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Transgender Rights

From healthcare and employment matters to family, name and gender marker changes, NYLAG is here to help. The rollback of rights at the federal level continues to spread fear and confusion throughout our country as hateful attacks on trans and gender-nonconforming people threaten the very livelihood of our trans community members.

While policy continues to change rapidly at the federal level, trans New Yorkers have rights afforded to them and enshrined in New York state law in everyday matters from employment and family to healthcare.

Resources: Know Your Rights

The Trump Administration issued an Executive Order (EO) to address “Gender Ideology Extremism” in the United States, targeting LGBTQIA citizens, namely those who have undergone gender reassignment.

What is the current status of enforcement of the Executive Order?

  • One of the directives requires that federal government departments issue identification documents only utilizing the gender markers that are assigned to an individual at birth.
  • The important thing to know about this executive order is that it only impacts federally issued identification (i.e., passports, social security cards, work authorization documents, green cards, naturalization certificates, etc.). It does not affect state- or city-issued documents.
  • On November 6, 2025, the Supreme Court overturned a lower court order barring the enforcement of the Executive Order. The ruling from the Court means that a passport with a sex designation that aligns with one’s gender identity or with an “X” designation designation are no longer allowed to be issued.

I need my passport for an emergency. How can I protect myself as best as possible when submitting my passport application?

  • Certified copies of required documents should be submitted instead of originals wherever possible.

Can I use my current passport with a changed gender marker? What if it is an X marker?

  • Yes, however, you may have difficulty returning to the United States if you have an X marker. While the White House has confirmed that current, unexpired passports, including passports with X markers and those already updated to reflect someone’s gender, are still valid, recent guidance from Customs and Border Protection (CBP) has upended the previous system carriers used to report traveler information. Under a rule implemented on October 14, 2025, all carriers must report whether a passenger is Male or Female based on the traveler’s documentation. While CBP stated that if there is no gender identification on a traveler’s passport then carriers may input “male” or “female” without being penalized for submitting incorrect information, it is unclear how airlines will respond to this rule change. As of now, there are no reports of travelers with X markers being denied from boarding a flight. 

Can I apply for a passport with a name change, but not a gender change?

  • Yes. The Executive Order did not apply to name changes.

I have an X marker on my passport (or other immigration document) and/or my personal documentation and need to apply for a renewal. Can I keep the X marker? What will my gender be if not?

  • No. Passports and all other immigration document applications will likely be altered to remove the X marker as an option after the Supreme Court’s ruling. It is unclear at this time how the government will decide what your documented gender will be, but it will likely be based on your gender assigned at birth.

I already sent in my application for a passport or renewal with a gender marker change and have not received it yet. What should I do?

What is the impact on the Social Security Administration?

  • While there is no gender recognized on the card itself, the Social Security Administration is not currently accepting gender marker changes. Your assigned gender will remain part of their records.

Do New York Driver’s Licenses or New York City IDs have to follow the Executive Order?

  • No. The Executive Order only applies to federal identification. Both New York driver’s licenses and New York City IDs allow you to reflect your gender identity, including using an X marker.

What is Currently Covered Under Privately Run Insurance Carriers?

  • What is and is not covered can vary significantly based on the type of plan that you have, regardless of any state or federal-level directives. Some plans do not cover gender-affirming care or may not cover all types of care. Under federal law, providers can refuse to provide gender-affirming care even if the same procedures are provided to another person for a different purpose.
  • However, New York law prohibits private insurers from excluding gender-affirming care that would otherwise be available to non-LGBTQIA+ individuals and state regulated plans must provide gender-affirming care. If you feel you were improperly denied coverage, you can call our intake line Monday to Friday at 212.659.6161 for further assistance.

Has the Federal Government Banned Gender Affirming Healthcare?

  • No. The Trump Administration issued an Executive Order (EO) that would have restricted gender-affirming medical care for individuals under 19 years old on January 28, 2025.
  • However, the legality of the EO was challenged in PFLAG v. Trump, and the court issued a preliminary injunction preventing the EO from being enacted. In that case, the New York Attorney General and 17 other attorneys general reiterated that any health insurance subject to regulation by New York law must cover medically necessary gender-affirming care. The injunction was appealed to the 4th Circuit and is currently on hold pending a decision in Anderson v. Crouch.

Has the Federal Government Banned Gender-Affirming Healthcare for Minors?

