sexual orientation and gender identity in kindergarten through third grade;⁶³ in 2023, the state expanded the law’s reach to twelfth grade and added restrictions on use of pronouns consistent with a student’s gender identity.⁶⁴ Florida also requires that district school boards “adopt procedures for notifying a student’s parent if there is a change in the student’s services or monitoring related to the student’s mental, emotional, or physical health or well-being[.]”⁶⁵

Other states followed suit enacting versions of the Florida law.⁶⁶ In 2023, Iowa passed a similar sweeping law requiring parental notification if a child requests an accommodation related to gender identity, such as asking to use pronouns different than those in registration records, limiting instruction related to gender identity and sexual orientation, and banning certain books.⁶⁷ In early 2024 a court enjoined portions of Iowa’s law regarding instruction on sexual orientation and gender identity and banning books but found plaintiffs did not have standing to challenge the parental notification portion of the law⁶⁸ and the scope of portions of Florida’s law was limited by a settlement agreement.⁶⁹ Thirteen states prohibit transgender students from accessing restrooms and other school facilities consistent with their identity.⁷⁰

Sports. Prior to Idaho’s law in 2020,⁷¹ there were no states banning a transgender student’s participation in school sports.  Since then, 25 states have joined Idaho and passed laws prohibiting trans youth from participating in school sports consistent with their identity, with most focused on excluding trans girls from participating in girl’s programs.⁷²

Facility Exclusion — General. Thirteen states have laws in place that exclude TNGD people from accessing spaces and facilities consistent with their gender identity, including two states with bans that apply to publicly-owned bathrooms and facilities in all government-owned buildings and spaces (K-12 schools, colleges, and more), four states limited to K-12 schools and least some government buildings consistent with their identity, and seven states limited to K-12 schools only.⁷³

Identity Documents. Eight states have added requirements making it more difficult for TNGD people to change identity documents to accurately reflect their identity.⁷⁴ In 2023, Utah prohibited name change on a birth certificate for youth under 15 years and six months old and added additional requirements severely limiting when youth under 16 years of age could change the name listed on their birth certificate, including an appointment of a guardian ad litem to determine if a name change is in the “child’s best interests.”⁷⁵

Foster and Adoptive Parent Recruitment and Licensure. Since 2017, nine states have taken steps to permit discrimination by child welfare agencies in the recruitment and approval process for prospective foster and adoptive parents.⁷⁶ These efforts largely permit taxpayer-funded child welfare agencies performing a state government function to exclude prospective LGBTQ+ and minority religion foster and adoptive parents on the basis of religion. Arizona and Texas even allow foster parents and certain child welfare providers to engage in “religious education” of youth⁷⁷ or “guide, instruct or raise a child in a manner consistent with the person’s religious belief” without losing their license.⁷⁸ Seven states enacted similar discriminatory laws prior to 2017.⁷⁹ In 2024, Tennessee passed a law that prohibits the state child welfare agency from denying licenses foster parents who refuse to affirm the identity of LGBTQ+ children and youth.⁸⁰

System-Specific Findings

Below, the authors provide a system-by-system breakdown of states with promising law, policy, and practice guidance, those that made significant improvement since 2017, and those that still fail to provide any explicit, specific protection for TNGD youth and/or have passed harmful laws or policies.

1. Child Welfare

A. States with Promising Law, Policy, and Practice Guidance

There are a number of states that have taken, and continue to take, steps to promote the health and well-being of TGND youth. Specifically, five states include gender identity as a protected class in statute through a “foster care bill of rights” or in other nondiscrimination provisions: California, Colorado, Hawai’i, Nevada, and Rhode Island.⁸¹ Of those, Rhode Island has additional LGBTQ+-specific agency policy regarding how to support and affirm LGBTQ+ youth, including requiring use of chosen name and pronoun, acknowledging that healthcare of LBGTQ+ youth should follow the usual foster system standards for medical and behavioral health care, and requiring LGBTQ+-specific staff training requirements.⁸² While California has an “All County Information Notice” specific to LGBTQ+ youth, it does not include detailed practice guidance for caseworkers on how to support LGBTQ+ youth.⁸³ California’s statute governing the rights of minors and older youth in the foster system does, however, include requirements that minors be provided access to gender-affirming medical care and placement consistent with gender identity.⁸⁴ No other state contains these requirements in state statute.

Washington, D.C. is taking important steps to implement promising law, policy, and practice guidance. While there are no explicit protected classes in the District’s statute defining Rights of Youth in Foster Care, the statute does state that independent living programs, foster, and group homes must incorporate “existing rights for youth in foster care provided by local law, federal law, local regulations, agency administrative issuances, and other policy documents[.]”⁸⁵ Given that there are both regulatory and policy-based nondiscrimination protections based on sex, sexual orientation, and gender identity in D.C, the combination provides solid legal protection for TNGD youth.⁸⁶

Nevada has improved its statutory and regulatory requirements for training regarding working with LGBTQ+ youth, and has added affirming placement procedures, and nondiscrimination protections in regulation since 2017.⁸⁷ Yet the state does not have LGBTQ+-specific policy or practice guidance.

New York protects TNGD youth from discrimination on the basis of gender identity in regulation and has LGBTQ+-specific policy, including a 2021 “LGBTQ+ Community Practice Model” designed by OCFS to “establish a consistent and affirming approach when engaging members of the [LGBTQ+ community] across OCFS programming, policy, and practice in in New York State.⁸⁸

Of these, states all but Hawai’i have a system-specific ombudsman and publicly available information about grievance and complaint procedures.⁸⁹

B. States with Improvements in Law, Policy, and Practice Guidance Since 2017

Four states, Delaware, Oklahoma, Oregon, and Vermont have added gender identity as a protected class in regulation,⁹⁰ they join nine states with these protections, California, Florida, Mississippi, New Jersey, New Mexico, New York, Ohio, Rhode Island, and Washington.⁹¹ While gender identity appears in these states’ regulations governing child welfare programs or services, protection from discrimination is not comprehensive and does cover all aspects of placement, programs, and services in all states. Two states, Colorado and Hawai’i have added gender identity as a protected class in statute.⁹² The total states that include gender identity as a protected class in statute or regulation is now 16.⁹³ Thirty-one states now have nondiscrimination protections on the basis of gender identity in agency policy.⁹⁴ Of the states with regulatory protections listed above, New Jersey, New York, Rhode Island, Vermont, and Washington have additional LGBTQ+ specific agency policy or practice guidance,⁹⁵ a critical component of ensuring that TNGD youth’s experience in out-of-home systems more closely aligns with legal protections, bringing the total of states with LGBTQ+-specific-policy or practice guidance to 17.⁹⁶ In 2023 and 2024, Arizona added a SOGIE-inclusive nondiscrimination policy and LGBTQ+-specific practice guidance.⁹⁷

1. Nondiscrimination Protections

Since the publication of Safe Havens I, seven of the states that previously had no nondiscrimination law or agency policy inclusive of sex (or gender), sexual orientation, or gender identity as protected classes, have since incorporated such provisions; Arizona, Georgia, Kansas, Kentucky, Nebraska, North Carolina, and Viriginia now include protection from discrimination on one or more of these bases.⁹⁸

a. Improvements in Statute and Regulation⁹⁹

b. Improvements in Agency Policy¹⁰⁰

c. LGBTQ+-Specific Agency Policy or Practice Guidance¹⁰¹

C. Lack of protective law and policy and/or law and policy actively harmful to TNGD youth.

1. No system-specific nondiscrimination protection in law or policy

2. States without gender identity as protected class in law or policy and anti-LGBTQ+ law or executive action

Without Gender Identity Protection and Harmful General Law or Policy 

Thirteen states do not include gender identity as a protected class in law or agency policy or have no nondiscrimination provision and have a general law that is harmful to TNGD youth.¹⁰⁵

Without Gender Identity as Protected Class 

Sixteen states do not include gender identity as a protected class in law or agency policy or have nondiscrimination provision.¹⁰⁶

Harmful General Law or Policy

Twenty-eight states have statutes, regulations, or agency policy harmful to TNGD youth.¹⁰⁷ While Arizona has gender identity as a protected class and LGBTQ+-specific practice guidance, it has a law in place prohibiting gender-affirming surgeries for minors.¹⁰⁸

2. Juvenile Legal

A. States with Promising Law, Policy, and Practice Guidance

The District of Columbia, Louisiana, New York, and Rhode Island rank highest among state juvenile legal systems by providing not only SOGIE-inclusive nondiscrimination protections in statute or regulation,¹⁰⁹ but also LGBTQ+-specific policy as well.¹¹⁰ California offers statutory and regulatory protections¹¹¹ yet with its county-based system, there is no statewide LGBTQ+-specific policy or practice guidance. Nevada has SOGIE-inclusive nondiscrimination protections in its juvenile legal bill of rights,¹¹² regulatory protections ensuring the gender identity of youth is respected in all aspects,¹¹³ and a training requirement,¹¹⁴ but does not have LGBTQ+-specific policy or practice guidance in place. New Mexico, Oregon, and Texas also provide SOGIE-inclusive regulatory protections.¹¹⁵ Colorado, Connecticut, Delaware, Georgia, Hawai’i, Idaho, Illinois, Kentucky, Maine, Massachusetts, New Jersey, North Carolina, Ohio, Pennsylvania, Tennessee, Vermont, and Washington¹¹⁶ rank high because they, like D.C., New York, Louisiana, and Rhode Island have LGBTQ+-specific statewide policies.

Of the states with SOGIE-inclusive nondiscrimination protections in statute or regulation Nevada, New Mexico, New York, Rhode Island, Texas also have system-specific ombudsman and publicly available information about grievance and complaint processes.¹¹⁷

B. States with Improvements in Law, Policy, and Practice Guidance Since 2017

Two states, New Mexico and Oregon have added gender identity as a protected class in regulation,¹¹⁸ they join five states with these protections, California, Louisiana, New York, Rhode Island, and Texas.¹¹⁹ While gender identity appears in these states’ regulations governing their juvenile legal system or services, protection from discrimination is not comprehensive and does cover all aspects of placement, programs, and services in all states. One state, Nevada has added gender identity as a protected class in statute.¹²⁰ The total states that include gender identity as a protected class in statute or regulation is now eight.¹²¹ Thirty-seven states now have nondiscrimination protections on the basis of gender identity in agency policy.¹²² Of the states with gender identity protections in regulation or statute, Louisiana, New York, and Rhode Island have additional LGBTQ+ specific agency policy or practice guidance,¹²³ a critical component of ensuring that TNGD youth’s experience in out-of-home systems more closely aligns with legal protections, bringing the total number of states with LGBTQ+-specific-policy or practice guidance to 20.¹²⁴

1. Nondiscrimination Protections

a. Statute and Regulation¹²⁵

b. Agency Policy¹²⁶

c. LGBTQ+-Specific Policy or Practice Guidance¹²⁷

C. Lack of protective law and policy and/or law and policy actively harmful to TNGD youth.

1. No system-specific nondiscrimination protection in law or policy

2. States without gender identity as protected class in law or policy and anti-LGBTQ+ law or executive action

Without Gender Identity Protection and Harmful Law or Policy 

Ten states do not include gender identity as a protected class in law or agency policy or have no nondiscrimination provision and have a general law that is harmful to TNGD youth.¹²⁸

Without Gender Identity as Protected Class 

Thirteen states and Puerto Rico do not include gender identity as a protected class in law or agency policy or have no nondiscrimination provision.¹²⁹

Harmful Law or Policy

Twenty-eight states all have statutes, regulations, or agency policy in place harmful to TNGD youth.¹³⁰

3. Youth Experiencing Homelessness

As noted in Safe Havens I, state-based statutes, regulations, and agency policy also offer protection against SOGIE-based discrimination for youth experiencing homelessness and living in government-funded shelter or housing or receiving services. These sources may be the same regulations that govern licensing of other types of congregate facilities, including facilities that serve youth in child welfare or juvenile justice systems. State Department of Human Services or Social Services nondiscrimination policy may also cover providers and programs.

While providers that receive federal funding through the Department of Health and Human Services (“HHS”) or the Department of Housing and Urban Development (“HUD”) are prohibited from discriminating against TNGD youth based on gender identity and sexual orientation,¹³¹ not all providers serving youth at the state and local level receive federal funds. Most states do not provide explicit protection from discrimination based on gender identity or sexual orientation in state law. In addition, most states do have a single agency that oversees programs and services for youth experiencing homelessness. This means the agency-level policy protections for TNGD youth in child welfare and juvenile justice systems are often absent for youth experiencing homelessness.¹³²

Since 2017, only two states, Connecticut and Maine, have joined California, New York and the District of Columbia and promulgated regulations prohibiting discrimination on the basis of gender identity that explicitly protect youth experiencing homelessness.

Public Accommodation statutes or human rights statutes may apply and offer protections as may state fair housing laws.¹³³ For example, New Mexico recently expanded its gender identity-inclusive Human Rights Act to cover services provided by government entities, including government contractors.¹³⁴

C. STATE-BASED LICENSING, TRAINING AND OTHER REQUIREMENTS¹³⁵

Research for Safe Havens I captured the variety of regulations state-administered out-of-home systems for youth rely on to guide everything from living arrangements to clothing to training for staff. These regulations may impact TNGD youth in positive or negative ways and encompass the following categories:  1) Definitions of sex (or gender); 2) Admissions procedures and facility licensing; 3) Sleeping arrangements, 4) Clothing, 5) Supervision, 6) Body searches, and 7) Training requirements. Requirements in some of these categories, such as training or a definition of sex (or gender), may also be found in statute or agency policy in some jurisdictions.

For the most part, state regulatory frameworks have continued to improve since 2017 with 17 states and D.C. promulgating additional requirements to support TNGD youth within and in addition to the categories listed above. Of note, however, are changes in the definition of sex (or gender) in regulation or, at times, in state statute in ways that either positively or negatively impact TNGD youth depending on the change. In addition, since 2017, some states have promulgated regulations (or elsewhere in law or policy) requiring efforts to prevent homelessness for LGBTQ+ youth, to implement programs to increase family acceptance and reduce rejecting behaviors, or to gather SOGI demographic information.

Supportive of TNGD Youth

New Mexico and Michigan joined California, New York, and Florida as states where sex (or gender) is defined by gender identity.¹³⁶ These definitions are consistent with professional standards,¹³⁷ affirm the identity of youth, and clear up misconceptions about whether youth can or cannot be placed consist with their identity in group home and foster home settings. Similarly, California promulgated a regulation stating that transgender youth may “share a bedroom consistent with their gender identity regardless of the gender or sex listed on the court or child welfare documents”¹³⁸ and Rhode Island’s regulation states that a child three years of age or older may share a bedroom with a child of the opposite sex to “meet the needs of transgender or gender non-conforming youth.”¹³⁹

In regulatory improvement in other areas, eight states added additional training requirements¹⁴⁰ and eight states added requirements that TNGD youth receive gender-affirming health care, are placed consistent with their identity, or are allowed to express themselves through clothing or grooming.¹⁴¹

Since 2017, one state, New Mexico, has added specific prohibitions on conduct by foster parents that “attempt[s] to change or discourage” a youth’s sexual orientation or gender identity.¹⁴² North Dakota prohibits “verbal abuse or derogatory remarks about a child in foster care[’s] . . . gender identity.”¹⁴³

A. Defining Sex (or Gender) Consistent with Self Determination and Professional Standards or Otherwise Eliminating Licensing Barriers¹⁴⁴

B. Ensuring Freedom of Expression, Access to Necessary Care, and Affirmation of Identity¹⁴⁵

C. Requiring SOGI or LGBTQ+-Specific Training ¹⁴⁶

D. Data Collection ¹⁴⁷

E. Requiring Access to Community Support and Services and Prevention¹⁴⁸

Harmful to TNGD Youth

As noted above, a total of 19 states¹⁴⁹ have passed laws since 2022 with harmful definitions of “sex,” including Tennessee that defines sex as determined by “anatomy and genetics existing at the time of birth,” and states that “‘evidence of a person’s biological sex,’ includes, […] a government-issued identification document that accurately reflects a person’s sex listed on the person’s original birth certificate.¹⁵⁰

For example, in 2023, Utah included the following definition in two bills, SB 39 and SB 93 limiting the ability of transgender adults and minors to change their name on their birth certificate: “‘Biological sex at birth’ means an individual’s sex, as being male or female, according to distinct reproductive roles as manifested by sex and reproductive organ anatomy, chromosomal makeup, and endogenous hormone profiles.”¹⁵¹ Not only does this definition eliminate gender identity, but it also excludes nonbinary and intersex people. Fourteen states defined sex in the context of laws banning gender-affirming medical care for minors,¹⁵² but nine states have laws that apply to the entire code or statutory scheme.¹⁵³ Those definitions may impact housing for transgender youth consistent with their identity where licensing regulations prohibit placement of children of a certain age with another child of the “opposite sex.”

