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.

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.

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.

Three transgender people currently incarcerated in federal custody have filed a class action lawsuit against the Trump Administration and the Federal Bureau of Prisons (BOP) challenging an Executive Order and new BOP policies prohibiting their access to gender-affirming care. The class action lawsuit was filed in federal court in Washington, D.C., on behalf of approximately 2,000 transgender people incarcerated in federal prisons across the United States.