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Around the world

U.S. and World Progress

We’re winning all over the world, one conversation at a time, one law at a time. See where your country or state stands.

First · United States

United States

State-by-state hub · federal record

2025–2026

United States

MedicalMixed

Many states have banned or limited sex-rejecting procedures — puberty blockers, hormones of the opposite sex, and surgeries meant to make a child look like the opposite sex. In June 2025 United States v. Skrmetti said those state bans may stand. A federal Medicaid and children’s-insurance (CHIP) rule (CMS-2451-F) stops taxpayer funding for those procedures on minors.

Open the U.S. hub and state grid
Medical status map

click a state for more details.

  • BanStatute in force.
  • RestrictionNarrower than a total ban.
  • Litigation-setbackBan or limit was enacted, then a court blocked it. The statute is on the books; it is not enforced.
  • Proposed billA bill has been introduced. It is not a statewide law yet.
  • No banNo statewide medical ban. Shield laws, if any, are in the state summary.
DC

Jump to a state

  • Ban · 22
  • Restriction · 3
  • Litigation-setback · 2
  • Proposed bill · 4
  • No ban · 20

One A–Z grid: all 50 states and D.C. Color is medical status. Full sourced cards are on the hub.

Next · Around the world

World

Country-by-country medical status · click for the official record

Medical status map

click a country for more details.

  • BanStatute in force.
  • RestrictionNarrower than a total ban.
  • MixedNo one nationwide medical rule.
  • Proposed billA bill has been introduced. It is not law yet.
  • No banNo medical ban.

Middle East

Official medical and school policies — country by country. Click for sources.

Country cards below →

Americas

Official medical and school policies — country by country. Click for sources.

United States

MedicalMixed

2025–2026

Many states banned or limited sex-rejecting procedures for minors, the Supreme Court said those state bans may stand, and a federal Medicaid rule cuts funding for those procedures on minors.

Official sources

Medical and school rules are separate.

  • Puerto Rico

    MedicalBanned

    Puerto Rico banned sex-rejecting drugs and surgeries for people under 21.

    Open Puerto Rico →

Open hub →

Canada

MedicalMixedSchoolsSchools mixed

2024–2026

Alberta is the only Canadian jurisdiction with a medical restriction on puberty blockers and opposite-sex hormones for minors. There is no federal ban.

Official sources

Provinces and territories open on the Canada hub.

Open the Canada hub — provinces and territories →

Chile

MedicalMixedSchoolsCSE in schools

2024–2026

MINSAL’s 2024 circular names puberty blockers and opposite-sex hormones for adolescents and suggests deferring new starts. A 2025 bill would ban those interventions under 18; it has not been enacted.

Official sources

Official circular plus a bill that is not law.

Read full update →

Colombia

MedicalProposed billSchoolsCSE in schools

2018–2026

Senate bills, including 2026 “Ley Laura,” would restrict puberty blockers and opposite-sex hormones for minors. They have not been enacted.

Official sources

Senate bill before Congress.

Read full update →

El Salvador

MedicalAffirmingSchoolsSchools ban

2024–2025

No official medical policy listed.

Official sources

Central America. Official action against gender ideology in public schools.

Read full update →

French Guiana

MedicalAffirmingSchoolsCSE in schools

2025

No official pediatric medical policy listed.

Official sources

South America. France overseas department — French medical and school rules apply.

Read full update →

Mexico

MedicalAffirmingSchoolsCSE in schools

2020

A Secretaría de Salud protocol says clinics may consider puberty blockers for trans minors, then hormones.

Official sources

Americas. CSE in schools (LGDNNA Art. 58).

Read full update →

Paraguay

MedicalAffirmingSchoolsSchools restriction

2017–2025

No official medical policy listed.

Official sources

South America. School-content restriction.

Read full update →

Uruguay

MedicalAffirmingSchoolsCSE in schools

2016

Uruguay’s 2016 hormonization guide recommends puberty suppression with GnRH analogues from Tanner 2–3, and opposite-sex hormones from 16.

Official sources

South America. CSE in schools (Ley 18.437).

Read full update →

Caribbean

Antigua and Barbuda

MedicalAffirming

2026

No data at this time. Please email us at Contact if you have official updates.

Read full update →

Bahamas

MedicalAffirming

2012 / 2023

No official medical policy listed.

Official sources

Caribbean. Ministry HFLE, Focus on Youth, and Director of Education remarks.

Read full update →

Saint Kitts and Nevis

MedicalAffirming

2026

No data at this time. Please email us at Contact if you have official updates.

Read full update →

Saint Vincent and the Grenadines

MedicalAffirming

2026

No data at this time. Please email us at Contact if you have official updates.

Read full update →

Trinidad and Tobago

MedicalAffirmingSchoolsCSE in schools

2018 / 2023

No official medical policy listed.

Official sources

Caribbean. Official HFLE curriculum includes sexual-orientation outcomes.

Read full update →

Europe

Official medical and school policies — country by country. Click for sources.