In three states’ regulation permits evaluations by medical professionals to “determine[]” a child’s sex or gender as part of facility admissions process.¹⁵⁴

Endnotes

1.  The authors use “juvenile legal” to refer to the system where youth are charged with delinquencies and may face a range of interventions, requirements, and restrictions on their behavior and liberty including short and long-term incarceration or informal conduct conditions or formal probation requirements. Youth under 18 may be treated within juvenile systems or adult criminal systems depending on the jurisdiction and type and severity of delinquency or crime alleged. The authors do not use “juvenile justice” due to the system being profoundly unjust for youth for a variety or reason, including, the overrepresentation and disparately harmful treatment of youth of color, LGBTQ+ youth, and LGBTQ+ youth of color.
2.  Christina Wilson Remlin et al., Safe Havens: Closing the Gap Between Recommended Practice and Reality for Transgender and Gender-Expansive Youth in Out-of-Home Care, Children’s Rights, Lambda Legal, and Center for Social Policy, State Law and Policy Section 12-26 (April 2017), https://legacy.lambdalegal.org/sites/default/files/publications/downloads/tgnc-policy-report_2017_final-web_05-02-17.pdf.
3. Coccia, Alex. “50 State and District of Columbia Survey: Licensing regulations in Child Welfare, Juvenile Legal, and Systems Serving Runaway and Homeless Youth relating to sexual orientation, gender identity and expression.” Center for the Study of Social Policy, July 2024. https://lambdalegal.org/publication/us_20240801_state-licensing-regulations-in-out-of-home-systems/
4.  New Mexico expanded the scope of their Human Rights Act to apply to public accommodations nondiscrimination requirements on the basis of sex, gender, sexual orientation and gender identity to all government entities including public contractors see H.B. 207, 56th Leg., 1st Sess. (N.M. 2023), https://www.nmlegis.gov/Sessions/23%20Regular/final/HB0207.pdf; Public Accommodations Nondiscrimination Laws, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/non_discrimination_laws; Human Rights Campaign, Municipal Equality Index 2023, https://www.hrc.org/resources/municipal-equality-index; True Colors United & National Homelessness Law Center, The State Index on Youth Homelessness, https://www.youthstateindex.com/.
5. TNGD—transgender
6.  LGBTQ+ emphasizes that there are a variety of ways people identify or describe themselves in addition to lesbian, gay, bisexual, transgender, queer or questioning. For example, youth from some indigenous communities may identify as Two Spirit. For more information about the concepts of sexual orientation, gender identity, and gender expression (“SOGIE”) or terms youth may use to describe or identify themselves, please see https://cssp.org/resource/key-equity-terms-concepts/. Because people use labels in different ways, or reject labels altogether, the authors recommend that best practice is to honor the language individuals use to describe themselves. Uses of other acronyms in the text are used to reflect research particular to that instance in the text.
7.  37 bills have been passed in 19 states; Arkansas, Alabama, Florida, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Montana, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Utah, Wyoming;
   see (Definitions of sex applicable across state law) Regulating Gender to Allow Discrimination, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/nondiscrimination/defining_sex; H.B. 421, 67th Leg., 2nd Reg. Sess. (Idaho 2024) https://legislature.idaho.gov/sessioninfo/2024/legislation/H0421/; S.B. 180, 2023 Leg., Reg. Sess. (Kan. 2023), https://kslegislature.org/li/b2023_24/measures/SB180/; H.B. 608 2024 Leg., Reg. Sess. (La. 2023),https://www.legis.la.gov/legis/BillInfo.aspx?s=24RS&b=HB608; S.B. 2753, 2024 Leg., Reg. Sess. (Miss. 2024), https://billstatus.ls.state.ms.us/2024/pdf/history/SB/SB2753.xml; S.B. 458, 68th  Leg., Reg. Sess. (Mont. 2023), https://laws.leg.mt.gov/legprd/LAW0210W$BSIV.ActionQuery?P_BILL_NO1=458&P_BLTP_BILL_TYP_CD=SB&Z_ACTION=Find&P_SESS=20231; H.B. 1474, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/bill-index/bi1474.html; H.B. 1449, 2024 Leg., Reg. Sess. (Okla. 2024),
   http://webserver1.lsb.state.ok.us/cf_pdf/2023-24%20ENR/hB/HB1449%20ENR.PDF; S.B. 1440, 113th Gen. Assemb. (Tenn. 2023), https://wapp.capitol.tn.gov/apps/BillInfo/default.aspx?BillNumber=SB1440&ga=113;  H.B. 257, 2024 Gen. Sess. (Utah 2024) https://le.utah.gov/~2024/bills/static/HB0257.html; see (Gender Affirming Care Bans w. definitions of sex) S.B. 184, 2022 Gen. Sess. (Ala. 2022), https://legiscan.com/AL/text/SB184/2022; S.B. 254, 2023 Leg., Reg. Sess. (Fla. 2023), https://www.flsenate.gov/Session/Bill/2023/254; H.B. 71, 67th Leg., 1st Reg. Sess. (Idaho 2023), https://legislature.idaho.gov/sessioninfo/2023/legislation/H0071/; S.B. 480, 123rd Gen. Assemb., 1st Reg. Sess. (Ind. 2023), https://iga.in.gov/pdf-documents/123/2023/senate/bills/SB0480/SB0480.05.ENRH.pdf;  S.F. 538, 90th Gen. Assemb., Reg. Sess. (Iowa 2023), https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=SF538; S.B. 150, 2023 Leg., Reg. Sess. (Ky. 2023), https://legiscan.com/KY/text/SB150/2023; H.B. 648, 2023 Leg., Reg. Sess. (La. 2023), https://www.legis.la.gov/legis/ViewDocument.aspx?d=1331071; H.B. 1125, 2023 Leg., Reg. Sess. (Miss. 2023) https://billstatus.ls.state.ms.us/2023/pdf/history/HB/HB1125.xml; S.B. 99, 68th  Leg., Reg. Sess. (Mont. 2023) https://laws.leg.mt.gov/legprd/LAW0210W$BSIV.ActionQuery?P_BILL_NO1=99&P_BLTP_BILL_TYP_CD=SB&Z_ACTION=Find&P_SESS=20231; H.B. 1254, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/bill-index/bi1254.html; H.B. 68, 135th Gen. Assembl. (Ohio 2024), https://search-prod.lis.state.oh.us/solarapi/v1/general_assembly_135/bills/hb68/EN/05/hb68_05_EN?format=pdf; H.B. 4624, 125th Sess. (S.C. 2024), https://www.scstatehouse.gov/sess125_2023-2024/prever/4624_20240507.htm; H.B. 1080, 98th Leg., Reg. Sess. (S.D. 2023), https://sdlegislature.gov/Session/Bill/24100; H.B. 1, 113th Gen. Assemb. (Tenn. 2023), https://legiscan.com/TN/text/HB0001/2023; see (Exclusionary Facility, Harmful School and Identity Document Laws w. definitions of sex) H.B. 1156, 94th General Assembly, Reg. Sess. (Ark. 2023) https://www.arkleg.state.ar.us/Bills/FTPDocument?path=%2FBills%2F2023R%2FPublic%2FHB1156.pdf; HB. 1069, 2023 Leg., Reg. Sess. (Fla. 2023) https://www.flsenate.gov/Session/Bill/2023/1069/ByVersion; H.B. 1521, 2023 Leg., Reg. Sess. (Fla. 2023), https://www.flsenate.gov/Session/Bill/2023/1521/ByVersion; H.B. 538, 67th Leg., 2nd Reg. Sess. (Idaho 2024), https://legislature.idaho.gov/sessioninfo/2024/legislation/H0538/; S.B. 1110, 67th Leg., 1st Reg. Sess. (Idaho 2023), https://legislature.idaho.gov/sessioninfo/2023/legislation/S1100/; S.F. 482, 90th Gen. Assemb., Reg. Sess. (Iowa 2023), https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=SF%20482&v=i; H.B. 1139, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/bill-index/bi1139.html; H.B. 1297, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/bill-index/bi1297.html; S.B. 100, 2023 Gen. Sess. (Utah 2023),  https://le.utah.gov/~2023/bills/sbillenr/SB0100.pdf; see (Laws that prohibit transgender youth from playing sports in accordance w. their gender identity w. definitions of sex) H.F. 2416, 89th Gen. Assemb., Reg. Sess. (Iowa 2022), https://www.legis.iowa.gov/legislation/BillBook?ga=89&ba=HF2416;  H.B. 1249, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/documents/23-0569-05000.pdf; H.B. 1489, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/documents/23-0967-04000.pdf; H.B. 11, 2022 Gen. Assemb. (Utah 2022), https://le.utah.gov/~2022/bills/static/HB0011.html; S.F. 133, 67th Leg., Gen. Sess. (2023), https://www.wyoleg.gov/Legislation/2023/SF0133.
8.  LGBTQ Policy Spotlight: Bans on Medical Care for Transgender People Infographics, Movement Advancement Project, https://www.mapresearch.org/2023-medical-care-bans-report-infographics; Bans on Best Practice Medical Care for Transgender Youth, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/healthcare/youth_medical_care_bans.
9.  Bans on Transgender People Using Public Bathrooms and Facilities According to their Gender Identity, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/nondiscrimination/bathroom_bans; Bans on Transgender Youth Participation in Sports, Map Advancement Project, https://www.lgbtmap.org/equality-maps/youth/sports_participation_bans.
10.  LGBTQ Curricular Laws, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/curricular_laws.
11.  Governor Abbott Directs DFPS To Investigate Gender-Transitioning Procedures As Child Abuse, Office of the Texas Governor (Feb. 22, 2022), https://gov.texas.gov/news/post/governor-abbott-directs-dfps-to-investigate-gender-transitioning-procedures-as-child-abuse.
12.  Identity Document Laws and Policies, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/identity_documents/name_change; Restrictions on Drag Performances, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/criminaljustice/drag_restrictions.
13.  Michael S. Broder, Anti-LGBTQ laws claiming to protect children actually harm them, University experts say, San Francisco State University (June 12, 2023), https://news.sfsu.edu/news/anti-lgbtq-laws-claiming-protect-children-actually-harm-them-university-experts-say; Marie-Amélie George, False claims of protecting children are fueling anti-trans legislation, The Washington Post (July 6, 2021), https://www.washingtonpost.com/outlook/2021/07/06/false-claims-protecting-children-are-fueling-anti-trans-legislation/.
14.  Farnan M. Clarke et al., Gender-Affirming Care Is Trauma-Informed Care, National Center for Child Traumatic Stress (2022), https://www.nctsn.org/sites/default/files/resources/fact-sheet/gender-affirming-care-is-trauma-informed-care.pdf; American Academy of Pediatrics et al., Major Health, Education, and Child Welfare Organizations Oppose Anti-LGBTQ State-Based Legislation (March 5, 2021), https://www.aap.org/en/news-room/news-releases/aap/2021/major-health-education-and-child-welfare-organizations-oppose-anti-lgbtq-state-based-legislation/; Medical Organization Statements, TLDF’s Trans Health Project, https://transhealthproject.org/resources/medical-organization-statements/; Susan D. Boulware et al, Biased Science: The Texas and Alabama Measures Criminalizing Medical Treatment for Transgender Children and Adolescents Rely on Inaccurate and Misleading Scientific Claims, Yale School of Medicine (April 28, 2022), https://medicine.yale.edu/lgbtqi/research/gender-affirming-care/report%20on%20the%20science%20of%20gender-affirming%20care%20final%20april%2028%202022_442952_55174_v1.pdf; AMA strengthens its policy on protecting access to gender-affirming care, Endocrine Society (June 12, 2023), https://www.endocrine.org/news-and-advocacy/news-room/2023/ama-gender-affirming-care.
15.  Trevor Project, 2023 U.S. National Survey on the Mental Health of LGBTQ Young People, (Nearly 1 in 3 LGBTQ young people said their mental health was poor most of the time or always due to anti-LGBTQ policies and legislation,) https://www.thetrevorproject.org/survey-2023/#intro; Lindsay Y. Dhanani & Rebecca R. Totton, Have You Heard the News? The Effects of Exposure to News About Recent Transgender Legislation on Transgender Youth and Young Adults, Sexuality Research and Social Policy (2023), https://link.springer.com/article/10.1007/s13178-023-00810-6; Laura E. Kuper et al., Supporting and Advocating for Transgender and Gender Diverse Youth and Their Families Within the Sociopolitical Context of Widespread Discriminatory Legislation and Policies, 10 Clinical Practice in Pediatric Psychology 336, 339 (2022), https://psycnet.apa.org/doiLanding?doi=10.1037%2Fcpp0000456.
16.  For example, Tennessee law now bans gender affirming healthcare for transgender minors, but Tennessee Department of Children’s Services (“DCS”) policy states they are “committed to providing all youth and families served a safe, healthy, inclusive, and affirming environment” and that, “ALL DCS employees and persons are prohibited from discrimination on the basis of race, ethnicity, creed, color, age, sex, national origin, religion, mental or physical disability, gender identity, gender expression, sexual orientation, and alien/citizenship status. DCS shall provide services to all children/youth to ensure safety and well-being, to promote dignity and respect for all children/youth and families inclusive of their gender identity, gender expression, and sexual orientation, and to protect their civil rights consistent with State and Federal laws including youth who identify as lesbian, gay, bisexual, transgender, and intersex.” See H.B. 1, 113th Gen. Assembl., Reg. Sess. (Tennessee 2023); State of Tennessee Department of Children’s Services, Administrative Policies and Procedures: 20.20 Guidelines for Managing Children/Youth in DCS Custody Related to Sexual Orientation, Gender Identity and Expression (Jan. 30, 2015), https://files.dcs.tn.gov/policies/chap20/20.20.pdf. 
17.  Adoption and Safe Families Act, 111 Stat. 2115, Pub. L. No. 105-89 (1997), https://www.govinfo.gov/content/pkg/PLAW-105publ89/pdf/PLAW-105publ89.pdf; Dep’t of Health and Hum. Servs. – Children’s Bureau, Integrating Safety, Permanency and Well-Being Series, 1 (Feb. 2014), https://www.acf.hhs.gov/sites/default/files/documents/cb/wp_overview.pdf.