  • No, however, gender affirming healthcare coverage for minors could be severely limited in the next few months. On December 19, 2025, the Centers for Medicare & Medicaid Services (CMS) released two proposed rules aimed at restricting transgender care for minors. There is a mandatory 60-day notice and comment period before the rules can be enacted.
  • One rule would ban hospitals from performing gender-affirming procedures on minors as a condition of participation in Medicare and Medicaid. Nearly all hospitals in the United States participate in Medicare and Medicaid, and this rule would force them to choose between providing gender-affirming care to minors or losing federal funding.
  • CMS also proposed a rule prohibiting Medicaid funding for gender-affirming procedures for individuals under 18 years old. This would include banning coverage for care such as puberty blockers, hormone therapy, and surgical operations.
  • The FDA has also issued warning letters to 12 manufacturers and retailers of breast binders due to their use in gender-affirming care for minors. This may limit access to them in the future.
  • On December 23, 2025, New York and 18 other states sued the federal government to try to block these changes, which may temporarily or permanently halt them from going into effect.

What is Currently Covered Under Government Run Insurance Carriers?

  • Federal Employees: The U.S. Office of Personnel Management announced on August 15, 2025 that starting in 2026, the Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) Programs will remove gender-affirming care from the health care services they cover. This will impact all federal employees, retirees, and their family members who rely on FEHB/PSHB for health insurance. These changes will apply to treatments such as hormone therapy and gender-affirming surgeries, but mental health counseling for gender dysphoria will remain covered. Additionally, case-by-case exceptions may be processed for individuals already receiving care that would no longer be covered, such as those who are mid-treatment within a surgical or hormonal regimen.
  • Tricare: Tricare covers some, but not all, medical care related to gender-affirming care. Tricare Policy Manual Chapter 7, Section 1.3 describes the medical services provided for gender dysphoria and gender-affirming health care for service members and their beneficiaries along with what is excluded. Under the policy manual, psychotherapy and endocrine treatments for service members and beneficiaries are covered. However, gender-affirming surgeries for dependents are not covered. For additional questions regarding your rights related to military service, please see our Military Service FAQ.
  • Department of Veterans Affairs (the “VA”): The VA announced that it was rescinding VHA Directive 1341(4), significantly reducing who can receive gender-affirming care. At this time, only Veterans already receiving hormone therapy will be able to continue to receive care along with Veterans who were receiving hormone therapy prior to and upon separation from service. All other treatments for gender dysphoria are no longer covered by the VA. The VA will also no longer provide letters of support encouraging non-VA providers to perform sex-change surgeries on Veterans.
  • Affordable Care Act (commonly referred to as the “ACA” or “Obamacare”): The Center for Medicare & Medicaid Services (“CMS”) has proposed a rule change that, starting in 2026, would prohibit insurers on the ACA Marketplace from covering gender-affirming care as an essential health benefit. This could lead to insurers dropping coverage or shifting costs to the state or policyholder. Section 1557 of the Affordable Care Act prohibits discrimination based on sex in health programs that receive federal funding. However, Health & Human Services rescinded a 2022 Notice that interpreted Section 1557’s protections covered gender identity-based discrimination.
  • Medicaid: New York’s Medicaid policy explicitly covers transgender-related healthcare.
  • Medicare: Medicare covers medically necessary hormone therapy and transition-related surgery in addition to routine preventative care. If you have Medicare Advantage though, you should make sure to consult your member handbook for more details about your plan and potential conditions on your coverage.

What is the coverage available to homeless youth?

  • New York state law allows for homeless and runaway youth to consent to their own medical procedures.

What happens if I travel outside of New York?

  • Your insurance travels with you wherever you go and if your insurance covers gender-affirming care in New York, your insurance will cover you while you travel. However, some states have banned certain gender-affirming care for youth, and you probably will not find care in those states.

Are healthcare providers who wish to provide gender-affirming healthcare at risk in New York?

  • No, while Attorney General Pamela Bondi has stated that the Department of Justice will be investigating doctors that provide gender-affirming care to minors, New York’s Shield Law protects healthcare providers and patients that seek, provide, or help others obtain abortions or gender-affirming healthcare that is legal in New York but may be criminalized in other places. New York’s shield law protects these individuals by prohibiting law enforcement and other state officials from cooperating with investigations into reproductive or gender-affirming care so long as that care was lawfully provided in New York.   

If you feel you were improperly denied coverage, you can call our intake line Monday to Friday at 212.659.6161 for further assistance.

Is my marriage still valid?

