Amelia Marquez is transgender woman and life-long Montanan. John Doe is a transgender man who was born in Montana, but currently lives out of state. Both wish to correct the sex marker on their birth certificates to reflect who they are. However, a law enacted in 2021, Montana Senate Bill 280, sought to prohibit transgender individuals born in Montana from correcting the sex marker listed on their birth certificate without obtaining a court order indicating that their “sex . . . has been changed by surgical procedure.” The ACLU, the ACLU of Montana, and Nixon Peabody LLP have sued, claiming that SB 280 violates the equal protection and due process clauses of the Montana State Constitution.

After a years-long effort by the state of Montana to deny transgender people the right to update their identity documents, two transgender women filed a class-action lawsuit against the state and several of its agencies and officials. 26 states and the District of Columbia issue new birth certificate and do not require sex reassignment surgery nor court order in order to change gender marker, while Montana is one of five states that prohibits any changes.

Four Hoosier families, joined by medical providers, are challenging an Indiana law passed in April 2023 barring access to gender-affirming care for transgender youth. Indiana is home to over 4,000 transgender adolescents and the health care targeted by this law is supported by the entire mainstream of the medical community.

Transgender young adults and families with transgender youth, together with PFLAG National and GLMA, filed a federal legal challenge against a January 2025 executive order from the Trump administration directing federal agencies to withhold funds from medical providers and institutions that provide gender-affirming medical treatments for people under nineteen.