18.  Letter from Greg Abbott, Governor of Texas, to Jaime Masters, Commissioner of Texas Department of Family and Protective Services (Feb. 22, 2022), https://gov.texas.gov/uploads/files/press/O-MastersJaime202202221358.pdf; Sara Tiano, LGBTQ Foster Youth in Texas Suffer Years of Political Attacks and Scaled Back Protections, The Imprint (Dec. 21, 2021), https://imprintnews.org/foster-care/lgbtq-foster-youth-in-texas-suffer-political-attacks/61451; Fla. Admin. Code r. 59G-1.050(7) (2022).
19.  Alabama, Alaska, Arkansas, Hawai’i, Idaho, Iowa, Kansas, Louisiana, Mississippi, North Carolina, North Dakota, Ohio, Pennsylvania, South Dakota, Vermont, Wisconsin, Wyoming.
20.  Alabama, Alaska, California, Hawai’i, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Minnesota, Mississippi, Montana, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Utah, Vermont, West Virginia, Wisconsin, Wyoming.
21.  Arizona (Policy), Colorado (Statute), Delaware (Regulation, Policy), Georgia (Policy), Hawai’i (Statute), Kansas (Regulation, Policy), Kentucky (Regulation, Policy), Louisiana (Policy), Maine (Regulation), Mississippi (Policy), Missouri (Policy), Nebraska (Policy), Nevada (Regulation), New Mexico (Policy), North Carolina (Policy), North Dakota (Policy), Oklahoma (Regulation), Oregon (Regulation), South Carolina (Policy), Vermont (Regulation), Virginia (Regulation), Washington (Policy), West Virginia (Policy).
22.  Statute: Colorado, Hawai’i; Regulation: Delaware, Kansas, Kentucky, Maine, Nevada, Oklahoma, Oregon, Vermont, Virginia.
23.  Arizona, Delaware, Georgia, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, New Mexico, North Carolina, North Dakota, South Carolina, Washington, West Virginia.
24.  Arizona (Policy), Colorado (Statute), Delaware (Regulation and Policy), Georgia (Policy), Hawai’i (Statute), Mississippi (Policy), Missouri (Policy), New Mexico (Policy), Oklahoma (Regulation), Oregon (Regulation), South Carolina (Policy), Vermont (regulation), Washington (Policy), West Virginia (Policy).
25.  Arizona, California, Connecticut, Colorado, Delaware, Georgia, Florida, Hawai’i, Idaho, Illinois, Indiana, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Washington, West Virginia.
26.  Arizona, Michigan, Missouri, North Carolina, Vermont, Virginia, Washington.
27.  Arizona, Connecticut, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Rhode Island, Tennessee, Vermont, Virginia, Washington.
28.  California, Colorado, Connecticut, Delaware, Illinois, Louisiana, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, Ohio, Oregon, Rhode Island, South Carolina, Utah, Washington, D.C.
29.  Alaska, Arkansas, Delaware, Idaho, Kansas, Maine, Maryland, Mississippi, Missouri, Nevada, New Mexico, North Carolina, North Dakota, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, West Virginia, Wisconsin, Wyoming.
30.  Statute: Nevada; Regulation: Arkansas, Maine, Missouri, New Mexico, Oregon, Tennessee, Wisconsin, Wyoming.
31.  Alaska, Arkansas, Delaware, Idaho, Kansas, Maine, Maryland, Mississippi, Missouri, Nevada, New Mexico, North Carolina, North Dakota, Pennsylvania, South Dakota, Utah, Virginia, West Virginia, Wisconsin.
32.  Delaware, Georgia, Idaho, Kentucky, Maine, North Carolina, Pennsylvania, Vermont, Washington.
33.  Colorado, Connecticut, Delaware, Georgia, Hawai’i, Idaho, Illinois, Kentucky, Louisiana, Maine, Massachusetts, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Tennessee, Vermont, Washington.
34.  Alaska, Arkansas, Delaware, Idaho, Kansas, Maine, Maryland, Missouri, Nevada, New Mexico, North Carolina, North Dakota, Oregon, Pennsylvania, Utah, West Virginia.
35.  Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Hawai’i, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Vermont, Washington, West Virginia.
36.  Connecticut and Maine join California, New York and D.C.
37.  Colorado, Connecticut, Delaware, Hawai’i, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Hampshire, New Mexico, New York, Pennsylvania, Rhode Island, Utah, Virginia, Washington, see Conversion “Therapy” Laws, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/conversion_therapy.
38.  California, Illinois, New Jersey, Oregon, Vermont, see Conversion “Therapy” Laws, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/conversion_therapy.
39.  Conversion “Therapy” Laws, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/conversion_therapy.
40.  California, Colorado, Connecticut, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Mexico, New York, Oregon, Rhode Island, Vermont, Washington and D.C., Transgender Healthcare “Shield” Laws, Movement Advancement Project, http://www.mapresearch.org/equality-maps/healthcare/trans_shield_laws.
41.  Arizona, New Jersey; Transgender Healthcare “Shield” Laws, Movement Advancement Project, http://www.mapresearch.org/equality-maps/healthcare/trans_shield_laws.
42.  Alaska, California, Colorado, Connecticut, Delaware, Georgia, Illinois, Iowa, Maine, Mayland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New York, North Dakota, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, Wisconsin, see Medicaid Coverage of Transgender-Related Health Care, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/healthcare/medicaid.
43.  Employment: Alaska, Arizona, Florida, Kansas, Kentucky, Nebraska, North Dakota, Ohio, Pennsylvania, Texas, see State Nondiscrimination Laws: Employment, Movement Advancement Project, https://www.lgbtmap.org/img/maps/citations-nondisc-employment.pdf; Public Accommodations: Arizona, Florida, Kansas, North Dakota, Ohio, Pennsylvania see State Nondiscrimination Laws: Public Accommodations, Movement Advancement Project, https://www.lgbtmap.org/img/maps/citations-nondisc-public-accom.pdf; Housing: Arizona, Florida, Kansas, Kentucky, Nebraska, North Dakota, Ohio, Pennsylvania, see State Nondiscrimination Laws: Housing, Movement Advancement Project, https://www.lgbtmap.org/img/maps/citations-nondisc-housing.pdf.
44. Nondiscrimination Laws: Employment, Movement Advancement Project, https://www.lgbtmap.org/img/maps/citations-nondisc-employment.pdf; Nondiscrimination Laws: Public Accommodations, Movement Advancement Project, https://www.lgbtmap.org/img/maps/citations-nondisc-public-accom.pdf; Nondiscrimination Laws: Housing, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/non_discrimination_laws.
45.  Utah Department of Health and Human Services, 300.5 Safety For Lesbian, Gay, Bisexual, Transgender, And Questioning (LGBTQ) Youth (May 2024), https://public.powerdms.com/UTAHDHHS/documents/274994.
46.  Alabama, Alaska, Arkansas, Kansas, Kentucky, Louisiana, Montana, Nebraska, New Hampshire, North Carolina, Pennsylvania, Texas, Utah, Virginia, Wisconsin, Wyoming: note that North Carolina and Virginia’s LGBTQ+ specific policies have no explicit nondiscrimination protections based on gender identity for youth in the child welfare system.
47.  Alabama, Florida, Indiana, Minnesota, Mississippi, Montana, Nebraska, Oklahoma, South Carolina, South Dakota, Virginia, Wisconsin, Wyoming.
48.  Only California, Connecticut, Maine, New York, and the District of Columbia have protections against discrimination on the basis of gender identity for youth served by runaway and homeless youth programs and shelters.
49.  Alabama, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, and Wyoming, see Bans on Best Practice Medical Care for Transgender Youth, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/healthcare/youth_medical_care_bans.
50.  Medicaid exclusion limited to youth: Arkansas, Mississippi; Medicaid excludes coverage for all ages: Arizona, Florida, Idaho, Kentucky, Missouri, Nebraska, Ohio, South Carolina, Tennessee, and Texas; Medicaid Coverage of Transgender-Related Health Care, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/healthcare/medicaid.
51.  Letter from Greg Abbott, Governor of Texas, to Jaime Masters, Commissioner of Texas Department of Family and Protective Services (Feb. 22, 2022), https://gov.texas.gov/uploads/files/press/O-MastersJaime202202221358.pdf.
52.  PFLAG, Inc. v. Abbott, D-1-GN-22-002569 (Tex. Dist. 2022), https://lambdalegal.org/case/pflag-v-abbott/; Doe v. Abbott, D-1-GN-22-000977 (Tex. Dist. 2022), https://lambdalegal.org/case/doe-v-abbott/#:~:text=The%20lawsuit%20names%20Texas%20Gov,Masters%20and%20DFPS%2C%20as%20defendants.
53.  Treatment of Gender Dysphoria for Children and Adolescents, Florida Department of Health (April 20, 2022), https://perma.cc/W33H-6P5Q.
54.  Florida Medicaid: Generally Accepted Professional Medical Standards Determination on the Treatment of Gender Dysphoria, Florida Agency for Health Care Administration, (June 2, 2022), https://perma.cc/SUB9-V7DW.
55.  Florida Agency for Health Care Administration, Fla. Admin. Code r. 59G-1.050 (2022), https://www.flrules.org/gateway/View_Notice.asp?id=26157328.
56.  Dekker v. Weida, No. 22-cv-00325 (N.D. Fla. 2022), https://lambdalegal.org/case/dekker-v-marstiller/.
57.  Emergency Rule, 15 C.S.R. 60-17.010, Experimental Interventions to Treat Gender Dysphoria (Apr. 13, 2023). https://ago.mo.gov/docs/default-source/press-releases/2023-04-13—emergency-reg.pdf?sfvrsn=7f78d4fc_2; Southampton Community Healthcare v. Bailey, 23SL-CC01673, (Mo. Dist. 2023), https://lambdalegal.org/case/southampton-community-healthcare-v-bailey/.
58.  Arkansas, Alabama, Florida, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Montana, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Utah, Wyoming; Of these states, nine states’ definition is applicable across state law (Idaho, Kansas, Louisiana, Mississippi, Montana, North Dakota, Oklahoma, Tennessee and Utah.) The remaining states define sex within a specific chapter or section. Eight of these states do so in a gender affirming care ban for minors (Alabama, Florida, Indiana, Iowa, Kentucky, Ohio, South Carolina, South Dakota). Additionally, Arkansas’ exclusionary facility and harmful school law and Wyoming legislation banning transgender students playing sports in accordance with their gender identity define sex. see (Definitions of sex applicable to state law) H.B. 421, 67th Leg., 2nd Reg. Sess. (Idaho 2024) https://legislature.idaho.gov/sessioninfo/2024/legislation/H0421/; S.B. 180, 2023 Leg., Reg. Sess. (Kan. 2023), https://kslegislature.org/li/b2023_24/measures/SB180/; H.B. 608 2024 Leg., Reg. Sess. (La. 2023), https://www.legis.la.gov/legis/BillInfo.aspx?s=24RS&b=HB608; S.B. 2753, 2024 Leg., Reg. Sess. (Miss. 2024), https://billstatus.ls.state.ms.us/2024/pdf/history/SB/SB2753.xml; S.B. 458, 68th  Leg., Reg. Sess. (Mont. 2023), https://laws.leg.mt.gov/legprd/LAW0210W$BSIV.ActionQuery?P_BILL_NO1=458&P_BLTP_BILL_TYP_CD=SB&Z_ACTION=Find&P_SESS=20231; H.B. 1474, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/bill-index/bi1474.html; H.B. 1449, 2024 Leg., Reg. Sess. (Okla. 2024), http://webserver1.lsb.state.ok.us/cf_pdf/2023-24%20ENR/hB/HB1449%20ENR.PDF; S.B. 1440, 113th Gen. Assemb. (Tenn. 2023), https://wapp.capitol.tn.gov/apps/BillInfo/default.aspx?BillNumber=SB1440&ga=113;  H.B. 257, 2024 Gen. Sess. (Utah 2024) https://le.utah.gov/~2024/bills/static/HB0257.html; see (Gender Affirming Care Bans w. definitions of sex) S.B. 184, 2022 Gen. Sess. (Ala. 2022), https://legiscan.com/AL/text/SB184/2022; S.B. 254, 2023 Leg., Reg. Sess. (Fla. 2023), https://www.flsenate.gov/Session/Bill/2023/254; H.B. 71, 67th Leg., 1st Reg. Sess. (Idaho 2023), https://legislature.idaho.gov/sessioninfo/2023/legislation/H0071/; S.B. 480, 123rd Gen. Assemb., 1st Reg. Sess. (Ind. 2023), https://iga.in.gov/pdf-documents/123/2023/senate/bills/SB0480/SB0480.05.ENRH.pdf;  S.F. 538, 90th Gen. Assemb., Reg. Sess. (Iowa 2023), https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=SF538; S.B. 150, 2023 Leg., Reg. Sess. (Ky. 2023), https://legiscan.com/KY/text/SB150/2023; H.B. 648, 2023 Leg., Reg. Sess. (La. 2023), https://www.legis.la.gov/legis/ViewDocument.aspx?d=1331071; H.B. 1125, 2023 Leg., Reg. Sess. (Miss. 2023) https://billstatus.ls.state.ms.us/2023/pdf/history/HB/HB1125.xml; S.B. 99, 68th  Leg., Reg. Sess. (Mont. 2023) https://laws.leg.mt.gov/legprd/LAW0210W$BSIV.ActionQuery?P_BILL_NO1=99&P_BLTP_BILL_TYP_CD=SB&Z_ACTION=Find&P_SESS=20231; H.B. 1254, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/bill-index/bi1254.html; H.B. 68, 135th Gen. Assembl. (Ohio 2024), https://search-prod.lis.state.oh.us/solarapi/v1/general_assembly_135/bills/hb68/EN/05/hb68_05_EN?format=pdf; H.B. 4624, 125th Sess. (S.C. 2024), https://www.scstatehouse.gov/sess125_2023-2024/prever/4624_20240507.htm; H.B. 1080, 98th Leg., Reg. Sess. (S.D. 2023), https://sdlegislature.gov/Session/Bill/24100; H.B. 1, 113th Gen. Assemb. (Tenn. 2023), https://legiscan.com/TN/text/HB0001/2023; see (Exclusionary Facility, Harmful School and Identity Documents Laws w. definitions of sex) H.B. 1156, 94th General Assembly, Reg. Sess. (Ark. 2023) https://www.arkleg.state.ar.us/Bills/FTPDocument?path=%2FBills%2F2023R%2FPublic%2FHB1156.pdf; HB. 1069, 2023 Leg., Reg. Sess. (Fla. 2023) https://www.flsenate.gov/Session/Bill/2023/1069/ByVersion; H.B. 1521, 2023 Leg., Reg. Sess. (Fla. 2023), https://www.flsenate.gov/Session/Bill/2023/1521/ByVersion; H.B. 538, 67th Leg., 2nd Reg. Sess. (Idaho 2024), https://legislature.idaho.gov/sessioninfo/2024/legislation/H0538/; S.B. 