There are currently more than 400 anti-LGBTQIA+ bills across the U.S., with over 150 specifically targeting trans people. According to the Human Rights Campaign (HRC), this is the highest number on record. The nation is also seeing a rise in anti-abortion legislation since the Supreme Court overturned Roe v. Wade.
As organizations like the HRC and the American Civil Liberties Union (ACLU) do the much needed work of fighting these attacks on bodily autonomy, some states are protecting and decriminalizing access to reproductive and gender-affirming care. This includes protections for those who must travel to get the care they need.
In the face of fascist attempts to control our reproduction and gender expression while also increasing state surveillance that violates our privacy, it’s important to recognize the safe havens in our midst. Here is what some U.S. states are doing to ensure that access to abortion and gender-affirming care is legal and secure within their borders.
In February, Assemblymember Mia Bonta introduced Assembly Bill 793, which aims to protect people seeking abortion and gender-affirming care from dragnet surveillance. AB 793 would prevent the unconstitutional surveillance of geographical and search data by counteracting a law that enables police to obtain from tech companies the names of anyone whose digital footprint shows time spent near an abortion clinic or researching gender-affirming care. The bill is supported by reproductive justice, civil liberties organizations, and privacy groups.
“With states across the country passing anti-abortion and anti-trans legislation, it’s vital that California shore up our protections against digital tracking of vulnerable people seeking health care,” Bonta said in a press release.
State Sen. Nancy Skinner also announced SB 345, which would ensure legal protections for providers who dispense medication for abortion, contraception, or gender-affirming care to out-of-state patients.
“Medication abortion is widely used and proven to be safe and effective,” Skinner said in a press release announcing the legislation, which acknowledged that a growing number of states are criminalizing and restricting this care. “Under SB 345, California health care practioners [sic] will be able to provide essential reproductive and gender-affirming care that is legal in California, regardless of their patient’s geographic location, knowing that California is doing everything it can to protect them against the draconian laws of other states.”
Legislators introduced the Safe Access to Protected Health Care Package in March, a collection of bills that would legally enshrine abortion access and gender-affirming care. Not only would these bills protect patients and providers while expanding access to necessary care, they would also outlaw deceptive practices and misinformation from anti-abortion centers.
Rep. Brianna Titone, Colorado’s first openly trans representative, remarked at a March 9 press conference, “While other states are trying to limit or completely dismantle our rights as trans people—we’re enshrining them into state law.”
Colorado legislators are prioritizing the protection of out-of-state patients from surveillance, investigations, and prosecutions as the state becomes a haven for abortion access. In surrounding states with significant abortion restrictions and bans—including Wyoming, Arizona, Nebraska, and Utah—there is also legislation targeting trans youth and drag performance.
“The Supreme Court decision to overturn Roe v. Wade unleashed a wave of anti-abortion legislation across the country, which puts critical reproductive care for too many of our neighbors out of reach,” said state Sen. Julie Gonzales in a press release. The senator also added that the bills introduced will “protect the rights and privacy of patients and providers who seek abortion or gender-affirming care, prohibit deliberate health care misinformation in our communities, and make it easier and more affordable for folks to access the health care they need to thrive.”
Gov. J.B. Pritzker signed a reproductive rights and gender-affirming care omnibus bill in January. HB 4664 both expands reproductive and gender-affirming care access throughout the state and shields patients and providers from legal attacks by neighboring states.
Pritzker stated in a Jan. 13 press release, “[W]hen Roe v. Wade was overturned, I made a promise that Illinois would remain a beacon of hope and an island for reproductive justice for all who seek it. This bill fulfills that promise.”
The bill also broadens the scope of care for many providers—as well as insurance coverage for care—and strengthens protections for families using in vitro fertilization (IVF) or surrogacy.
According to state Attorney General Kwame Raoul, “The fight for access to reproductive and gender-affirming care does not end here.” He also added that the work will continue to “ensure Illinois remains a health care oasis for anyone seeking care.”
Lawmakers in the state are pushing for the passage of the Trans Health Equity Act. HB 283 would require Maryland Medicaid to expand coverage for multiple types of gender-affirming treatments currently only covered by private insurance, including voice therapy, laser treatments for surgical scars, and more.
