With over 75 anti-LGBTQ+ legislative bills signed into law this year, the Human Rights Campaign (HRC) officially declared a state of emergency for LGBTQ+ people in the United States.

A new report released by HRC — the nation’s largest lesbian, gay, bisexual, transgender and queer (LGBTQ+) civil rights organization — details the unprecedented spike in anti-LGBTQ+ bills sweeping state houses this year. The number of bills more than doubled the number last year, which was previously the worst year on record, noted HRC.

“The sharp rise in anti-LGBTQ+ measures has spawned a dizzying patchwork of discriminatory state laws that have created increasingly hostile and dangerous environments for LGBTQ+ people, prompting HRC to also issue a national warning and downloadable guidebook for the LGBTQ+ community,” according to HRC. The guidebook provides an of state-by-state laws, “know your rights” information, and resources designed “to support LGBTQ+ travelers as well as those already living in hostile states,” noted HRC.  

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“As we kick off LGBTQ+ Pride Month, HRC will be working tirelessly to educate and arm the LGBTQ+ community with information and resources to ensure their safety — whether they’re planning summer travel through regions that are becoming increasingly hostile to LGBTQ+ people, or whether they already live in a state where legislative assaults and political extremism are continuing to put a target on our backs,” said Kelley Robinson, HRC president.

Table 1. Highlights of 2023 State anti-LGBTQ+ Legislation

More than 525 bills were introduced in 41 states
Over 220 of these bills explicitly targeted transgender people
Over 75 bills have been signed into law as of June 5, 2023 — more than any year on record, and more than double over last year.
Source: HRC

Medical Communities Support Transgender Care

Of particular concern for health care professionals has been the effect of these bills on transgender, nonbinary, and gender nonconforming youth. Anti-LGBTQ+ legislation has caused youths to lose access to life saving medical care, comprehensive and inclusive education, and activities, spaces, and facilities, said HRC.

Twenty states now have gender-affirming care bans, according to HRC. Approximately 31% of transgender youth aged 13 to 17 years are living in states where they can no longer access medical care. In some states, care has been banned not only for youth, but adults as well, “especially through bans on public funds going to provide this best practice health care,” noted HRC.

The American Medical Association (AMA) supports everyone’s access to quality evidence-based health care regardless of gender or sexual orientation. According to the AMA, “to ensure that LGBTQ+ patients are not discriminated against in seeking the care they need, nor forced into medically un-sound programs, the AMA works diligently at the state and federal levels to expand access to medical services, reduce stigma in treating patients with unique needs, and break down discriminatory barriers to necessary care.”

The American Nurses Association (ANA) also strongly opposes any legislation or policy that places restrictions on transgender health care or criminalizes gender-affirming care. “These restrictive laws interfere with the trust and confidentiality between patients, parents or guardians, and clinicians in the delivery of evidence-based care,” noted the ANA. “The legislative intent and medical claims behind these laws are not grounded in reputable science and conflict with the nurse’s obligation to promote, advocate, and protect the rights, health, and safety of patients.”

The National Association of Pediatric Nurse Practitioners (NAPNAP) also cited evidence-based research in support of transgender health. “Pediatric-focused nurse practitioners and our fellow pediatric clinicians provide transgender health care based on the Endocrine Society’s Clinical Practice Guideline for Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons [CPG], which was developed following extensive interprofessional collaboration with nationally regarded experts,” said NAPNAP Immediate Past President Andrea Kline-Tilford, PhD, CPNP-AC/PC, FCCM, FAAN. “This is the gold standard of peer-reviewed, evidence-based gender-affirming care and supported by leading organizations including NAPNAP, the American Academy of Pediatrics, the Endocrine Society and the American Psychological Association.”

Showing support for the transgender community, the American Academy of Physician Associates (AAPA) recently canceled the appearance of Bari Weiss, the anti-transgender author and editor of The Free Press, after what the organization called “member concerns.” In advance of the meeting, the AAPA sent an email to members that noted that the Board of Directors “recognizes and values the diverse perspectives and viewpoints of our members which are based on their personal experiences and we have taken seriously each and every member voice we have heard.”


For the first time ever, human rights campaign officially declares ‘State of Emergency’ for LGBTQ+ Americans. News release. Human Rights Campaign. Accessed June 7, 2023. https://www.hrc.org/press-releases/for-the-first-time-ever-human-rights-campaign-officially-declares-state-of-emergency-for-lgbtq-americans-issues-national-warning-and-guidebook-to-ensure-safety-for-lgbtq-residents-and-travelers

NAPNAP strongly opposes actions by Texas leaders. National Association of Pediatric Nurse Practitioners. Accessed June 7, 2023. https://www.napnap.org/napnap-strongly-opposes-actions-by-texas-leaders/

Ennis D. AAPA conference cancels anti-trans Bari Weiss after complaints. May 14, 2023. Los Angeles Blade. https://www.losangelesblade.com/2023/05/14/aapa-conference-cancels-anti-trans-bari-weiss-after-complaints/