1110, 67th Leg., 1st Reg. Sess. (Idaho 2023), https://legislature.idaho.gov/sessioninfo/2023/legislation/S1100/; S.F. 482, 90th Gen. Assemb., Reg. Sess. (Iowa 2023), https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=SF%20482&v=i; S.B. 639 (N.C. 2023), https://www.ncleg.gov/BillLookup/2023/S639; H.B. 1139, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/bill-index/bi1139.html; H.B. 1297, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/bill-index/bi1297.html; S.B. 100, 2023 Gen. Sess. (Utah 2023),  https://le.utah.gov/~2023/bills/sbillenr/SB0100.pdf; see (Laws that prohibit transgender youth from playing sports in accordance w. their gender identity w. definitions of sex) H.F. 2416, 89th Gen. Assemb., Reg. Sess. (Iowa 2022), https://www.legis.iowa.gov/legislation/BillBook?ga=89&ba=HF2416;  H.B. 1249, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/documents/23-0569-05000.pdf; H.B. 1489, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/documents/23-0967-04000.pdf; H.B. 11, 2022 Gen. Assemb. (Utah 2022), https://le.utah.gov/~2022/bills/static/HB0011.html; S.F. 133, 67th Leg., Gen. Sess. (2023), https://www.wyoleg.gov/Legislation/2023/SF0133. Arkansas, Missouri, Nebraska, North Carolina, West Virginia’s gender affirming care bans defines “biological sex.”S.B. 49, 102nd Gen. Assemb., 1st Reg. Sess. (Mo. 2023), https://senate.mo.gov/23info/pdf-bill/tat/SB49.pdf; L.B. 574, 108th Leg., 1st Sess. (Neb. 2023) https://nebraskalegislature.gov/FloorDocs/108/PDF/Final/LB574.pdf; H.B. 808, 2023 Leg., Reg. Sess. (N.C. 2023) https://www.ncleg.gov/Sessions/2023/Bills/House/PDF/H808v7.pdf; H.B. 2007, 2023 Leg.., Reg. Sess. (W.V. 2023), https://www.wvlegislature.gov/Bill_Status/bills_text.cfm?billdoc=hb2007%20sub%20enr.htm&yr=2023&sesstype=RS&i=2007; H.B. 1156, 94th General Assembly, Reg. Sess. (Ark. 2023) https://www.arkleg.state.ar.us/Bills/FTPDocument?path=%2FBills%2F2023R%2FPublic%2FHB1156.pdf; S.B. 270, 94th General Assembly, Reg. Sess. (Ark. 2023) https://www.arkleg.state.ar.us/Bills/FTPDocument?path=%2FBills%2F2023R%2FPublic%2FSB270.pdf; S.F. 482, 90th Gen. Assemb., Reg. Sess. (Iowa 2023), https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=SF%20482&v=i; S.F. 538, 90th Gen. Assemb., Reg. Sess. (Iowa 2023), https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=SF%20538; H.B. 576, 2023 Reg. Sess. (Miss. 2023), http://billstatus.ls.state.ms.us/documents/2023/pdf/HB/0500-0599/HB0576IN.pdf; S.B. 16, Gen. Sess. (Utah 2023), https://le.utah.gov/~2023/bills/sbillenr/SB0016.pdf; S.B. 93, 2023 Gen. Sess. (Utah 2023), https://le.utah.gov/~2023/bills/sbillenr/SB0093.pdf; S.B. 100, 2023 Gen. Sess. (Utah 2023),  https://le.utah.gov/~2023/bills/sbillenr/SB0100.pdf.
59.  S.F. 538, 90th Gen. Assemb., Reg. Sess. (Iowa 2023), https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=SF%20482&v=i.
60.  S.F. 482, 90th Gen. Assemb., Reg. Sess. (Iowa 2023), https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=SF%20482&v=i;
61.  Remlin et al., Safe Havens: Closing the Gap Between Recommended Practice and Reality for Transgender and Gender-Expansive Youth in Out-of-Home Care, 20; 775 Ill. Comp. Stat. 5/1-103(O).
62.  Arizona, Arkansas, Florida, Montana, New Hampshire, Tennessee, Wyoming see LGBTQ Youth: LGBTQ Curricular Laws, Movement Advancement Project, https://www.lgbtmap.org/img/maps/citations-curricular-laws.pdf.
63.  H.B. 1557, 2022 Leg., Reg. Sess. (Fla. 2022), https://www.flsenate.gov/Session/Bill/2022/1557.
64.  H.B. 1069, 2023 Leg., Reg. Sess. (Fla. 2023), https://www.flsenate.gov/Session/Bill/2023/1069.
65.  Fla. Stat. § 1001.42(8)(c); H.B. 1557, 2022 Leg., Reg. Sess. (Fla. 2022), https://www.flsenate.gov/Session/Bill/2022/1557.
66.  Alabama, Arkansas, Indiana, Iowa, Kentucky, Louisiana, North Carolina, see LGBTQ Youth: LGBTQ Curricular Laws, Movement Advancement Project, https://www.lgbtmap.org/img/maps/citations-curricular-laws.pdf.
67.  S.F. 496, 90th Gen. Assemb., Reg. Sess. (Iowa 2023), https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=SF496.
68.  Order Granting in Part and Denying in Part Motion for Preliminary Injunction, Iowa Safe Schools v. Reynolds, No. 23-cv-00474 (S.D. Iowa Dec. 29,2023), ECF 65, https://lambdalegal.org/wp-content/uploads/2024/01/Order-Granting-in-Part-and-Denying-in-Part-Motion-for-Preliminary-Injunction.pdf.
69.  Kaplan Hecker & Fink LLP, KHF and the National Center for Lesbian Rights Reach Historic Settlement Agreement Resolving Facial Challenge to Florida’s “Don’t Say Gay” Law, (March 11, 2024), https://www.kaplanhecker.com/newsroom/khf-and-national-center-lesbian-rights-reach-historic-settlement-agreement-resolving; Settlement Agreement, Equality Florida v. Florida State Board of Education, No. 22-cv-134 (N.D. Fla. 2022), https://manage.kaplanhecker.com/sites/default/files/2024-03/Settlement%20Agreement.03.11.24.pdf; See also LGBTQ Youth: LGBTQ Curricular Laws, Movement Advancement Project, https://www.lgbtmap.org/img/maps/citations-curricular-laws.pdf.
70.  State bans transgender people from using bathrooms and facilities consistent with their gender identity in K-12 schools: Arkansas, Idaho, Iowa, Kentucky, Oklahoma, South Carolina, Tennessee; 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: Alabama, Louisiana, Mississippi, North Dakota; 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: Florida, Utah; Ban on Transgender People Using Public Bathrooms and Facilities According to their Gender Identity, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/youth/school_bathroom_bans.
71.  H.B. 500, 65th Leg., 2d Reg. Sess. (Idaho 2020), https://legislature.idaho.gov/sessioninfo/2020/legislation/h0500/.
72.  Alabama, Alaska, Arizona, Arkansas, Florida, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, and Wyoming, Bans on Transgender Youth Participation in Sports, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/youth/sports_participation_bans; in March 2024, a former college swimmer, along with more than a dozen college athletes, filed a lawsuit against the NCAA in March of 2024, accusing it of violating their Title IX rights by allowing transgender woman to compete at the national championships in 2022.  The lawsuit was filed in the U.S. District Court for the Northern District of Georgia. This lawsuit is yet another effort to eviscerate Title IX protection for transgender students, and to erode the autonomy of sport governing bodies to set evidence-based eligibility criteria instead of implementing harmful categorical bans. Gaines v. National Collegiate Athletic Association, No. 24-cv-01109 (N.D. Ga. 2024). https://swimswam.com/wp-content/uploads/2024/03/Complaint-re-2022-Championships-FINAL.pdf
73.  State bans transgender people from using bathrooms and facilities consistent with their gender identity in K-12 schools: Arkansas, Idaho, Iowa, Kentucky, Oklahoma, South Carolina, Tennessee; 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: Alabama, Louisiana, Mississippi, North Dakota; 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: Florida, Utah; Ban on Transgender People Using Public Bathrooms and Facilities According to their Gender Identity, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/youth/school_bathroom_bans.
74.  Driver’s License: Arkansas, Florida, Kansas, Montana; Tennessee;see State of Arkansas Department of Finance and Administration, Proposed Emergency Rule – Gender Information Required to be Displayed on an Arkansas Driver’s License or State-Issued Identification Card (Mar. 7, 2024), https://www.arkleg.state.ar.us/Home/FTPDocument?path=%2FAssembly%2FMeeting+Attachments%2F045%2F26367%2FExhibit+B.01+-+DFA+Proposed+Emergency+Rule+-+Gender+on+DL+and+ID+Cards.3.7.2024.pdf; Denise Royal & Carlos Suarez, Florida residents can no longer elect to change their gender on their driver’s license. Transgender people feel targeted by the policy, CNN (Feb. 2, 2024), https://www.cnn.com/2024/01/31/us/florida-transgender-drivers-license-reaj/index.html;Alejandra Caraballo, Florida Department of Highway Safety and Motor Vehicles Memo, X (Jan. 29, 2024), https://x.com/Esqueer_/status/1752168280322609330/photo/1; Memorandum Decision and Order on Motion for Temporary Injunction, Kansas v. Harper, No. SN-2023-cv-422 (Shawnee Cnty. Dist. Ct., Kan. 2024), https://ag.ks.gov/docs/default-source/documents/doc_99394829.pdf; ACLU of Montana, New Class-Action Lawsuit Challenges Montana’s Refusal to Update Transgender People’s Birth Certificates & Driver’s Licenses, ACLU (Apr. 18, 2014), https://www.aclu.org/press-releases/new-class-action-lawsuit-challenges-montanas-refusal-to-update-transgender-peoples-birth-certificates-drivers-licenses; Christopher Wiggins, Tennesseans Can No Longer Update Gender Markers on Official Documents, Advocate (July 9, 2023), https://www.advocate.com/law/transgender-id-tennessee;  Birth Certificate: Kansas, Montana, North Dakota, Oklahoma, Utah;see Kansas Department of Health and Environment, SB 180 Impacts on Birth Certificates (Sept. 15, 2023), https://www.kdhe.ks.gov/DocumentCenter/View/30719/SB-180-Impacts-on-Birth-Certificates?bidId=; Montana Department of Public Health and Human Services, DPHHS Officials State 2022 Administrative Rule Governs Sex Marker Birth Certificate Change Requests (Feb. 20, 2024), https://dphhs.mt.gov/News/2024/February/DPHHSOfficialsState2022AdministrativeRuleGovernsSexMarkerBirthCertificateChangeRequests; H.B. 1297, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/documents/23-0408-06000.pdf; H.B. 1139, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/documents/23-0079-03000.pdf; Oklahoma Office of the Governor, Executive Order 2021-24 (Nov. 8, 2021), https://www.sos.ok.gov/documents/executive/2014.pdf; S.B. 1100, 2024 Leg., Reg. Sess. (Okla. 2022), http://webserver1.lsb.state.ok.us/cf_pdf/2021-22%20ENR/SB/SB1100%20ENR.PDF; S.B. 93, 2023 Leg., Gen. Sess. (Utah 2023), https://le.utah.gov/~2023/bills/static/SB0093.html;Also see Identity Document Laws and Policy, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/identity_documents/.
75.  S.B. 93, 26-2-11, 2023 Gen. Sess. (Utah 2023), https://le.utah.gov/~2023/bills/sbillenr/SB0093.pdf.
76.  Alabama (only applies to state-licensed agencies that do not receive state funding), Texas, Oklahoma, Kansas, South Carolina, Tennessee, Arizona, Utah (only applies to private agencies), Idaho;14 States Total (Chonologically): North Dakota, Virginia, Michigan (only applies to state-licensed agencies that do not receive state funding), Mississippi, South Dakota, Alabama (only applies to state-licensed agencies that do not receive state funding), Texas, Oklahoma, Kansas, South Carolina, Tennessee, Arizona, Utah, Idaho; see Religious Exemption Laws, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/religious_exemption_laws/religious_exemption_services.
77.  Tex. Hum. Res. Code Ann. §§ 45.001-45.010, H.B. 3859, 85th Leg. (Tex. 2017), https://capitol.texas.gov/tlodocs/85R/billtext/pdf/HB03859I.pdf.
78.  Ariz. Rev. Stat. Ann. § 8-921, S.B. 1399, 55th Leg., 2nd Reg. Sess. (2022), https://www.azleg.gov/legtext/55leg/2R/laws/0115.pdf.
79.  North Dakota, Virginia, Michigan (only applies to state-licensed agencies that do not receive state funding), Mississippi, South Dakota;14 States Total: North Dakota, Virginia, Michigan (only applies to state-licensed agencies that do not receive state funding), Mississippi, South Dakota, Alabama (only applies to state-licensed agencies that do not receive state funding), Texas, Oklahoma, Kansas, South Carolina, Tennessee, Arizona, Utah, Idaho; see Religious Exemption Laws, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/religious_exemption_laws/religious_exemption_services.
80.  H.B. 2169, 113th Gen. Assemb., Reg. Sess. (Tenn 2024), https://wapp.capitol.tn.gov/apps/BillInfo/Default.aspx?BillNumber=HB2169.
81.  Cal. Welf. & Inst. Code § 16001.9 (2023); Colo. Rev. Stat. § 19-7-101 (2023); H.B. 24-1017, 74th Gen. Assemb., 2024 Reg. Sess. (CO 2024); Haw. Rev. Stat. § 587A-3.1 (2018); Nev. Rev. Stat. § 432.525 (2017); R.I. Gen. Laws 42-72-15 (2015).
82.  Rhode Island Department of Children, Youth and Families, Department Operating Procedure 100.0095, Sexual Orientation, Gender Identity and Expression (Nov. 10, 2016), https://dcyf.ri.gov/about-us/dcyf-policies-operating-procedures.
83.  State of California Health and Human Services Agency, Department of Social Services, All County Information Notice I-81-10, Serving Lesbian, Gay Bisexual, Transgender And Questioning (LGBTQ) Youth, LGBTQ Caregivers And LGBTQ Prospective Foster And Adoptive Parents (Oct. 20, 2010), https://www.cdss.ca.gov/lettersnotices/entres/getinfo/acin/2010/I-81_10.pdf.
84.  Cal. Welf. & Inst. Code § 16001.9(22)(A) (2023).
85.  D.C. Code § 4-1303.72 (2013).
86.  D.C. Mun. Regs. tit. 29, § 6004 (2024), D.C. Mun. Regs. tit. 29, § 6203 (2014); D.C. Child and Family Services Agency, Gender Identity and Expression (May 26, 2017), https://cfsa.dc.gov/sites/default/files/dc/sites/cfsa/publication/attachments/GAP_Gender_Identity_and_Expression_FINAL.pdf; D.C. Child and Family Services Agency, Statement of Nondiscrimination (Oct. 14, 2011), https://cfsa.dc.gov/publication/statement-nondiscrimination; D.C. Child and Family Services Agency, Non-Discrimination Statement, https://cfsa.dc.gov/page/cfsa-non-discrimination.
