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.

The American Civil Liberties Union, Lambda Legal, the ACLU of Texas, and Baker Botts filed a lawsuit in Texas State Court on behalf of PFLAG National and three Texas families. This is the second of two lawsuits challenging unlawful attempts to ban essential health care for transgender youth by Texas state leaders.

The ACLU has joined a lawsuit defending the interests of trans student athletes in Connecticut.

The North Carolina Department of Public Safety has continually denied Kanautica Zayre-Brown, an incarcerated transgender woman in their custody, access to gender-affirming surgery.

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.