  • Yes. Both state and federal law protect your marriage.
    • In New York, the New York Marriage Equality Act grants same-sex couples the same rights as opposite-sex couples.
    • Under federal law, the Respect for Marriage Act requires the federal government and all states to recognize any marriage as long as the marriage was valid in the state where it was performed. In Obergefell v. Hodges, the Supreme Court also guaranteed the right for same-sex couples to marry.

Will all states recognize my marriage?

  • Yes. The Respect for Marriage Act and Obergefell requires all states to recognize same-sex couples as the same as opposite-sex couples.

Can I still adopt my child?

  • Yes. New York Domestic Relation Law Section 110 allows unmarried adults, married couples, and unmarried adults in an intimate relationship to adopt children. All states currently allow transgender parents and same sex couples to adopt children and there are no federal restrictions.

How do I get proof of family relationship with my child if I am not listed on the child’s birth certificate?

  • There are two ways you can be legally recognized as a child’s parent in New York. One is through establishing an Order of Parentage in the court. This is commonly done when neither parent is the birth parent (for example, surrogacy, assisted reproduction), but its use is not limited to these situations in particular. To get an order, you must draft a Parentage Petition and file it online or by going to the court.
  • The other method is by completing an Acknowledgment of Parentage form. This can only be used in two scenarios: with an unmarried birth parent and an alleged parent, or a married or unmarried birth parent and an intended parent. An intended parent is someone who intends to be legally bound as the child’s parent when the child was born from assisted reproduction.
  • An in-depth guide on how to establish an Order of Parentage can be found here or you can call our intake line Monday to Friday at 212.659.6161 for further explanation or assistance.
  • While commonly used in Surrogacy situations, Orders of Parentage aren’t limited to situations where neither parent is the birth parent.

What is the impact of the Executive Order on Employment Discrimination for Transgender Individuals (EO)?

  • It is unclear: President Trump’s EO directs the Attorney General to allow private employers to refuse to respect peoples’ pronouns and removes federal protections for transgender, nonbinary, and intersex people in the workplace. In addition, it orders the Attorney General to make sure that single-sex spaces at work are used by people of the “matching” sex according to the order’s definitions.
    • These proposed changes could mean that transgender people would lose federal protections in these day-to-day workplace scenarios.
    • However, they would still have federal employment protections in hiring and firing and protections under New York state law.
  • The EO also calls for the Equal Employment Opportunity Commission (EEOC) to undo its prior guidance on workplace harassment, which included direction on when harassing conduct based on gender identity would qualify as employment discrimination.
    The EO does not state how the order will be enforced, making it unclear what the impact of the order will be.

What are the current protections under federal law?

  • Title VII of the Civil Rights Act provides for protection against discrimination from employers on the basis of sexual orientation or gender identity. This was further affirmed by the case Bostock v. Clayton County, where the Supreme Court ruled that an employer with more than 15 employees is subject to federal regulation, and the firing of an employee on the basis of sexual orientation is a violation of that individual’s protections under Title VII.
  • It is the responsibility of the EEOC and the Department of Justice (depending on whether the employer is publicly or privately run) to, among other things, investigate and litigate violations of the Civil Rights Act.

What is the EEOC? Has it taken any action pursuant to the EO?

  • The EEOC is the federal agency authorized to investigate and litigate against businesses and other private employers for violations of federal laws prohibiting employment discrimination, including sexual harassment. For public employers, the EEOC shares jurisdiction with the Department of Justice’s Civil Rights Division.
  • The EEOC also is responsible for investigating charges against state and local government employers before referring them to DOJ for potential litigation.
  • The Acting Chair of the EEOC does not have the power to rescind certain “gender-identity”-related documents subject to the directives in the EO. Even though she cannot rescind portions of the agency’s harassment guidance that are inconsistent with the EO, she has issued statements in support of the EO and has rolled back certain Biden Administration policies that promoted a more inclusive workplace.
  • The impact of the EEOC directive is unclear. If the EEOC undoes its workplace harassment guidance that includes gender identify protections, employees may not have protections at their workplace. However, employees still would have protections in hiring firing and protections under New York state law.

Can I serve in the military if I am transgender?

  • No, not at this time. President Trump issued Executive Order 14183 “Prioritizing Military Excellence and Readiness” (EO) on January 20, 2025. That EO effectively bans transgender individuals from serving in the military.

  • The Supreme Court has allowed the EO to remain in place while the lower courts decide on its legality. This means that the court has not made a final decision, but for now it will remain in place.