87.  Nev. Rev. Stat. § 432.525 (2017); Nev. Rev. Stat. § 424.0445 (2017); Nev. Rev. Stat. § 432B.195 (2017); Nev. Rev. Stat. § 424.0365 (2017); Nev. Rev. Stat. § 432B.60845 (2023); Nev. Rev. Stat. § 424.235 (2017); Nev. Rev. Stat. § 432A.177 (2017); Nev. Rev. Stat. § 432B.172 (2022); Nev. Rev. Stat. § 432A.1759 (2022); Nev. Admin. Code § 424.450 (2017); Nev. Admin. Code § 424.500 (2021); Nev. Admin. Code § 424.270 (2021).
88.  N.Y. Comp. Codes R. & Regs. tit. 18, § 441.24 (2022); N.Y. Comp. Codes R. & Regs. Tit. 18, § 423.4 (2013); New York State Office of Children and Family Services, 21-OCFS-INF-06, Informational Letter: Introduction of the LGBTQ+ Community Practice Model (July 23, 2021), https://ocfs.ny.gov/main/policies/external/ocfs_2021/INF/21-OCFS-INF-06.pdf; New York State Office of Children and Family Services, Lesbian, Gay, Bisexual, Transgender, and Questioning Youth/clients; Promoting Dignity and Respect (2021), https://ocfs.ny.gov/main/policies/external/ocfs_2021/ADM/21-OCFS-ADM-05-Att-E-LGBTQ.pdf; New York State Office of Children and Family Services, PPM 3442.00, Lesbian, Gay, Bisexual, Transgender and Questioning Youth (March 17, 2008), https://www.nycourts.gov/ip/judicialinstitute/transgender/220U.pdf; New York State Office of Children and Family Services, 09-OCFS-INF-06, Informational Letter: Promoting a Safe and Respectful Environment for Lesbian, Gay, Bisexual, Transgender, and Questioning Children and Youth in Out-of-Home Placement (Dec. 30, 2009), https://ocfs.ny.gov/main/policies/external/ocfs_2009/infs/09-ocfs-inf-06%20promoting%20a%20safe%20and%20respectful%20environment%20for%20lesbian%20gay%20bisexual%20transgender%20and%20questioning%20%20children%20and%20youth%20%20in%20out-of-home%20placement.pdf
89.  California Ombudsman for Foster Care, http://www.fosteryouthhelp.ca.gov/; Child Protection Ombudsman of Colorado, http://www.coloradocpo.org/; Nevada Division of Child & Family, Systems Advocate, http://dcfs.nv.gov/Programs/SA/; New York State Office of Children and FamiliesOffice of the Ombudsman, https://ocfs.ny.gov/main/ombudsman/; Rhode Island Office of the Child Advocate, http://www.child-advocate.ri.gov/index.php.
90.  14 Del. Admin. Code § 934-20.0 (2022), Okla. Admin. Code § 340:75-14-1 (2020); Or. Admin. R. 419-400-0060 (2022); 12-3 Vt. Code R. § 103:3.4 (2022).
91.  Cal. Code Regs. tit. 22, § 83072 (2024); Fla. Admin. Code Ann. r. 65C-46.009 (2021); 18 Miss. Code R. Pt. 6, A II XIV (2016); 18 Miss. Code R. Pt. 6, A II XII (2016); N.J. Admin. Code § 3A:11-1.4 (2017); N.M. Code R. § 8.26.5.15 (2011); N.M. Code R. § 8.26.4.17 (2020); N.M. Code R. § 8.10.8.10 (2021); N.M. Admin. Code  R. § 8.26.6.16 (2014); N.M. Admin. Code R. § 8.26.2.12 (2021); N.Y. Comp. Codes R. & Regs. tit. 18, § 441.24 (2022); N.Y. Comp. Codes R. & Regs. Tit. 18, § 423.4 (2013); Ohio Admin. Code 5101:2-5-35 (2021); Ohio Admin. Code 5101:2-7-09 (2019); 214 R.I. Code R. § 40-00-4.1 (2013), 214 R.I. Code R. § 10-00.1.14 (2018); Wash. Admin. Code § 110-145-1710 (2022); Wash. Admin. Code § 110-147-1595 (2022); Wash. Admin. Code § 110-148-1520 (2022).
92.  Colo. Rev. Stat. § 19-7-101 (2023); H.B. 24-1017, 74th Gen. Assemb., 2024 Reg. Sess. (CO 2024); Haw. Rev. Stat. § 587A-3.1 (2018).
93.  California, Colorado, Delaware, Florida, Hawai’i, Mississippi, Nevada, New Jersey, New Mexico, New York, Ohio, Oklahoma, Oregon, Rhode Island, Vermont, Washington.
94.  Arizona, California, Connecticut, Delaware, Georgia, Hawai’i, Idaho, Illinois, Indiana, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Washington, West Virginia.
95.  New Jersey Department of Children and Families, Policy Manual CP&P VI-B-1-500, LGBTQI Policy (Aug. 30, 2016), https://dcfpolicy.nj.gov/; New Jersey Department of Children and Families, Policy ManualCP&P I-A-1-100, CP&P Mission, Vision and Goals (March 25, 2011), https://dcfpolicy.nj.gov/; New Jersey Department of Children and Families, CP&P X-A-1-5.44, Youth Bill of Rights (Aug. 5, 2019), https://dcfpolicy.nj.gov/; New York State Office of Children and Family Services, 21-OCFS-INF-06, Informational Letter: Introduction of the LGBTQ+ Community Practice Model (July 23, 2021), https://ocfs.ny.gov/main/policies/external/ocfs_2021/INF/21-OCFS-INF-06.pdf; New York State Office of Children and Family Services, Lesbian, Gay, Bisexual, Transgender, and Questioning Youth/clients; Promoting Dignity and Respect (2021), https://ocfs.ny.gov/main/policies/external/ocfs_2021/ADM/21-OCFS-ADM-05-Att-E-LGBTQ.pdf; New York State Office of Children and Family Services, PPM 3442.00, Lesbian, Gay, Bisexual, Transgender and Questioning Youth (March 17, 2008), https://www.nycourts.gov/ip/judicialinstitute/transgender/220U.pdf; New York State Office of Children and Family Services, 09-OCFS-INF-06, Informational Letter: Promoting a Safe and Respectful Environment for Lesbian, Gay, Bisexual, Transgender, and Questioning Children and Youth in Out-of-Home Placement (Dec. 30, 2009), https://ocfs.ny.gov/main/policies/external/ocfs_2009/infs/09-ocfs-inf-06%20promoting%20a%20safe%20and%20respectful%20environment%20for%20lesbian%20gay%20bisexual%20transgender%20and%20questioning%20%20children%20and%20youth%20%20in%20out-of-home%20placement.pdf; Rhode Island Department of Children, Youth and Families, Department Operating Procedure 100.0095, Sexual Orientation, Gender Identity and Expression (Nov. 10, 2016), https://dcyf.ri.gov/about-us/dcyf-policies-operating-procedures; Vermont Department for Children and Families, Family Services Policy Manual 76, Supporting and Affirming LGBTQ Children & Youth (Oct. 13, 2017), https://outside.vermont.gov/dept/DCF/Shared%20Documents/FSD/Policies/Policy76.pdf; Washington State Department of Children, Youth, and Families, Administrative Policy 6.04, Supporting LGBTQIA+ Individuals (Oct. 20, 2022), https://www.dcyf.wa.gov/sites/default/files/pdf/Admin-6.04.pdf. 
96.  Arizona, Connecticut, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Rhode Island, Tennessee, Utah, Vermont, Virginia, Washington
97.  Arizona Department of Child Safety, Administrative Policy DCS 01-04, Non-Discrimination Policy (Dec. 2, 2021), https://extranet.azdcs.gov/DCSPolicy/Content/Adminstrative%20Policy/DCS%2001/DCS%2001-04%20Non-Discrimination%20Policy.pdf; Arizona Department of Child Safety, Office of Licensing and Regulation, DCS 15-39, LGBTQ+ Policy (Dec. 2, 2021), https://extranet.azdcs.gov/DCSPolicy/Content/Adminstrative%20Policy/DCS%2015/DCS%2015-39%20LGBTIA%20Policy.pdf; Arizona Department of Child Safety, Engagement with LGBTQ+ Youth (Feb. 10, 2021), https://extranet.azdcs.gov/DCSPolicy/Content/Practice%20Guides%20&%20Additional%20Info/Links/Guides/Practice%20Guidelines%20-%20LGTBQ.pdf; Arizona Department of Child Safety, Inclusive Language (Feb. 15, 2021), https://extranet.azdcs.gov/DCSPolicy/Content/Practice%20Guides%20&%20Additional%20Info/Links/Guides/Practice%20Guidelines%20-%20Inclusive%20Language.pdf; 
98.  Arizona Department of Child Safety, Administrative Policy DCS 01-04, Non-Discrimination Policy (Dec. 2, 2021), https://extranet.azdcs.gov/DCSPolicy/Content/Adminstrative%20Policy/DCS%2001/DCS%2001-04%20Non-Discrimination%20Policy.pdf; Arizona Department of Child Safety, Office of Licensing and Regulation, DCS 15-39, LGBTQ+ Policy (Dec. 2, 2021), https://extranet.azdcs.gov/DCSPolicy/Content/Adminstrative%20Policy/DCS%2015/DCS%2015-39%20LGBTIA%20Policy.pdf; Georgia Division of Family and Children Services, Nondiscrimination and Disability, https://dfcs.georgia.gov/adasection-504-and-civil-rights;  Georgia Division of Family and Children Services, Child Welfare Policy Manual, Administration, Policy # 1.4, Non-Discriminatory Child Welfare Practices (June 2023), https://odis.dhs.ga.gov/General; Kan. Admin. Regs. § 28-4-339; Kan. Admin. Reg. § 30-2-1; Kansas Department for Children and Families, Policy 0220, Discrimination Prohibited by Law (Feb. 2022), https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Policy_and_Procedure_Manual.pdf; Kansas Department for Children and Families, Policy 0220, Discrimination Prohibited by Law (Feb. 2022), https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Policy_and_Procedure_Manual.pdf; 920 Ky. Admin. Regs. 1:090 (2019); Kentucky Cabinet for Health and Family Services, Civil Rights (Apr. 2019), https://www.chfs.ky.gov/agencies/dcbs/Documents/civilrightsbrochure.pdf; Kentucky Department of Community Based Services, Standards of Practice Online Manual, Chapter 1, 1.1 Ethical Practice (March 28, 2014), https://manuals-sp-chfs.ky.gov/chapter1/Pages/1-1.aspx; Nebraska Department of Health and Human Services, Notice of Nondiscrimination and Program Accessibility, https://dhhs.ne.gov/Pages/Non-Discrimination-Notice.aspx; North Carolina Department of Health and Human Services, Department Initiatives, Notice Informing Individuals About Nondiscrimination and Accessibility Requirements, https://www.ncdhhs.gov/about/department-initiatives; 22 Va. Admin. Code § 40-211-80 (2019).
99.  Colo. Rev. Stat. § 19-7-101 (2023); H.B. 24-1017, 74th Gen. Assemb., 2024 Reg. Sess. (CO 2024); 14 Del. Admin. Code § 934-20.0 (2022); Haw. Rev. Stat. § 587A-3.1 (2018); Kan. Admin. Regs. § 28-4-339; Kan. Admin. Reg. § 30-2-1; 920 Ky. Admin. Regs. 1:090 (2019); 10-148 Me. Code R. Ch. 35, § 5 (2021); Nev. Admin. Code § 424.450 (2017); Okla. Admin. Code § 340:75-14-1 (2020); Or. Admin. R. 419-400-0060 (2022); 12-3 Vt. Code R. § 103:3.4 (2022); 22 Va. Admin. Code § 40-211-80 (2019).
100.  Arizona Department of Child Safety, Administrative Policy DCS 01-04, Non-Discrimination Policy (Dec. 2, 2021), https://extranet.azdcs.gov/DCSPolicy/Content/Adminstrative%20Policy/DCS%2001/DCS%2001-04%20Non-Discrimination%20Policy.pdf; Arizona Department of Child Safety, Office of Licensing and Regulation, DCS 15-39, LGBTQ+ Policy (Dec. 2, 2021), https://extranet.azdcs.gov/DCSPolicy/Content/Adminstrative%20Policy/DCS%2015/DCS%2015-39%20LGBTIA%20Policy.pdf; Delaware Children’s Department, Policy #217, Non-discrimination Policy  (Apr. 1, 2019), https://kidsfiles.delaware.gov/policies/dscyf/dsc217-non-discrimination.pdf; Georgia Division of Family and Children Services, Nondiscrimination and Disability, https://dfcs.georgia.gov/adasection-504-and-civil-rights;  Georgia Division of Family and Children Services, Child Welfare Policy Manual, Administration, Policy # 1.4, Non-Discriminatory Child Welfare Practices (June 2023), https://odis.dhs.ga.gov/General; Kansas Department for Children and Families, Policy 0220, Discrimination Prohibited by Law (Feb. 2022), https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Policy_and_Procedure_Manual.pdf; Kentucky Cabinet for Health and Family Services, Civil Rights (Apr. 2019), https://www.chfs.ky.gov/agencies/dcbs/Documents/civilrightsbrochure.pdf; Kentucky Department of Community Based Services, Standards of Practice Online Manual, Chapter 1, 1.1 Ethical Practice (March 28, 2014), https://manuals-sp-chfs.ky.gov/chapter1/Pages/1-1.aspx; Louisiana Department of Children & Family Services, Department Policy, 2 Civil Rights, 2-2 Non-Discrimination in Service Provision (Nov. 16, 2018), https://public.powerdms.com/LADCFS/tree/documents/393313; State of Mississippi Department of Human Services, Division of Family and Children’s Services, Section D: Foster Care Policy, Appendix L: Notice of Rights & Responsibilities for Youth 14 and Over in Foster Care (Sept. 11, 2017), https://www.mdcps.ms.gov/sites/default/files/about-us/policies-%26-procedures/DFCS-Policy-Section-D-09-11-17.pdf; Missouri Department of Social Services, Nondiscrimination Policy Statement (Dec. 2023), https://dss.mo.gov/files/missouri-nondiscrimination-policy-statement.htm; Nebraska Department of Health and Human Services, Notice of Nondiscrimination and Program Accessibility, https://dhhs.ne.gov/Pages/Non-Discrimination-Notice.aspx; State of New Mexico Children, Youth, and Families Department, Nondiscrimination Policy Statement (June 29, 2020), https://www.cyfd.nm.gov/wp-content/uploads/2023/03/LGBTQIAEnglish.pdf; North Carolina Department of Health and Human Services, Department Initiatives, Notice Informing Individuals About Nondiscrimination and Accessibility Requirements, https://www.ncdhhs.gov/about/department-initiatives; South Carolina Department of Social Services Human Services, Policy and Procedure Manual, Chapter 7: Foster Family Licensing & Support, 7.10 Non-Discrimination, (July 21, 2016), https://dss.sc.gov/media/2079/foster_home_licensing_v16-01.pdf; Washington State Department of Children, Youth, and Families, Administrative Policy 6.04, Supporting LGBTQIA+ Individuals (Oct. 20, 2022), https://www.dcyf.wa.gov/sites/default/files/pdf/Admin-6.04.pdf; West Virginia Department of Health and Human Resources, Bureau for Children and Families, Office of Child and Adult Services, Foster Care Policy, 9.1 Nondiscrimination (June 2021), https://dhhr.wv.gov/bcf/policy/Documents/Foster%20Care%20Policy%20June%202021%20(4).pdf; West Virginia Department of Health and Human Resources, Bureau for Children and Families, Youth Services Policy, 11.1 Nondiscrimination (Jan. 2021), https://dhhr.wv.gov/bcf/policy/Documents/Youth%20Services%20January%202021.pdf.