Austria

MedicalAffirmingSchoolsCSE in schools

2015–2026

Austria’s health ministry points clinicians to the German-language AWMF child-and-adolescent guideline for diagnosis and treatment.

Official sources

Europe.

Read full update →

Denmark

MedicalRestrictedSchoolsCSE in schools

2023

Denmark’s health authority is revising 2018 clinical guidance. No legislative ban is listed.

Official sources

Restriction — clinical guidance, no legislative ban.

Read full update →

Estonia

MedicalRestrictedSchoolsCSE in schools

2022–2023

The Social Ministry–funded hormone guideline requires adulthood before opposite-sex hormones.

Official sources

Europe. Social Ministry–funded hormone guideline requires adulthood. CSE includes gender identity.

Read full update →

Greece

MedicalAffirmingSchoolsCSE in schools

2017–2021

Law 4491/2017 lets a person from age 15 change the registered sex after an interdisciplinary medical committee.

Official sources

Europe. Legal gender recognition from 15 with a medical committee. Skills Labs sexuality education.

Read full update →

Italy

MedicalRestrictedSchoolsSchools proposed

2024

Italy’s bioethics committee said the evidence on puberty blockers for minors is too weak.

Official sources

CNB research-framed guidance on triptorelin for minors.

Read full update →

Lithuania

MedicalAffirmingSchoolsSchools mixed

2022–2024

Lithuania’s 2022 health-ministry procedure for gender-identity disorder is for adults. No official pediatric puberty-blocker protocol is listed.

Official sources

Court struck a minors-information rule. Remaining school and life-skills sources pull in more than one direction.

Read full update →

Moldova

MedicalAffirmingSchoolsCSE in schools

2022–2024

No official medical policy listed.

Official sources

Europe. Education Ministry healthy-lifestyle curriculum includes gender roles.

Read full update →

North Macedonia

MedicalAffirmingSchoolsSchools restriction

2013–2025

The health ministry’s 2013 guideline sets an official adult-framed pathway for hormones and surgery.

Official sources

Europe. Official ministry transsexualism guideline. 2025 school-law amendment.

Read full update →

Romania

MedicalAffirmingSchoolsSchools mixed

2020

No official medical policy listed.

Official sources

Europe. Constitutional Court struck a school gender-identity ban.

Read full update →

Russia

MedicalBannedSchoolsSchools ban

2023

Russia banned medical interventions aimed at changing sex, with an exception for inborn sex-development conditions (DSD).

Official sources

Federal statute. Applies to adults and children. Congenital / DSD exception.

Read full update →

Slovakia

MedicalAffirmingSchoolsSchools restriction

2025

Slovakia’s health ministry said its transsexualism standard was for adults over 18 only, then cancelled it. No official pediatric puberty-blocker protocol is listed.

Official sources

Europe. Constitutional sex definition and parental consent in sex education.

Read full update →

Spain

MedicalMixedSchoolsCSE in schools

2026

A Valencian rule on pharmacological treatment for minors is in court.

Official sources

Valencia’s 2025 amendments sit under Constitutional Court suspension.

Read full update →

United Kingdom

MedicalRestrictedSchoolsSchools restriction

2024

The UK limited new puberty blockers for under-18s to research; the PATHWAYS trial is ongoing. No Act of Parliament has banned them.

Official sources

Restriction — no legislative ban. PATHWAYS puberty blockers trial ongoing. Wales is listed for the Curriculum for Wales RSE Code (CSE in schools). England RSHE stays a restriction on this parent card. Scotland is a separate Restricted card for the NHS board pause — not listed here.

  • Wales

    MedicalRestrictedSchoolsCSE in schools

    The UK ban on puberty blockers applies in Wales.

    Open Wales →

Read full update →

Oceania

Official medical and school policies — country by country. Click for sources.

Australia

MedicalMixed

2025–2028

The NHMRC is writing national under-18 gender-dysphoria guidelines. Queensland and the Northern Territory restrict new public-hospital puberty blockers and opposite-sex hormones for minors.

Official sources

National guideline review. Open this hub for states and territories. Queensland and the Northern Territory restrict public-hospital care only.

  • Australian Capital Territory

    MedicalAffirming

    No official medical policy listed.

    Open Australian Capital Territory →

  • New South Wales

    MedicalAffirmingSchoolsCSE in schools

    NSW Health’s official specialist service for people under 25 includes puberty blockers and opposite-sex hormones where clinically appropriate.

    Open New South Wales →

  • Northern Territory

    MedicalRestricted

    Northern Territory public hospitals will stop puberty blockers and hormones for under-18s.

    Open Northern Territory →

  • Queensland

    MedicalRestricted

    Queensland public hospitals stopped new puberty blockers and hormones of the opposite sex for under-18s.

    Open Queensland →

  • South Australia

    MedicalAffirming

    SA Health’s model of care lists puberty blockers and opposite-sex hormones for children and young people up to 17.

    Open South Australia →

  • Tasmania

    MedicalAffirming

    The Tasmanian Department of Health lists puberty blockers and opposite-sex hormones for children and young people.