What happens now with the ban reinstated?

  • Under the ban, most, if not all, transgender service members will be honorably separated from the military. Active Component service members had until June 6, 2025, to self-identify for separation while Reserve Component service members had until July 7, 2025. The military will begin involuntary separations since the window for voluntary separations has closed.

     

  • Under the provisions of the EO and corresponding Department of Defense policy, transgender service members will still be able to receive an honorable discharge regardless of whether they were voluntarily or involuntarily separated. The DOD provided a FAQ that clarifies this and other issues, which can be accessed here.

Can I get an honorable discharge from the military?

  • Yes. Transgender service members who are voluntarily and involuntarily discharged under the transgender ban will receive honorable discharges.

Can I retire from the military instead of receiving a separation?

  • Maybe. DOD guidance allowed service members to with 15-18 years of service to apply for early retirement exception to policy. The Air Force announced on August 4, 2025 that they were denying all requests. It is currently unclear if the other branches will adopt the same policy or if this will be challenged in court.
Voluntary & Involuntary Separation

Under the EO, transgender service members were given the option of voluntarily separating or involuntarily separating. The window for Active and Reserve Component service members to separate voluntarily has closed.

As a service member, you can seek free assistance from a judge advocate assigned to a legal assistance services office. If you do not know where your closest legal assistance office is, you can call or use the search function provided by Military OneSource.

Can I get a separation waiver?

  • Yes, but only under certain narrow conditions. The policy guidance from the DOD is that a service member may receive a waiver to the requirement that all transgender service members separate from the military if:
    • There is a compelling Government interest in retaining the Service member that directly supports warfighting capabilities and the Service member concerned meets the following criteria:

      1. The Service member demonstrates 36 consecutive months of stability in the Service member’s sex without clinically significant distress or impairment in social, occupational, or other important areas of functioning; and

        2. The Service member demonstrates that he or she has never attempted to transition to any sex other than their sex; and

        3. The Service Member is willing and able to adhere to all applicable standards associated with the Service member’s sex.

    • Based on the above standards, most transgender service members would not qualify even if they were identified as serving in a position that “directly supports warfighting capabilities.” Additionally, service members retained under this waiver will not be able to transition to the gender of their choice.

Can I dispute my involuntary separation before a board?

  • Yes. When you are notified that involuntary separation action has been initiated, you should be informed of your right to counsel. You can seek free assistance from a judge advocate assigned to a legal assistance services office or hire your own counsel. If you do not know where your closest legal assistance office is, you can call or use the search function provided by Military OneSource.
  • In an August 12, 2025 memo, the Air Force announced that is it deviating from normal board procedures where boards make findings or recommendations on retention. Instead, boards are only allowed to decide whether or not the service member “has a current diagnosis or history of gender dysphoria, or exhibits symptoms consistent with gender dysphoria.” It is unclear if other services will follow or if this decision is legal.
Care Access

Can I access gender affirming care if I am active military? What about my family?

  • Tricare, the healthcare provider for the military, covers some, but not all, medical care related to gender affirming care. Tricare Policy Manual Chapter 7, Section 1.3 describes the medical services provided for gender dysphoria and gender-affirming health care for service members and their beneficiaries along with what is excluded. Under the policy manual, psychotherapy and endocrine treatments for service members and beneficiaries are covered. However, gender affirming surgeries for dependents are not covered.
  • In a May 9, 2025 memo, the Acting Director for the Defense Health Agency stated that after 45 calendar days from the date of the memo, all gender dysphoria care for service members and covered beneficiaries 19 years of age or older, excluding mental health care and counseling, will be referred to the private sector

Can I receive gender affirming care at a VA hospital? What if I am currently receiving care?

  • The VA announced that it was rescinding VHA Directive 1341(4), significantly reducing who can receive gender affirming care. At this time, only Veterans already receiving hormone therapy will be able to continue to receive care along with Veterans who were receiving hormone therapy prior to and upon separation from service.
  • All other treatments for gender dysphoria are no longer covered by the VA.
  • The VA will also no longer provide letters of support encouraging non-VA providers to perform sex-change surgeries on Veterans.

Who can I contact if I have problems accessing the medical care that I need at the VA?

  • If you need assistance accessing healthcare or need to have an issue resolved, you should talk to the Patient Advocate at your local VA Medical Center. You can also call our intake line, Monday to Friday at 212.659.6161 for further explanation or assistance.

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