101.  Arizona Department of Child Safety, Office of Licensing and Regulation, DCS 15-39, LGBTQ+ Policy (Dec. 2, 2021), https://extranet.azdcs.gov/DCSPolicy/Content/Adminstrative%20Policy/DCS%2015/DCS%2015-39%20LGBTIA%20Policy.pdf; Arizona Department of Child Safety, Engagement with LGBTQ+ Youth (Feb. 10, 2021), https://extranet.azdcs.gov/DCSPolicy/Content/Practice%20Guides%20&%20Additional%20Info/Links/Guides/Practice%20Guidelines%20-%20LGTBQ.pdf; Arizona Department of Child Safety, Inclusive Language (Feb. 15, 2021), https://extranet.azdcs.gov/DCSPolicy/Content/Practice%20Guides%20&%20Additional%20Info/Links/Guides/Practice%20Guidelines%20-%20Inclusive%20Language.pdf; Michigan Department of Health and Human Services, MDHHS-Pub-1211, A Practice Guide for Working with Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex, and Two Spirit Youth in Michigan’s Child Welfare System, https://www.michigan.gov/-/media/Project/Websites/mdhhs/Folder3/Folder87/Folder2/Folder187/Folder1/Folder287/MDHHS-Pub-1211.pdf?rev=cadf9a132fb7407bb1e39edbb7fe670b; Missouri Department of Social Services, Children’s Division,Best Practice Guidance for Supporting LGBTQ Youth In Foster Care For Child Welfare Staff (2020), https://dss.mo.gov/cd/older-youth-program/files/best-practice-guide-for-staff.pdf; North Carolina Division of Social Services, Child Welfare Practice Guidance for LGBTQ+ Youth, https://policies.ncdhhs.gov/divisional/social-services/child-welfare/policy-manuals/child-welfare-practice-guidance-for-lgbtq-youth.pdf; Vermont Department for Children and Families, Family Services Policy Manual, Policy 76 Supporting and Affirming LGBTQ Children & Youth (Oct. 13, 2017), https://outside.vermont.gov/dept/DCF/Shared%20Documents/FSD/Policies/Policy76.pdf; Virginia Department of Social Services, Child and Family Services Manual, 17.14 Working with Lesbian, Gay, Bi-sexual, Transgender, Questioning (LGBTQ) youth in foster care (July 2021), https://www.dss.virginia.gov/files/division/dfs/fc/intro_page/guidance_manuals/fc/07_2021/section_17_managing_foster_care_services.pdf; Washington State Department of Children, Youth, and Families, Administrative Policy 6.04, Supporting LGBTQIA+ Individuals (Oct. 20, 2022), https://www.dcyf.wa.gov/sites/default/files/pdf/Admin-6.04.pdf.
102.  North Carolina has an LGBTQ+ specific policy but it does not explicitly include a SOGI-inclusive nondiscrimination requirement.
103.  Utah has an LGBTQ+ specific policy but it does not explicitly include a SOGI-inclusive nondiscrimination requirement.
104.  Virginia has an LGBTQ+ specific policy but it does not explicitly include SOGI-inclusive nondiscrimination requirement.
105.  Alabama, Alaska, Arkansas, Kansas, Kentucky, Louisiana, Montana, Nebraska, New Hampshire, North Carolina, Texas, Utah, Wyoming.
106.  Alabama, Alaska, Arkansas, Kansas, Kentucky, Louisiana, Montana, Nebraska, New Hampshire, North Carolina,  Pennsylvania, Texas, Utah, Virginia, Wisconsin, Wyoming, note that North Carolina and Virginia’s LGBTQ+ specific policies have no explicit nondiscrimination protections based on gender identity for youth in the child welfare system.
107.  Alabama, Alaska, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, and Wyoming, LGBTQ Curricular Laws, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/curricular_laws; Forced Outing of Transgender Youth in Schools, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/youth/forced_outing; Bans on Transgender People using Bathrooms and Facilities According to their Gender Identity, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/youth/school_bathroom_bans; Bans on Transgender Youth Participation in Sports, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/youth/sports_participation_bans; Bans on Best Practice Medical Care for Transgender Youth, Movement Advancement Project, https://www.lgbtmap.org/equality-maps/healthcare/youth_medical_care_bans.
108. Arizona Department of Child Safety, Administrative Policy, DCS 01-04, Non-Discrimination Policy (Dec. 2, 2021), https://extranet.azdcs.gov/DCSPolicy/Content/Adminstrative%20Policy/DCS%2001/DCS%2001-04%20Non-Discrimination%20Policy.pdf; Arizona Department of Child Safety, Administrative Policy, Office of Licensing and Regulation, DCS 15-39, LGBTQIA+ Policy (Dec. 2, 2021), https://extranet.azdcs.gov/DCSPolicy/Content/Adminstrative%20Policy/DCS%2015/DCS%2015-39%20LGBTIA%20Policy.pdf; Arizona Department of Child Safety, Practice GuidesEngagement with LGBTQ+ Children (Feb. 10, 2022),  https://extranet.azdcs.gov/DCSPolicy/Content/Practice%20Guides%20&%20Additional%20Info/Links/Guides/Practice%20Guidelines%20-%20LGTBQ.pdf; Arizona Department of Child Safety, Practice Guides, Inclusive and Affirming Language (Feb. 2, 2022),https://extranet.azdcs.gov/DCSPolicy/Content/Practice%20Guides%20&%20Additional%20Info/Links/Guides/Practice%20Guidelines%20-%20Inclusive%20Language.pdf; S.B. 1138, 55th Leg., 2nd Reg. Sess. (A.Z. 2022), https://apps.azleg.gov/BillStatus/BillOverview/76466.
109.  D.C. Code § 2-1402.73 (2022); La. Admin Code tit. 67, Pt. V, § 7515(A)(2) (2016); N.Y. Comp. Codes R. & Regs. tit. 9, § 180-1.5(a)(6) (2018); N.Y. Comp. Codes R. & Regs. tit. 9, § 7313.5 (2018); N.Y. Comp. Codes R. & Regs. tit. 9, § 7346.1 (2018); 42 R.I. Gen. Laws § 42-72-15 (2015); 214 R.I. Code R. § 40-00-4.1.2 (2013).
110.  Government of the District of Columbia, Department of Youth Rehabilitation Services, Policy and Procedure Manual, Policy DYRS-007, Lesbian, Gay, Bisexual, Transgender, Questioning and Intersex (LGBTQI) Youth (May 11, 2012), https://dyrs.dc.gov/sites/default/files/dc/sites/dyrs/publication/attachments/DYRS-007LesbianGayBisexualTransgenderQuestioningandIntersexLGBTQIYouth.pdf; State of Louisiana, Office of Juvenile Justice, Youth Services Policy No. B.2.20, Non-Discriminatory Services to Lesbian, Gay, Bisexual, Transgender, Intersex, Questioning (LGBTIQ), and Nonconforming Youth (Nov. 7, 2022),  https://ojj.la.gov/assets/docs/policies/classification-sentencing-service-functions/B.2.20-Non-Discriminatory-Services-to-Lesbian-Gay-Bisexual-Transgender-Intersex-Questioning-LGBTIQ-and-Nonconforming-Youth-11-07-22.pdf; New York State Office of Children and Family Services, 09-OCFS-INF-06, Informational Letter: Promoting a Safe and Respectful Environment for Lesbian, Gay, Bisexual, Transgender, and Questioning Children and Youth in Out-of-Home Placement (Dec. 30, 2009), https://ocfs.ny.gov/main/policies/external/ocfs_2009/infs/09-ocfs-inf-06%20promoting%20a%20safe%20and%20respectful%20environment%20for%20lesbian%20gay%20bisexual%20transgender%20and%20questioning%20%20children%20and%20youth%20%20in%20out-of-home%20placement.pdf; New York State Office of Children and Family Services, PPM 3442.00, Lesbian, Gay, Bisexual, Transgender and Questioning Youth (March 17, 2008), https://www.nycourts.gov/ip/judicialinstitute/transgender/220U.pdf; Rhode Island Department of Children, Youth and Families, Department Operating Procedure No. 100.0100, Sexual Orientation, Gender Identity and Expression (Nov. 10, 2016), https://datadcyf.ri.gov/policyregs/sexual_orientation__gender_identity_and_expression_print.htm.
111.  Cal. Welf. & Inst. Code § 224.71 (2023); Cal. Welf. & Inst. Code § 224.73 (2023); Cal. Code Regs. tit. 15, § 1324 (2019), Cal. Code Regs. tit. 15, § 1352.5 (2019).
112.  Nev. Rev. Stat. § 62B.510 (2017).
113.  Nev. Admin. Code § 62B.085 (2018).
114.  Nev. Rev. Stat. § 62B.607 (2022).
115.  N.M. Admin. Code § 8.14.14.18 (2019), Or. Admin. R. 416-435-0010 (2022), 37 Tex. Admin. Code § 355.620 (2013); 37 Tex. Admin. Code § 380.9301 (2015); 37 Tex. Admin. Code § 343.368.
116.  Colorado Department of Human Services, Division of Juvenile Corrections, Policy S 13.9,Non-Discriminatory Services to Lesbian, Gay, Bisexual, Transgender, Questioning, and Intersex (LGBTQI) Juvenile (Feb. 24, 2017), https://drive.google.com/file/d/0B6RNEF9DYEdYbDdNVHRyWDJGcFU/view; Connecticut Department of Children & Families, Policy 21-16, Non-Discrimination of LGBTQQIAA Individuals (Jan. 2, 2019), https://portal.ct.gov/-/media/DCF/Policy/Chapters/21-16.pdf; Connecticut Department of Children & Families, Working with Transgender Youth and Caregivers Practice Guide (Dec. 2018), https://portal.ct.gov/-/media/DCF/Policy/BPGuides/21-16PG-Transgender.pdf; Connecticut Department of Children & Families, Working with Transgender Youth and Caregivers Practice Guide (Dec. 2018), https://portal.ct.gov/-/media/DCF/Policy/BPGuides/21-16PG-Transgender.pdf; Delaware Division of Youth Rehabilitative Services, Policy No. 2.20, Chapter 2: Professional Practices, Lesbian, Gay, Bisexual, Transgender, Questioning, and Intersex (LGBTQI) (Mar. 5, 2019), https://legacy.lambdalegal.org/sites/default/files/de_dyrs_lgbtqi_policy.pdf?_gl=1*9qh7yq*_ga*MjEwNTE4NjAwMi4xNjE2MDAzMzk0*_ga_290ZG8GMP3*MTY5MjE5NjczNy41OC4xLjE2OTIxOTgwMTYuNjAuMC4w; Georgia Department of Juvenile Justice, Policy No. 15-1, Basic Rights and Responsibilities of Youth (Aug. 10, 2022), https://public.powerdms.com/GADJJ/documents/28144; Hawai’i Youth Correctional Facility, Policy No. 1.43.03, Non-Discriminatory, Developmentally-Sound Treatment of Lesbian, Gay, Bi-Sexual and Transgender (LGBT) Youth (Oct. 1, 2014),http://www.lambdalegal.org/sites/default/files/jj_hawaii_2007.pdf; Idaho Department of Juvenile Corrections, Institutional Policy/Procedure 672, Non-Discriminatory, Developmentally-Sound Treatment of Lesbian, Gay, Bisexual, Transgender and Intersex Youth (Oct. 16, 2017) [link currently unavailable]; Illinois Department of Juvenile Justice, Administrative Directive 04.01.303, Lesbian, Gay, Bisexual, Transgender and Questioning (LGBTQ) Youth (June 1, 2014), https://www.lambdalegal.org/sites/default/files/il_ad_4.01.303.pdf; Kentucky Justice Cabinet, Department of Juvenile Justice Policy and Procedures, Policy No. DJJ 912, Sexual Orientation and Gender Identity (Mar. 9, 2018), https://djj.ky.gov/900%20Policy%20Manual/DJJ%20912%20Sex%20Orientation%20and%20Gender%20Identity.pdf; State of Maine Department of Corrections, Policy No. 9.5, Transgender, Gender Nonconforming, and Intersex Clients (March 16, 2021), https://www.maine.gov/corrections/sites/maine.gov.corrections/files/inline-files/Policy%209.5.pdf; Massachusetts Department of Youth Services, Policy 03.04.09, Prohibition of Harassment and Discrimination Against Youth (Mar. 2, 2023), https://www.mass.gov/lists/dys-policies-regulations; New Jersey Juvenile Justice Commission, Policy 13ED:01.02A, Lesbian, Gay, Bisexual, Transgender, Questioning, and Intersex (LGBTQI) Juveniles (June 2018), http://www.nj.gov/oag/jjc/pdf/PREA_LGBTQI-Juveniles_policy.pdf; North Carolina Department of Public Safety, Juvenile Justice Facilities YD 12 Housing LGBTQI Juveniles Policy and Requirements and Procedures (Apr. 2019), https://legacy.lambdalegal.org/sites/default/files/publications/downloads/yd_12_housing_lgbtqi_signed_4.16.19.pdf; Ohio Department of Youth Services, Procedure No. 179-YSA-02, Lesbian, Gay, Bisexual, Transgender and Intersex Youth (Apr. 1, 2019), https://www.dys.ohio.gov/static/About+DYS/PREA/DYS_Policy_179-YSA-02.pdf; Pennsylvania Bureau of Juvenile Justice Services, Policy and Procedure, Manual No. 1.15 Resident Sexuality and Gender Identity (Jan. 24, 2019),  https://legacy.lambdalegal.org/sites/default/files/resident_sexuality_and_gender_identity.pdf?_gl=1*1e8lo3r*_ga*MjEwNTE4NjAwMi4xNjE2MDAzMzk0*_ga_290ZG8GMP3*MTY5MjIwNTczMi41OS4wLjE2OTIyMDU3NzYuMTYuMC4w; State of Tennessee Department of Children’s Services, Administrative Policies and Procedures: 20.20 Guidelines for Managing Children/Youth in DCS Custody Related to Sexual Orientation, Gender Identity and Expression (Jan. 30, 2015), https://files.dcs.tn.gov/policies/chap20/20.20.pdf; Vermont Department for Children and Families, Family Services Policy Manual, Family Services Policy 76, Supporting and Affirming LGBTQ Children & Youth (Feb. 27, 2020), https://outside.vermont.gov/dept/DCF/Shared%20Documents/FSD/Policies/Policy76.pdf; Washington State Department of Children, Youth, and Families, Administrative Policy 6.04, Supporting LGBTQIA+ Individuals (Oct. 20, 2022), https://www.dcyf.wa.gov/sites/default/files/pdf/Admin-6.04.pdf.
117.  Nevada Division of Child and Family Services, Systems Advocate, http://dcfs.nv.gov/Programs/SA/; New Mexico Office of Children’s Rights, https://www.cyfd.nm.gov/cyfd-office-of-childrens-rights/how-to-file-a-complaint/; New York State Office of Children and Families, https://ocfs.ny.gov/main/ombudsman/; Rhode Island Office of the Child Advocate, http://www.child-advocate.ri.gov/index.php; Office of the Independent Ombudsman for the Texas Juvenile Justice Department, https://www.tjjd.texas.gov/index.php/independent-ombudsman.
118.  N.M. Admin. Code § 8.14.14.18 (2019); Or. Admin. R. 416-435-0010 (2022).
119.  Cal. Code Regs. tit. 15, § 1324 (2019), Cal. Code Regs. tit. 15, § 1352.5 (2019); La. Admin Code tit. 67, Pt. V, § 7515(A)(2) (2016); N.Y. Comp. Codes R. & Regs. tit. 9, § 180-1.5(a)(6) (2018); N.Y. Comp. Codes R. & Regs. tit. 9, § 7313.5 (2018); N.Y. Comp. Codes R. & Regs. tit. 9, § 7346.1 (2018); 42 R.I. Gen. Laws § 42-72-15 (2015); 214 R.I. Code R. § 40-00-4.1.2 (2013); 37 Tex. Admin. Code § 355.620 (2013); 37 Tex. Admin. Code § 380.9301 (2015); 37 Tex. Admin. Code § 343.368.
120.  Nev. Rev. Stat. § 62B.510 (2017).
121.  California, Louisiana, Nevada, New Mexico, New York, Oregon, Rhode Island, Texas.
122.  Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Hawai’i, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Vermont, Washington, West Virginia.