State Delegate Anne Kaiser, the bill’s chief House sponsor, called the effort “a mission of love.” She also noted that Gov. Wes Moore is on board and ready to sign the bill into law.
Last year, Massachusetts passed H. 5090, An Act Expanding Protections for Reproductive and Gender-Affirming Care, moving quickly after the fall of Roe v. Wade. H. 5090 secures rights to abortion and gender-affirming care and protects patients and the providers who treat them from legal action if they travel from another state where care is illegal.
“This act cements the state’s role as a leader in providing access to essential health care, including access to abortion and lifesaving care for transgender people,” said Polly Crozier, a GLBTQ Legal Advocates and Defenders (GLAD) senior staff attorney who has also worked closely with the Massachusetts Medical Society.
Since the passage of H. 5090, the Reproductive Equity Now Foundation has collaborated with Massachusetts Attorney General Andrea Joy Campbell, the ACLU, and five Massachusetts law firms to launch the Abortion Legal Hotline. The service is free and confidential and exists to assist Massachusetts-based care providers, patients, and facilitators by providing free legal advice and resources about abortion care.
The HF 1, or the Protect Reproductive Options Act, was passed in January, enshrining abortion rights into state law. It protects reproductive health care access and prevents restrictive regulations from being imposed by local governments.
“Since the overturning of Roe v. Wade, the U.S. is a patchwork of abortion access, and Minnesota is an island in providing this health care,” state Rep. Carlie Kotyza-Witthuhn stated.
Minnesota has also passed HF 366, or the Reproductive Freedom Defense Act, to preserve patient privacy and prevent other states from imposing their own laws on health care that takes place within Minnesota borders.
To address the needs of trans and nonbinary residents, Gov. Tim Walz signed an executive order protecting rights to gender-affirming care.
“Protecting and supporting access to gender affirming health care is essential to being a welcoming and supportive state,” Walz said following the signing.
The Minnesota House has also passed legislation to make Minnesota a “trans refuge state,” meaning the state would protect patients, facilitators, and providers who travel to Minnesota to access gender-affirming care.
“The passing of the Trans Refuge bill will send a strong message to the trans community that they are loved, supported, and protected here in our state,” said Rep. Leigh Finke.
Gov. Michelle Lujan Grisham signed House Bill 7, the Reproductive and Gender-Affirming Health Care Act, in March. “House Bill 7 will ensure that all New Mexicans can get the care they need to live healthy, happy lives,” said co-sponsor state Rep. Charlotte Little.
The act ensures an individual’s right to use or refuse reproductive or gender-related care. Little added that “New Mexicans should be free to make their own deeply personal health care decisions in consultation with their families and their providers, without unnecessary barriers or discrimination.”
The state Constitution has been updated to include the Reproductive Liberty Amendment, which safeguards reproductive rights, including abortion.
The Vermont legislature also passed a pair of bills concerning abortion and gender-affirming care. Together, these bills establish reproductive and gender-affirming care as legally protected “health care activities” and will protect providers from legal consequences for offering these forms of care. Additionally, public entities are forbidden to take part in interstate investigations that aim to hold practitioners or patients accountable in civil or criminal court.
State Sen. Ginny Lyons, the lead sponsor of the bill, said that the Dobbs decision last summer “upended our national understanding of reproductive autonomy.”
“Vermont must continue to do everything in our power to protect access to reproductive and gender-affirming care at the state level,” Lyons said.
The Senate Committee on Law and Justice of the Washington State Legislature held a public hearing in March. The prospective shield law measure, HB 1469, was one of the bills discussed. If adopted, reproductive and gender-affirming care would be categorized as protected services, and Washington would be a refuge state. Additionally, it would ensure that physicians would not face legal repercussions for providing these treatments.
“If other states want to be creative and aggressive in restricting abortion, Washington state can be creative and aggressive in fighting back,” said state Rep. Drew Hansen. “[The bill] eliminates the ability of other states to commandeer Washington state courts and judicial processes to enforce their own laws.”