A family in Texas had a child welfare investigator arrive at their home due to a directive from Governor Greg Abbott stating that health care that is medically necessary for treating gender dysphoria should be considered a form of child abuse. This family — an employee of DFPS, her husband, and their transgender teen — sued Governor Abbott and the Texas Department of Family and Protective Services. Dr. Megan Mooney, a licensed psychologist who works with transgender youth and their families, also joined the lawsuit.

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.

In May 2025, two transgender adolescents and their parents filed a challenge in Kansas state court against SB 63, a state law prohibiting access to gender-affirming medical treatments for transgender people under 18. Access to gender-affirming medical care, such as hormone therapies and pubertal suppressants, for transgender adolescents is supported by the American Medical Association, the American Psychological Association, and the American Academy of Pediatrics.