123.  State of Louisiana, Office of Juvenile Justice, Youth Services Policy No. B.2.20, Non-Discriminatory Services to Lesbian, Gay, Bisexual, Transgender, Intersex, Questioning (LGBTIQ), and Nonconforming Youth (Nov. 7, 2022),  https://ojj.la.gov/assets/docs/policies/classification-sentencing-service-functions/B.2.20-Non-Discriminatory-Services-to-Lesbian-Gay-Bisexual-Transgender-Intersex-Questioning-LGBTIQ-and-Nonconforming-Youth-11-07-22.pdf; New York State Office of Children and Family Services, 09-OCFS-INF-06, Informational Letter: Promoting a Safe and Respectful Environment for Lesbian, Gay, Bisexual, Transgender, and Questioning Children and Youth in Out-of-Home Placement (Dec. 30, 2009), https://ocfs.ny.gov/main/policies/external/ocfs_2009/infs/09-ocfs-inf-06%20promoting%20a%20safe%20and%20respectful%20environment%20for%20lesbian%20gay%20bisexual%20transgender%20and%20questioning%20%20children%20and%20youth%20%20in%20out-of-home%20placement.pdf; New York State Office of Children and Family Services, PPM 3442.00, Lesbian, Gay, Bisexual, Transgender and Questioning Youth (March 17, 2008), https://www.nycourts.gov/ip/judicialinstitute/transgender/220U.pdf; Rhode Island Department of Children, Youth and Families, Department Operating Procedure No. 100.0100, Sexual Orientation, Gender Identity and Expression (Nov. 10, 2016), https://datadcyf.ri.gov/policyregs/sexual_orientation__gender_identity_and_expression_print.htm.
124.  Colorado, Connecticut, Delaware, Georgia, Hawai’i, Idaho, Illinois, Kentucky, Louisiana, Maine, Massachusetts, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Tennessee, Vermont, Washington.
125.  016.01.10 Ark. Code R. § 7240.2 (2019); 016.01.10 Ark. Code R. § 7250.2 (2019); Mo. Code Regs. Ann. tit. 13, § 110-2.100 (2018); Mo. Code Regs. Ann. tit. 13, § 110-3.060 (2019); Nev. Rev. Stat. § 62B.510 (2017); N.M. Admin. Code § 8.14.14.18 (2019); Or. Admin. R. 416-435-0010 (2022); Tenn. Comp. R. & Regs. 0250-04-08-.02 (2017); Wis. Admin. Code DOC § 396.09 (2020); Wis. Adm. Code § DOC 393.04 (2020); Wyo. Admin Code 049.0029.3 § 23 (2021).
126.  State of Alaska, Department of Health & Social Services, Division of Juvenile Justice, Policy No. L-1 Nondiscrimination (Aug. 14, 2019), https://legacy.lambdalegal.org/sites/default/files/l-1_nondiscrimination_signed_10-14-19.pdf?_gl=1*tn6eod*_ga*MjEwNTE4NjAwMi4xNjE2MDAzMzk0*_ga_290ZG8GMP3*MTY5MjE5NjczNy41OC4xLjE2OTIxOTgwMTYuNjAuMC4w; Arkansas Department of Human Services, Division of Youth Services, A Guide for Families, https://humanservices.arkansas.gov/wp-content/uploads/DYS_Family_Handbook.pdf; Delaware Children’s Department, Policy No. 217, Nondiscrimination Policy (April 1, 2019), https://kidsfiles.delaware.gov/policies/dscyf/dsc217-non-discrimination.pdf; Idaho Department of Juvenile Corrections, Institutional Policy/Procedure 672, Non-Discriminatory, Developmentally-Sound Treatment of Lesbian, Gay, Bisexual, Transgender and Intersex Youth (Oct. 16, 2017) [link currently unavailable]; Indiana Department of Correction, Division of Youth Services, Youth Handbook (July 2019), https://www.in.gov/idoc/dys/files/DYS-handbook-7-1-19.pdf; Kansas Department of Corrections, Juvenile Services, https://www.doc.ks.gov/juvenile-services (See nondiscrimination notice at the bottom of the page); State of Maine Department of Corrections, Policy No. 1.6, Prohibition on Discrimination (Apr. 1, 2021), https://www.maine.gov/corrections/sites/maine.gov.corrections/files/inline-files/1.6.pdf; Maryland Department of Juvenile Services, Policy No. MGT-625-14, Nondiscrimination of Youth (Oct. 31, 2017), https://djs.maryland.gov/Documents/policies/management/Nondiscrimination-of-Youth_MGT-625-14.pdf;  Mississippi Department of Human Services, Division of Youth Services, Policy No. 1-111, DYS Code of Ethics (Apr. 15, 2018), https://www.mdhs.ms.gov/wp-content/uploads/2018/04/DOC041018-04102018144102.pdf; Missouri Department of Social Services, Nondiscrimination Policy Statement, https://dss.mo.gov/files/missouri-nondiscrimination-policy-statement.htm; Nevada Department of Health and Human Services, Division of Child and Family Services, Youth Justice Services, Policy No. DCFS/JJS 300.03, Youth Rights (Feb. 21, 2022), https://dcfs.nv.gov/uploadedFiles/dcfsnvgov/content/Programs/JJS/300_03_Youth_Rights.pdf; State of New Mexico Children, Youth and Families Department, CYFD Directive: Nondiscrimination Policy Statement (June 29, 2020), https://www.cyfd.nm.gov/wp-content/uploads/2023/03/LGBTQIAEnglish.pdf; North Carolina Department of Public Safety, Juvenile Justice Facilities YD 12 Housing LGBTQI Juveniles Policy and Requirements and Procedures (April 2019), https://legacy.lambdalegal.org/sites/default/files/publications/downloads/yd_12_housing_lgbtqi_signed_4.16.19.pdf;North Dakota Department of Corrections and Rehabilitation, Division of Juvenile Services, North Dakota Facility (Detention) Rules, https://www.docr.nd.gov/sites/www/files/documents/ycc/documents/Juvenile%20Detention%20Rules.pdf;  Pennsylvania Bureau of Juvenile Justice Services, Policy and Procedure, Manual No. 1.15 Resident Sexuality and Gender Identity (Jan. 24, 2019),  https://legacy.lambdalegal.org/sites/default/files/resident_sexuality_and_gender_identity.pdf?_gl=1*1e8lo3r*_ga*MjEwNTE4NjAwMi4xNjE2MDAzMzk0*_ga_290ZG8GMP3*MTY5MjIwNTczMi41OS4wLjE2OTIyMDU3NzYuMTYuMC4w; South Dakota Department of Corrections, Juvenile Offender Living Guide (Nov. 2023), https://doc.sd.gov/documents/Juvenile%20Living%20Guide%20(12.01.2023).pdf; Utah Department of Human Services, Division of Juvenile Justice Services, Policy No: 04-09, Lesbian, Gay, Bi Sexual, Transgender, Questioning, Intersex (LGBTQI) and Gender Non-Conforming (GNC) Juveniles (July 30, 2015), [link not currently available]; Utah Department of Human Services, Division of Juvenile Justice and Youth Services, Policy No: 04-01, Rights and Responsibilities of Minors (Jan. 12, 2023), [link not currently available]; Virginia Department of Juvenile Justice, Resident Handbook (Nov. 15, 2021), https://www.djj.virginia.gov/documents/residential/Resident_Handbook.pdf; West Virginia Department of Health and Human Resources, Bureau for Children and Families, Youth Services Policy (Feb. 2022), https://dhhr.wv.gov/bcf/policy/Documents/Youth%20Services%20Policy%20February%202022%20%281%29.pdf; State of Wisconsin Department of Health Services, Department of Children and Families, Civil Rights Compliance Requirements (Mar. 2024), https://dcf.wisconsin.gov/files/publications/pdf/153.pdf.
127.  Delaware Division of Youth Rehabilitative Services, Policy No. 2.20, Chapter 2: Professional Practices, Lesbian, Gay, Bisexual, Transgender, Questioning, and Intersex (LGBTQI) (Mar. 5, 2019), https://legacy.lambdalegal.org/sites/default/files/de_dyrs_lgbtqi_policy.pdf?_gl=1*9qh7yq*_ga*MjEwNTE4NjAwMi4xNjE2MDAzMzk0*_ga_290ZG8GMP3*MTY5MjE5NjczNy41OC4xLjE2OTIxOTgwMTYuNjAuMC4w; Georgia Department of Juvenile Justice, Policy No. 15-1, Basic Rights and Responsibilities of Youth (Aug. 10, 2022), https://public.powerdms.com/GADJJ/documents/28144; Idaho Department of Juvenile Corrections, Institutional Policy/Procedure 672, Non-Discriminatory, Developmentally-Sound Treatment of Lesbian, Gay, Bisexual, Transgender and Intersex Youth (Oct. 16, 2017) [link currently unavailable]; Kentucky Justice Cabinet, Department of Juvenile Justice Policy and Procedures, Policy No. DJJ 912, Sexual Orientation and Gender Identity (Mar. 9, 2018), https://djj.ky.gov/900%20Policy%20Manual/DJJ%20912%20Sex%20Orientation%20and%20Gender%20Identity.pdf; State of Maine Department of Corrections, Policy No. 9.5, Transgender, Gender Nonconforming, and Intersex Clients (March 16, 2021), https://www.maine.gov/corrections/sites/maine.gov.corrections/files/inline-files/Policy%209.5.pdf; North Carolina Department of Public Safety, Juvenile Justice Facilities YD 12 Housing LGBTQI Juveniles Policy and Requirements and Procedures (Apr. 2019), https://legacy.lambdalegal.org/sites/default/files/publications/downloads/yd_12_housing_lgbtqi_signed_4.16.19.pdf; Pennsylvania Bureau of Juvenile Justice Services, Policy and Procedure, Manual No. 1.15 Resident Sexuality and Gender Identity (Jan. 24, 2019),  https://legacy.lambdalegal.org/sites/default/files/resident_sexuality_and_gender_identity.pdf?_gl=1*1e8lo3r*_ga*MjEwNTE4NjAwMi4xNjE2MDAzMzk0*_ga_290ZG8GMP3*MTY5MjIwNTczMi41OS4wLjE2OTIyMDU3NzYuMTYuMC4w; Utah Department of Human Services, Division of Juvenile Justice Services, Policy No: 04-09, Lesbian, Gay, Bi Sexual, Transgender, Questioning, Intersex (LGBTQI) and Gender Non-Conforming (GNC) Juveniles (July 30, 2015), [link not currently available]; Vermont Department for Children and Families, Family Services Policy Manual, Family Services Policy 76, Supporting and Affirming LGBTQ Children & Youth (Feb. 27, 2020), https://outside.vermont.gov/dept/DCF/Shared%20Documents/FSD/Policies/Policy76.pdf; Washington State Department of Children, Youth, and Families, Administrative Policy 6.04, Supporting LGBTQIA+ Individuals (Oct. 20, 2022), https://www.dcyf.wa.gov/sites/default/files/pdf/Admin-6.04.pdf.
128.  Alabama, Florida, Indiana, Mississippi, Montana, Nebraska, Oklahoma, South Carolina, South Dakota, and Wyoming.
129.  Alabama, Florida, Indiana, Minnesota, Mississippi, Montana, Nebraska, Oklahoma, South Carolina, South Dakota, Virginia, Wisconsin, and Wyoming.
130.  Alabama, Alaska, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, and Wyoming.
131.  Health and Human Services Grants Regulation, 45 C.F.R. § 75.300, 81 Fed. Reg. 89393 (Dec. 12, 2016), www.federalregister.gov/documents/2016/12/12/2016-29752/healthand-human-services-grants-regulation; Equal Access to Housing in HUD Programs Regardless of Sexual Orientation or Gender Identity, 24 C.F.R. §§ 5, 200, 203, 236, 400, 570, 574, 882, 891, and 982, 77 Fed. Reg. 5661 (Feb. 3, 2012), https://www.federalregister.gov/documents/2012/02/03/2012-2343/equal-access-to-housing-in-hud-programs-regardless-of-sexual-orientation-or-gender-identity.
132.  Conn. Agencies Regs. § 17b-800-4; 10-148-37 Me. Cod R. § 5 (2023); Cal. Code Regs. tit. 22, § 84072 (2024); N.Y. Comp. Codes R. & Regs. tit. 9, § 182-1.5 (2018); D.C. Mun. Regs. tit. 29, § 6203 (2014).
133.  Kerith J. Conron & Shoshana K. Goldberg, LGBT Protections from Discrimination Employment and Public Accommodations UCLA School of Law, Williams Institute (June 2019), https://williamsinstitute.law.ucla.edu/wp-content/uploads/LGBT-ND-Statutes-Empl-PA-Jun-2019.pdf.
134.  H.B. 207, 56th Leg., 1st Sess. (N.M. 2023), https://www.nmlegis.gov/Sessions/23%20Regular/final/HB0207.pdf.
135.  The research conducted on state-based regulatory requirement is up to date as of May 2023.
136.  N.M. Code R. § 8.26.4.7 (2020); Cal. Code Regs. Tit. 2, § 11030 (2016), N.Y. Civ. Rights Law § 79-n (2022); Fla. Admin. Code r. 65C-46.001 (2021).
137. Dru Levasseur, Gender Identity Defines Sex: Updating the Law to Reflect Modern Medical Science Is Key to Transgender Rights, 39 Vermont Law Review 943 (2015), https://lawreview.vermontlaw.edu/wp-content/uploads/2015/05/39-4-06_Levasseur.pdf; Brief of Amici Curiae The Equality Federation in Support of Respondent, Gloucester Cty. Sch. Bd. v. G.G. ex rel. Grimm, No. 16-273 at *10 (Mar. 6, 2017) (“Both medical science and courts have recognized that a variety of characteristics—including gender identity—collectively make up a person’s sex.”), https://www.aclu.org/cases/grimm-v-gloucester-county-school-board?document=gloucester-county-school-board-v-gg-equality-federation.
138.  Cal. Code Regs. tit. 22, § 83087(b)(2)(B) (2023); Cal. Code Regs. tit. 22, § 84087(b)(3)(C) (2024); Cal. Code Regs. tit. 22, § 89387(a)(2)(C) (2017).
139.   214 R.I. Code R. 40-00-3.7.2(H)(8)(b) (2017).
140.  California, Illinois, Michigan, Mississippi, Nevada, New Mexico, South Carolina, Utah.
141.  California, Colorado, Kansas, Massachusetts, Mississippi, New Mexico, Ohio, Oregon.
142.  N.M. Code R. § 8.26.4.17 (2020)
143.  N.D. Admin. Code 75-03-14-05(12)(f) (2024).
144. N.M. Code R. § 8.26.4.7(W) (2020); Cal. Code Regs. tit. 15, § 1302 (2019); 214 R.I. Code R. 40-00-3.7.2(H)(8)(b) (2017); Mich. Admin. Code r. 400.12101 (2023).
145.  Commonwealth of Massachusetts – Department of Children and Families, Policy No. 2021-01, Gender Affirming Medication Consent Policy (Sept. 20, 2021), https://www.mass.gov/doc/gender-affirming-medication-consent-policy/download; Or. Admin. R. 413-200-0352 (2024); Oregon Administrative Rules 413-200-0335 (2022), Or. Admin. R. 416-435-0010 – 416-435-0050 (2022); Cal. Welf. & Inst. Code § 16001.9(22)(A) (2023); Kan. Admin. Regs. § 28-4-339(13) (1999); Kan. Admin. Regs. § 28-4-355a(13) (1993); 12 Colo. Code Regs. § 2509-8:7.710.34 (2024); 12 Colo. Code Regs. § 2509-8-7.702.83(D)(1) (2021); 31 Miss. Admin. Code Pt. 9, R. 5.8 (2019); 31 Miss. Admin. Code Pt. 9, R. 2.7 (2019); Ohio Admin. Code 5101:2-5-35(A)(3)(c), (A)(9), (A)(10) (2021); Ohio Admin. Code 5101:2-42-20 (2021); N.M. Admin. Code § 8.26.4.17 (2020).
