In order to track these cases and the consequences of their decisions, this background document provides topline information while also illustrating the disturbing range of attacks facing LGBTQ+ people.

Health Care

Bans on Health Care for Transgender People

• Bans on health care for transgender youth have been passed in 24 states across the country, with 17 being challenged in state or federal court. In addition numerous states have also adopted restrictions or barriers for adult care. Final decisions will dictate where transgender medical care can be provided, which services can be provided and who can access them.
  • Some laws limit bans to transgender medical care services exclusively for minors. Challenges to these bans include:
    
    • L.W. v. Skrmetti

      • This case challenges Tennessee’s law (Senate Bill 1), that bans transgender medical care for minors in the state. This case came through the 6th Circuit and is now awaiting a decision by the Supreme Court on whether to grant a writ of certiorari alongside Jane Doe 1 v. Kentucky ex rel. Coleman, Attorney General. These cases have been distributed for conference by the Supreme Court.

    • Jane Doe 1 v. Kentucky ex rel. Coleman, Attorney General

      • This case challenges Kentucky’s law (Revised Statutes Section 311.372(2)), that bans transgender medical care services for minors. This case came through the 6th Circuit and is now awaiting a decision by the Supreme Court on whether to grant a writ of certiorari alongside L.W. v. Skrmetti. These cases have been distributed for conference by the Supreme Court.

• Other cases address restrictions in accessibility and coverage of transgender medical care for everyone, regardless of age. Important challenges to these kinds of laws include:
  
  • Doe v. Ladapo

    • The original complaint filed in the U.S. District Court for the Northern District of Florida challenged a Florida ban on transgender medical services for youth in the state. The complaint was later amended to address state law restrictions on access to care for adults and seeking class-wide relief for all transgender minors and adults.

    • This case is still awaiting a decision by the district court.

  • Dekker, et al., v. Weida, et al.

    • In September 2022, LGBTQ+ and health advocacy groups, including Lambda Legal, filed a lawsuit in the U.S. District Court for the Northern District of Florida challenging a Florida rule, and subsequently statute (SB 254) that denies coverage of transgender medical care under Medicaid.

    • In June 2023, the U.S. District Court for the Northern District of Florida ruled that the prohibition on Medicaid coverage was unconstitutional and violated both the federal Medicaid statute and the Affordable Care Act.

PrEP Restrictions

• Currently, there are legal challenges to laws that ensure PrEP access and coverage. Limitations on accessibility of PrEP, including limiting coverage, will have a disproportionate impact on Black and Latiné gay and bisexual men and transgender women who are disproportionately impacted by HIV.
  
  • Braidwood Management v. Becerra

    • This case challenges the United States Preventive Services Task Force (USPSTF) preventive care ratings that require healthcare plans to cover preventive services–including the HIV prevention medicine PrEP, breast cancer screenings, depression screenings, Hepatitis B/C and other STI counseling and screenings–under the Affordable Care Act (ACA) at no cost to the enrollee.

    • In March 2023, the District Court ruled that the USPSTF coverage mandates were unconstitutional. That decision was appealed to the 5th Circuit Court and is now awaiting a decision.

Affordable Care Act Section 1557 Regulations

• On April 26, 2024, the Department of Health and Human Services finalized a new regulation strengthening non-discrimination provisions (Section 1557) of the Affordable Care Act (ACA). The updated rule, implementing Section 1557 of the ACA, now provides clear protections on the basis of sexual orientation and sex characteristics. It also improved pre-existing protections for gender identity. To date, two lawsuits have been filed challenging the rule. These cases are in the early stages of litigation.

Education

In schools and classrooms across the country, LGBTQ+ students and families are facing LGBTQ+ legislation censoring what they can say and the resources and programs they can access.

LGBTQ+ Censorship Laws

• LGBTQ+ laws have been enacted, limiting discussions of LGBTQ+ identities and other related topics in classrooms. For LGBTQ+ students and teachers, affirming these discriminatory laws would result in a multitude of consequences including further isolation and potential threats to employment. Challenges to these laws include:
  
  • Roberta Kaplan Settlement Case

    • In March 2024, Kaplan Hecker & Fink LLP and the National Center for Lesbian Rights filed the agreement with in the 11th Circuit, effectively nullifying the majority of the anti-LGBTQ+ impacts of Florida’s “Don’t Say LGBTQ+ Law.” In part, the settlement strengthens protections from bullying, ensures that schools can have GSAs, guaranteed free speech rights, and prohibits treating LGBTQ+ people differently from others.

Sports Bans

• Targeting LGBTQ+ youth, especially transgender and non-binary youth, sports bans prevent young people from playing on school sports teams that align with their gender identity. These restrictions prevent LGBTQ+ youth from gaining the important social and health benefits of organized school sports. XX challenges to sports bans are working their way through the court system including the following:
  
  • Hecox v. Little

    • Filedby the ACLU, this case challenges Idaho’s HB 500, which bans transgender and intersex women and girls from participating in women’s sports. In August 2023, the 9th Circuit Appeals upheld the preliminary injunction, blocking the application of the law. The case is ongoing.

  • B.P.J. v. West Virginia State Board of Education

    • This case challenges a West Virginia law (HB 3293) banning transgender girls from participating in school sports that align with their gender identity. In April 2024, the 4th Circuit Court of Appeals blocked the law, allowing the plaintiff to continue playing on her school’s athletics team. The case is ongoing.

Title IX Regulations

• On April 19, 2024, U.S. Department of Education finalized a new Title IX rule that clarified the scope of nondiscrimination protections on the basis of sexual orientation and gender identity throughout federally funded educational activities and programs. The new rule also reversed Trump-era changes to Title IX that limited federally funded educational institutions’ obligation to address sexual harassment and assault, and clarifies protections for pregnant and parenting students. To date eight lawsuits that have been filed on behalf of states, counties, school districts, organizations and private litigants. In total, 26 states have challenged the new Title IX rules. These cases are in the early stages of litigation but have the potential to result in a nationwide injunction on enforcement by the Department of Education Office for Civil Rights.

The Human Rights Campaign is America’s largest civil rights organization working to achieve equality for lesbian, gay, bisexual, transgender and queer people. HRC envisions a world where LGBTQ+ people are embraced as full members of society at home, at work and in every community.

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