For most transgender youth, gender-affirming care means counseling and social steps such as a new name or clothing. Medical treatment for minors is guided by clinical standards and parental consent, and surgery for minors is rare.
Access has shrunk sharply. Arkansas passed the first state ban on gender-affirming care for minors in 2021, and at least 27 states had passed bans by 2025. In June 2025, the Supreme Court upheld Tennessee's ban in United States v. Skrmetti, ruling 6 to 3 that it did not violate the Equal Protection Clause. Families in banned states often travel hundreds of miles for care or move.
Advocates see these bans as part of a long US pattern of politicians controlling which bodies get care, a pattern that also includes forced sterilization and abortion bans. They argue that decisions about care belong to patients, families and doctors.