146.  Cal. Code Regs. tit. 22, § 83064 (2022); Cal. Code Regs. tit. 22, § 84065 (2022); D.C. Mun. Regs. tit. 29, § 2515 (2016); Delaware Division of Youth Rehabilitative Services, Policy No. 2.20, Chapter 2: Professional Practices, Lesbian, Gay, Bisexual, Transgender, Questioning, and Intersex (LGBTQI), 7 (March 5, 2019), https://legacy.lambdalegal.org/sites/default/files/de_dyrs_lgbtqi_policy.pdf?_gl=1*17jlzpi*_ga*MjEwNTE4NjAwMi4xNjE2MDAzMzk0*_ga_290ZG8GMP3*MTY5NDEwMTY4OC44Ni4xLjE2OTQxMDE3NjMuNjAuMC4w;  Ill. Admin. Code tit. 20, § 2602.20 (2021); Mich. Admin. Code r. 400.12209(2)(a) (2023); Mich. Admin. Code r. 400.12312(3)(m) (2023); 31 Miss. Code R. Pt. 9, R. 1.23 (2019); Nev. Rev. Stat. § 424.235 (2017); Nev. Rev. Stat. § 424.0365 (2017); Nev. Rev. Stat. § 432B.195 (2017); Nev. Rev. Stat. § 62B.607 (2022); Nev. Admin. Code § 424.270 (2021); N.M. Code R. § 8.8.2.21 (2021); N.M. Code R. § 8.26.4.16 (2020); N.M. Code R. § 8.26.5.18 (2011); North Carolina Division of Social Services, Child Welfare Practice Guidance for LGBTQ+ Youth 5, https://policies.ncdhhs.gov/divisional/social-services/child-welfare/policy-manuals/child-welfare-practice-guidance-for-lgbtq-youth.pdf; North Carolina Department of Public Safety, Juvenile Justice Facilities YD 12 Housing LGBTQI Juveniles Policy and Requirements and Procedures (April 2019), https://legacy.lambdalegal.org/sites/default/files/publications/downloads/yd_12_housing_lgbtqi_signed_4.16.19.pdf;  S.C. Code Regs. 114-591 (2023); Utah Code § 26B-2-109 (2023).
147.  Nev. Rev. Stat. § 239B.022 (2021); Nev. Rev. Stat. § 239B.024 (2024); Nev. Rev. Stat. § 239B.026 (2021); S.B. 109, 81st Leg., Reg. Sess. (Nev. 2021), https://legiscan.com/NV/bill/SB109/2021; Nev. Admin. Code R024-20 § 6 (2022);  Michelle Lujan Grisham, New Mexico Governor, Executive Order 2021-048, Directing Executive Departments to Collect Voluntary Self-Identification Information Pertaining to Sexual Orientation and Gender Identity (Aug. 16, 2021), https://www.governor.state.nm.us/wp-content/uploads/2021/08/Executive-Order-2021-048.pdf; D.C. Mun. Regs. tit. 29, § 2563.2-2563.3 (2016); Ohio Admin. Code 5139-37-07 (2024); Or. Admin. R. 416-435-0030 (2022); Utah Admin. Code r. R501-1-11.
148.  Conn. Gen. Stat. Ann. § 17a-6 (2018); D.C. Mun. Regs. tit. 29, § 2563.1 (2016); D.C. Mun. Regs. tit. 29, § 2515.27 (2016); Louisiana Department of Children & Family Services, 5 Family Services, 10 Case Closure, 5-1000 Case Closure 4 (Jan. 22, 2020), https://public.powerdms.com/LADCFS/documents/405113; Louisiana Department of Children & Family Services, 6 Foster Care, 10 Education, 6-1000 Education Services to Children in Foster Care 3 (Nov. 1, 2022), https://public.powerdms.com/LADCFS/documents/402787; Michigan Department of Health and Human Services, MDHHS-Pub-1211, A Practice Guide for Working with Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex, and Two Spirit Youth in Michigan’s Child Welfare System 8-10, https://www.michigan.gov/-/media/Project/Websites/mdhhs/Folder3/Folder87/Folder2/Folder187/Folder1/Folder287/MDHHS-Pub-1211.pdf?rev=cadf9a132fb7407bb1e39edbb7fe670b; 214 R.I. Code R. § 30-00-1.6 (2018); Utah Department of Health & Human Services, Child & Family Services, Policy No. 300.5, Safety For Lesbian, Gay, Bisexual, Transgender, And Questioning (LGBTQ) Youth 9-10 (May 2023), https://public.powerdms.com/UTAHDHHS/documents/274994.
149.  Arkansas, Alabama, Florida, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Montana, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Utah, Wyoming; Of these states, nine states’ definition is applicable across state law (Idaho, Kansas, Louisiana, Mississippi, Montana, North Dakota, Oklahoma, Tennessee and Utah.) The remaining states define sex within a specific chapter or section. Eight of these states do so in a gender affirming care ban for minors (Alabama, Florida, Indiana, Iowa, Kentucky, Ohio, South Carolina, South Dakota). Additionally, Arkansas’ exclusionary facility and harmful school law and Wyoming legislation banning transgender students playing sports in accordance with their gender identity define sex. see (Definitions of sex applicable to state law) H.B. 421, 67th Leg., 2nd Reg. Sess. (Idaho 2024) https://legislature.idaho.gov/sessioninfo/2024/legislation/H0421/; S.B. 180, 2023 Leg., Reg. Sess. (Kan. 2023), https://kslegislature.org/li/b2023_24/measures/SB180/; H.B. 608 2024 Leg., Reg. Sess. (La. 2023), https://www.legis.la.gov/legis/BillInfo.aspx?s=24RS&b=HB608; S.B. 2753, 2024 Leg., Reg. Sess. (Miss. 2024), https://billstatus.ls.state.ms.us/2024/pdf/history/SB/SB2753.xml; S.B. 458, 68th  Leg., Reg. Sess. (Mont. 2023), https://laws.leg.mt.gov/legprd/LAW0210W$BSIV.ActionQuery?P_BILL_NO1=458&P_BLTP_BILL_TYP_CD=SB&Z_ACTION=Find&P_SESS=20231; H.B. 1474, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/bill-index/bi1474.html; H.B. 1449, 2024 Leg., Reg. Sess. (Okla. 2024), http://webserver1.lsb.state.ok.us/cf_pdf/2023-24%20ENR/hB/HB1449%20ENR.PDF; S.B. 1440, 113th Gen. Assemb. (Tenn. 2023), https://wapp.capitol.tn.gov/apps/BillInfo/default.aspx?BillNumber=SB1440&ga=113;  H.B. 257, 2024 Gen. Sess. (Utah 2024) https://le.utah.gov/~2024/bills/static/HB0257.html; see (Gender Affirming Care Bans w. definitions of sex) S.B. 184, 2022 Gen. Sess. (Ala. 2022), https://legiscan.com/AL/text/SB184/2022; S.B. 254, 2023 Leg., Reg. Sess. (Fla. 2023), https://www.flsenate.gov/Session/Bill/2023/254; H.B. 71, 67th Leg., 1st Reg. Sess. (Idaho 2023), https://legislature.idaho.gov/sessioninfo/2023/legislation/H0071/; S.B. 480, 123rd Gen. Assemb., 1st Reg. Sess. (Ind. 2023), https://iga.in.gov/pdf-documents/123/2023/senate/bills/SB0480/SB0480.05.ENRH.pdf;  S.F. 538, 90th Gen. Assemb., Reg. Sess. (Iowa 2023), https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=SF538; S.B. 150, 2023 Leg., Reg. Sess. (Ky. 2023), https://legiscan.com/KY/text/SB150/2023; H.B. 648, 2023 Leg., Reg. Sess. (La. 2023), https://www.legis.la.gov/legis/ViewDocument.aspx?d=1331071; H.B. 1125, 2023 Leg., Reg. Sess. (Miss. 2023) https://billstatus.ls.state.ms.us/2023/pdf/history/HB/HB1125.xml; S.B. 99, 68th  Leg., Reg. Sess. (Mont. 2023) https://laws.leg.mt.gov/legprd/LAW0210W$BSIV.ActionQuery?P_BILL_NO1=99&P_BLTP_BILL_TYP_CD=SB&Z_ACTION=Find&P_SESS=20231; H.B. 1254, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/bill-index/bi1254.html; H.B. 68, 135th Gen. Assembl. (Ohio 2024), https://search-prod.lis.state.oh.us/solarapi/v1/general_assembly_135/bills/hb68/EN/05/hb68_05_EN?format=pdf; H.B. 4624, 125th Sess. (S.C. 2024), https://www.scstatehouse.gov/sess125_2023-2024/prever/4624_20240507.htm; H.B. 1080, 98th Leg., Reg. Sess. (S.D. 2023), https://sdlegislature.gov/Session/Bill/24100; H.B. 1, 113th Gen. Assemb. (Tenn. 2023), https://legiscan.com/TN/text/HB0001/2023; see (Exclusionary Facility, Harmful School and Identity Documents Laws w. definitions of sex) H.B. 1156, 94th General Assembly, Reg. Sess. (Ark. 2023) https://www.arkleg.state.ar.us/Bills/FTPDocument?path=%2FBills%2F2023R%2FPublic%2FHB1156.pdf; HB. 1069, 2023 Leg., Reg. Sess. (Fla. 2023) https://www.flsenate.gov/Session/Bill/2023/1069/ByVersion; H.B. 1521, 2023 Leg., Reg. Sess. (Fla. 2023), https://www.flsenate.gov/Session/Bill/2023/1521/ByVersion; H.B. 538, 67th Leg., 2nd Reg. Sess. (Idaho 2024), https://legislature.idaho.gov/sessioninfo/2024/legislation/H0538/; S.B. 1110, 67th Leg., 1st Reg. Sess. (Idaho 2023), https://legislature.idaho.gov/sessioninfo/2023/legislation/S1100/; S.F. 482, 90th Gen. Assemb., Reg. Sess. (Iowa 2023), https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=SF%20482&v=i; S.B. 639 (N.C. 2023), https://www.ncleg.gov/BillLookup/2023/S639; H.B. 1139, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/bill-index/bi1139.html; H.B. 1297, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/bill-index/bi1297.html; S.B. 100, 2023 Gen. Sess. (Utah 2023),  https://le.utah.gov/~2023/bills/sbillenr/SB0100.pdf; see (Laws that prohibit transgender youth from playing sports in accordance w. their gender identity w. definitions of sex) H.F. 2416, 89th Gen. Assemb., Reg. Sess. (Iowa 2022), https://www.legis.iowa.gov/legislation/BillBook?ga=89&ba=HF2416;  H.B. 1249, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/documents/23-0569-05000.pdf; H.B. 1489, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/documents/23-0967-04000.pdf; H.B. 11, 2022 Gen. Assemb. (Utah 2022), https://le.utah.gov/~2022/bills/static/HB0011.html; S.F. 133, 67th Leg., Gen. Sess. (2023), https://www.wyoleg.gov/Legislation/2023/SF0133. Arkansas, Missouri, Nebraska, North Carolina, West Virginia’s gender affirming care bans defines “biological sex.”S.B. 49, 102nd Gen. Assemb., 1st Reg. Sess. (Mo. 2023), https://senate.mo.gov/23info/pdf-bill/tat/SB49.pdf; L.B. 574, 108th Leg., 1st Sess. (Neb. 2023) https://nebraskalegislature.gov/FloorDocs/108/PDF/Final/LB574.pdf; H.B. 808, 2023 Leg., Reg. Sess. (N.C. 2023) https://www.ncleg.gov/Sessions/2023/Bills/House/PDF/H808v7.pdf; H.B. 2007, 2023 Leg.., Reg. Sess. (W.V. 2023), https://www.wvlegislature.gov/Bill_Status/bills_text.cfm?billdoc=hb2007%20sub%20enr.htm&yr=2023&sesstype=RS&i=2007; H.B. 1156, 94th General Assembly, Reg. Sess. (Ark. 2023) https://www.arkleg.state.ar.us/Bills/FTPDocument?path=%2FBills%2F2023R%2FPublic%2FHB1156.pdf; S.B. 270, 94th General Assembly, Reg. Sess. (Ark. 2023) https://www.arkleg.state.ar.us/Bills/FTPDocument?path=%2FBills%2F2023R%2FPublic%2FSB270.pdf; S.F. 482, 90th Gen. Assemb., Reg. Sess. (Iowa 2023), https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=SF%20482&v=i; S.F. 538, 90th Gen. Assemb., Reg. Sess. (Iowa 2023), https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=SF%20538; H.B. 576, 2023 Reg. Sess. (Miss. 2023), http://billstatus.ls.state.ms.us/documents/2023/pdf/HB/0500-0599/HB0576IN.pdf; S.B. 16, Gen. Sess. (Utah 2023), https://le.utah.gov/~2023/bills/sbillenr/SB0016.pdf; S.B. 93, 2023 Gen. Sess. (Utah 2023), https://le.utah.gov/~2023/bills/sbillenr/SB0093.pdf; S.B. 100, 2023 Gen. Sess. (Utah 2023),  https://le.utah.gov/~2023/bills/sbillenr/SB0100.pdf.
150.  S.B. 1440, 113th Gen. Assemb. (Tenn. 2023), https://legiscan.com/TN/text/SB1440/id/2817565; H.B. 1, 113th Gen. Assemb. (Tenn. 2023), https://legiscan.com/TN/text/HB0001/2023.
151.  S.B. 39, 2023 Gen. Sess. (Utah 2023), https://le.utah.gov/~2023/bills/static/SB0039.html#:~:text=9%20General%20Description%3A,and%20Utah%20Human%20Services%20Code; S.B. 93, 2023 Gen. Sess. (Utah 2023), https://le.utah.gov/~2023/bills/static/SB0093.html
152.  Alabama, Florida, Idaho, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Montana, North Dakota, Ohio, South Carolina, South Dakota, Tennessee; see S.B. 184, 2022 Leg., Reg. Sess. (Ala. 2022), https://legiscan.com/AL/text/SB184/2022; S.B. 254, 2023 Leg., Reg. Sess. (Fla. 2023), https://www.flsenate.gov/Session/Bill/2023/254;  H.B. 71, 67th Leg., 1st Reg. Sess. (Idaho 2023), https://legislature.idaho.gov/sessioninfo/2023/legislation/H0071/; S.B. 480, 123rd Gen. Assembl., 1st Reg. Sess. (Ind. 2023), https://iga.in.gov/pdf-documents/123/2023/senate/bills/SB0480/SB0480.05.ENRH.pdf; S.F. 538, 90th Gen. Assembl., Reg. Sess. (Iowa 2023), https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=SF538; S.B. 150, 2023 Leg., Reg. Sess. (Ky. 2023), https://legiscan.com/KY/text/SB150/2023; H.B. 648, 2023 Leg., Reg. Sess. (La. 2023), https://www.legis.la.gov/legis/ViewDocument.aspx?d=1331071; H.B. 1125, 2023 Leg., Reg. Sess. (Miss. 2023)https://billstatus.ls.state.ms.us/2023/pdf/history/HB/HB1125.xml; S.B. 99, 68th  Leg., Reg. Sess. (Mont. 2023) https://laws.leg.mt.gov/legprd/LAW0210W$BSIV.ActionQuery?P_BILL_NO1=99&P_BLTP_BILL_TYP_CD=SB&Z_ACTION=Find&P_SESS=20231; H.B. 1254, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/bill-index/bi1254.html; H.B. 68, 135th Gen. Assembl. (Ohio 2024), https://search-prod.lis.state.oh.us/solarapi/v1/general_assembly_135/bills/hb68/EN/05/hb68_05_EN?format=pdf; H.B. 4624, 125th Sess. (S.C. 2024), https://www.scstatehouse.gov/sess125_2023-2024/prever/4624_20240507.htm; H.B. 1080, 98th Leg., Reg. Sess. (S.D. 2023), https://sdlegislature.gov/Session/Bill/24100; H.B. 1, 113th Gen. Assemb. (Tenn. 2023), https://legiscan.com/TN/text/HB0001/2023.
153.  Idaho, Kansas, Louisiana, Mississippi, Montana, North Dakota, Oklahoma, Tennessee, Utah; see (Definitions of sex applicable to state law) H.B. 421, 67th Leg., 2nd Reg. Sess. (Idaho 2024) https://legislature.idaho.gov/sessioninfo/2024/legislation/H0421/; S.B. 180, 2023 Leg., Reg. Sess. (Kan. 2023), https://kslegislature.org/li/b2023_24/measures/SB180/; H.B. 608 2024 Leg., Reg. Sess. (La. 2023), https://www.legis.la.gov/legis/BillInfo.aspx?s=24RS&b=HB608; S.B. 2753, 2024 Leg., Reg. Sess. (Miss. 2024), https://billstatus.ls.state.ms.us/2024/pdf/history/SB/SB2753.xml; S.B. 458, 68th  Leg., Reg. Sess. (Mont. 2023), https://laws.leg.mt.gov/legprd/LAW0210W$BSIV.ActionQuery?P_BILL_NO1=458&P_BLTP_BILL_TYP_CD=SB&Z_ACTION=Find&P_SESS=20231; H.B. 1474, 68th Leg. Assemb., Reg. Sess. (N.D. 2023), https://ndlegis.gov/assembly/68-2023/regular/bill-index/bi1474.html; H.B. 1449, 2024 Leg., Reg. Sess. (Okla. 2024), http://webserver1.lsb.state.ok.us/cf_pdf/2023-24%20ENR/hB/HB1449%20ENR.PDF; S.B. 1440, 113th Gen. Assemb. (Tenn. 2023), https://wapp.capitol.tn.gov/apps/BillInfo/default.aspx?BillNumber=SB1440&ga=113;  H.B. 257, 2024 Gen. Sess. (Utah 2024) https://le.utah.gov/~2024/bills/static/HB0257.html.
154. Arizona, Illinois, and Mississippi; State of Arizona Juvenile Detention Standards, Section III A 16.7 Detention Operations, Safety, Security and Control, Searches of Persons and Facility (Dec. 19, 2016), https://www.azcourts.gov/Portals/29/JJSD%20Publication%20Reports/Detention_Standards.pdf?ver=3nMqQ9bwqXS42K1nLWi_UA%3d%3d; Ill. Admin. Code tit. 20, § 2602.140 (2021); 31 Code Miss. R. Pt. 9, R. 5.9 (2019).