Equality Maps

LGBTQ Equality Maps Updates: September 2023

Movement Advancement Project
7 min readSep 6, 2023

MAP’s Equality Maps provide a detailed snapshot of the current state of LGBTQ laws and policies in the United States. In this regularly changing landscape, these are the state and local policy updates from August 3 to September 5.

For a full look at changes in LGBTQ policy during the first half of the year, see MAP’s brief, Assessing the Damage: Reviewing How State LGBTQ Policies Changes in 2023.

▸▸ State Policy Updates

Bans on medical care for transgender youth

See our Equality Map here and our supporting citations and additional information here, including a chronology and details on effective dates, exceptions, lawsuits, and more.

More than 1 in 3 transgender youth (35%) now live in states with bans or restrictions on best practice medical care. At the beginning of 2023, only 4% of youth lived in such states.

Equality Map: Bans on Best Practice Medical Care for Transgender Youth (via MAP)
  • August 16: In North Carolina, the legislature overrode the governor’s veto, making North Carolina the 22nd state to ban or severely restrict transgender youth’s medical care, and the 19th state to do so in 2023 alone.
    — North Carolina’s ban also bans the state’s Medicaid program from covering medically necessary care for transgender youth.
  • August 21: In Georgia, a court temporarily blocked the state’s ban on necessary medication.
  • August 22: In Alabama, the Eleventh Circuit Court of Appeals overturned the temporary block on the state’s ban on necessary medication that has been in place since last year.
    — However, LGBTQ advocates in the case are asking the Eleventh Circuit to review that decision, a process that means the temporary block will stay in place for at least a couple more months — in other words, transgender youth should still be able to access medically necessary medication for the time being.
  • August 25: In Texas, a court temporarily blocked the state’s ban, but the state is appealing the decision. This appeal automatically pauses the court’s block.
    — This means the Texas ban went into effect as planned on September 1, though the court case continues.
  • August 25: In Missouri, a court denied the request for a temporary block of the state’s ban. This allowed the ban to go into effect on August 28.
    — This was the first trial court decision that did not rule in favor of transgender youth and their families, though the court case continues.
  • September 5: In Georgia, the full ban on medically necessary care for transgender youth has now gone into effect. A judge paused their own temporary block on the ban following an Eleventh Circuit ruling. A lawsuit is ongoing.

Bans on transgender kids playing school sports

See our Equality Map here and our supporting citations and additional information here, including a chronology of laws and vetoes, a breakdown of grade applicability, and further analyses.

More than 1 in 3 transgender youth live in states with these sports participation bans on the books.

  • August 16: In North Carolina, the legislature overrode the governor’s veto, making North Carolina the 23rd state to ban transgender youth from playing school sports according to their gender identity.
  • August 17: In Idaho, the Ninth Circuit Court of Appeals upheld a lower court’s block on the state’s ban. In 2020, Idaho became the first state to enact such a ban.

Defining “sex” to allow discrimination against transgender and nonbinary people

See our Equality Map here and our supporting citations and additional information here.

Six states have enacted these policies, all in 2023 alone: four via legislation and two via executive orders.

  • August 1: Oklahoma’s governor issued an executive order defining “sex” throughout state law to enable discrimination against transgender and nonbinary people, after the state legislature considered but did not pass a similar bill this session.
  • August 30: Nebraska’s governor also issued an executive order defining “sex” throughout state law.

Gender marker changes on birth certificates

See our Equality Map here and our supporting citations and additional information here.

  • August 31: In Kansas, a federal court ruled that — due to a new law defining “sex” — the state was no longer required to follow an earlier 2019 legal agreement allowing transgender people to update the gender marker on their birth certificate. This leaves the availability of gender marker changes unclear for now. Legal challenges to the sex definition law in state court are ongoing.

“Don’t Say LGBTQ” curriculum censorship laws

See our Equality Map here and our supporting citations and additional information here.

Eleven states have laws that censor what schools can say about LGBTQ people and issues.

  • August 16: In North Carolina, the legislature overrode the governor’s veto of a “Don’t Say LGBTQ” law that applies to grades K-4.
Equality Map: LGBTQ Curricular Laws (via MAP)

Forced or encouraged outing of transgender youth in schools

See our Equality Map here and our supporting citations and additional information here.

Five states have laws that require schools to out transgender students to their families, regardless of whether this may put the child at risk of harm. An additional six states have laws that promote, but do not require, outing transgender students.

  • August 16: In North Carolina, the new “Don’t Say LGBTQ” law also contains a provision forcing school staff and teachers to out transgender youth to their parents.

Targeting or restricting drag performances

See our Equality Map here and our supporting citations and additional information here.

  • August 31: In Texas, a judge temporarily blocked the state’s law targeting drag, ruling it likely unconstitutional.

Banning the use of “gay panic”/ “trans panic” defenses in courtrooms

See our Equality Map here and our supporting citations and additional information here.

  • August 8: New Hampshire became the 17th state (including Washington, D.C.) to ban these defenses. Now more than four in 10 (43%) LGBTQ adults live in states with these bans.

▸▸ Changes in MAP’s Policy Tally categorizations

See our Overall, Sexual Orientation, and Gender Identity Policy Tally “snapshot” Equality maps here, summarizing states’ LGBTQ policy environment across over 50 laws and policies we track in real time.

  • North Carolina fell to the “Low” ranking on both our Overall LGBTQ Policy Tally and our Gender Identity Policy Tally as a result of the numerous anti-LGBTQ laws enacted this year.
  • Following New Hampshire’s new ban on the use of gay/trans panic defenses, the state improved to “High” on our Sexual Orientation Policy Tally.

▸▸ Local Level Policy Updates

Bans on conversion “therapy”

  • The city of York, Pennsylvania, banned conversion “therapy,” becoming the first city in its county (York) to do so, and the first municipality in the state to do so since April 2021.

    Now more than 1 in 4 of all Pennsylvanians live in a municipality with a local-level ban.
  • Unfortunately, the city of Waterloo, Iowa, repealed its conversion “therapy” ban, which it recently enacted in May 2023. The city was reportedly being threatened with lawsuits over the ordinance.

▸▸ MAP Policy Research Updates

MAP recently published the latest report in its ongoing Under Fire series, which connects the dots on the widespread attacks on LGBTQ people in recent years.

The fourth report, Under Fire: How Opponents Are Enshrining Inequality for LGBTQ People, focuses on how opponents of LGBTQ equality are rolling back existing nondiscrimination protections for LGBTQ people, defining “sex” to explicitly allow discrimination in state law, attacking and undermining legal recognition of LGBTQ families, and denying LGBTQ people (especially transgender people) access to medically necessary health care.

MAP Opinion Pieces:

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Movement Advancement Project

MAP is an independent, nonprofit think tank that provides rigorous research, insight and communications that help speed equality and opportunity for all.