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.

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.

On January 23, 2019, the American Civil Liberties Union, and the American Civil Liberties Union of Arizona filed a class action lawsuit against the State of Arizona and the Arizona Board of Regents for denying medically necessary, gender-affirming health care to transgender people employed by the state. The lawsuit was filed on behalf of Dr. Russell B. Toomey, an associate professor of family studies and human development at the University of Arizona, and all other transgender individuals employed by the Arizona Board of Regents or enrolled in the State health plan, including dependents.

Eden Rogers and Brandy Welch were turned away by a government-funded foster care agency for failing to meet the agency’s religious criteria which exclude prospective foster parents who are not evangelical Protestant Christian or who are same-sex couples of any faith.