    Open Tasmania →

  • Victoria

    MedicalAffirmingSchoolsCSE in schools

    No official medical policy listed.

    Open Victoria →

  • Western Australia

    MedicalAffirming

    No official medical policy listed.

    Open Western Australia →

Open hub →

New Zealand

MedicalMixedSchoolsCSE in schools

2025–2026

Rules on puberty blockers exist; a court said the government should not enforce them for now.

Official sources

GnRH regulations exist; High Court non-enforcement recorded by the Court of Appeal. CSE in schools (RSE in HPE).

Read full update →

Asia

Official medical and school policies — country by country. Click for sources.

China

MedicalAffirming

2009–2022

A national surgery standard starts at 18.

Official sources

Asia. National surgery technical standard is 18-plus.

Read full update →

Japan

MedicalAffirming

2003–2025

Japan’s psychiatry society guideline lists puberty blockers from Tanner 2. A family-court statute lets a person change legal sex from 18.

Official sources

Asia. Society guideline names puberty blockers. Legal sex-change from 18.

Read full update →

Philippines

MedicalAffirmingSchoolsCSE in schools

2012–2025

No official medical policy listed.

Official sources

Asia.

Read full update →

Middle East

Official medical and school policies — country by country. Click for sources.

Iraq

MedicalBannedSchoolsSchools restriction

2024

Federal Iraq forbids changing biological sex based on personal desire.

Official sources

Middle East. Law 15/2024 forbids changing biological sex based on personal desire; DSD correction after a court order.

Read full update →

Israel

MedicalAffirming

2014–2026

A Ministry of Health procedure names hormone treatment and has a minors section. Surgery-committee rules start at 18.

Official sources

Middle East. Ministry of Health Procedure 90.01.

Read full update →

Saudi Arabia

MedicalRestricted

2019

Saudi Ministry of Health informed-consent guidelines list sex changes among forbidden procedures.

Official sources

Middle East. Sex-change listed as a forbidden procedure in Ministry of Health informed-consent guidelines.

Read full update →

Africa

Official medical and school policies — country by country. Click for sources.

Burkina Faso

MedicalAffirmingSchoolsSchools restriction

2025

No official medical policy listed.

Official sources

Africa. Family Code promotion clause.

Read full update →

Central African Republic

MedicalAffirming

2026

No data at this time. Please email us at Contact if you have official updates.

Read full update →

Democratic Republic of the Congo

MedicalAffirming

2026

No data at this time. Please email us at Contact if you have official updates.

Read full update →

Egypt

MedicalRestricted

2003

Egypt forbids sex-change operations except committee-approved correction for conditions where a baby’s sex development didn’t follow the usual path (DSD).

Official sources

Africa. Sex-change operations forbidden; committee-approved correction only for conditions where a baby’s sex development didn’t follow the usual path (DSD).

Read full update →

Equatorial Guinea

MedicalAffirming

2026

No data at this time. Please email us at Contact if you have official updates.

Read full update →

Ghana

MedicalAffirmingSchoolsSchools restriction

2026

No official medical policy listed.

Official sources

Africa. School-content restriction. Family Values Bill before the president.

Read full update →

Republic of the Congo

MedicalAffirming

2026

No data at this time. Please email us at Contact if you have official updates.

Read full update →

São Tomé and Príncipe

MedicalAffirming

2026

No data at this time. Please email us at Contact if you have official updates.

Read full update →

South Africa

MedicalAffirmingSchoolsCSE in schools

2012–2025

No official medical policy listed.

Official sources

Africa. Life Orientation includes official CSE.

Read full update →

What the labels mean

Medical

  • Ban (U.S.) / Banned (countries) — a law or rule stops doctors from giving children drugs or surgery to reject their sex
  • Restriction (U.S.) / Restricted (countries) — not a full stop. Care is limited (research only, public hospitals only, or rare exceptions)
  • Litigation-setback — a ban passed, then a court put it on hold (U.S. map: blue stripes)
  • No ban — no official ban or limit (U.S. map: light gray)
  • Affirming — no official medical ban or limit is listed
  • Mixed — no one nationwide medical rule
  • Under review — officials are reviewing the evidence
  • Proposed bill — a bill has been introduced. It is not law yet.
  • Court suspension — a rule exists but a court paused it

Schools

  • Schools ban / Schools restriction — official school limits (not medical)
  • Schools proposed — a school bill, not a school law yet
  • Schools mixed — official school sources pull in more than one direction
  • Schools court strike — a court struck down a school law
  • CSE in schools — required or expanded comprehensive sex education (broad sex-ed lessons, often including gender ideology)

Terms

  • DSD — conditions where a baby’s sex development didn’t follow the usual path. Some laws still allow medical correction for those conditions — not a sex-change for gender identity
  • Puberty blockers — drugs that block a child’s puberty
  • Sex-rejecting procedures — puberty blockers, hormones of the opposite sex, and surgeries meant to make a child look like the opposite sex

Medical and school rules are separate.

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