Families, transgender adolescents, and their medical providers are challenging a new law, signed by Governor Kevin Stitt in May 2023, that imposes criminal penalties on healthcare providers who provide age-appropriate medical care for transgender adolescents. Such restrictions are opposed by leading medical experts and organizations, including the American Medical Association, the American Psychiatric Association, and the American Academy of Pediatrics. According to the Williams Institute of UCLA, there are an estimated 2,600 transgender youth ages 13-17 in Oklahoma.

Following a request from the Office of the Attorney General of Texas for records and documents related to its advocacy on behalf of families with transgender youth, PFLAG National sued to block the request in February 2024. Represented by the American Civil Liberties Union and other LGBTQ legal organizations, PFLAG is also a plaintiff in two lawsuits in Texas relating to gender-affirming care for minors.

On his first day back in office in January 2025, President Donald Trump issued an executive order that led the State Department to suspend its policy allowing transgender, intersex, and nonbinary people to update the sex designations on their passports, leading some with pending applications to have their passports withheld from them and others to receive a new passport with the wrong sex designation listed. Soon after, the ACLU sued on behalf of seven transgender and nonbinary people on the grounds the policy violates their constitutional rights and the Administrative Procedure Act.

Four families of transgender youth and two doctors have challenged an Arkansas law that would prohibit healthcare professionals from providing or even referring transgender young people for medically necessary health care. The law would also bar any state funds or insurance coverage for gender-affirming health care for transgender people under 18, and it would allow private insurers to refuse to cover gender-affirming care for people of any age. The lawsuit, filed in federal court, alleges that House Bill 1570 is a violation of the U.S. Constitution.