Towards State Legislative Codification of the WPATH SOC Guidelines

Suresh Hanubal

Transgender rights have increasingly come under assault in the United States. As of early 2026, twenty-seven states have passed either bans or restrictions on access to gender-affirming care. The issue has also become a central focus at the federal level. The U.S. Supreme Court decided United States v. Skrmetti, a case concerning the legality of state restrictions on gender-affirming care, in the 2024 – 2025 term. Moreover, the second Trump administration has been clear that rolling back transgender rights, including access to gender-affirming care, is a priority. In this political environment, where access to gender-affirming care in the United States faces an ongoing onslaught at both the state and federal levels, creative strategies to preserve access to such care are needed. This note thus proposes that state legislatures codify the World Professional Association for Transgender Health’s (“WPATH”) Standard of Care (“SOC”) guidelines as the north star for the delivery of gender-affirming care in their states. Legislatively codifying the WPATH SOC guidelines would provide a bulwark against attacks on transgender rights, preserving access at the state level.

Link to Note

Towards State Legislative Codification of the WPATH SOC Guidelines

Suresh Hanubal

Transgender rights have increasingly come under assault in the United States. As of early 2026, twenty-seven states have passed either bans or restrictions on access to gender-affirming care. The issue has also become a central focus at the federal level. The U.S. Supreme Court decided United States v. Skrmetti, a case concerning the legality of state restrictions on gender-affirming care, in the 2024 – 2025 term. Moreover, the second Trump administration has been clear that rolling back transgender rights, including access to gender-affirming care, is a priority. In this political environment, where access to gender-affirming care in the United States faces an ongoing onslaught at both the state and federal levels, creative strategies to preserve access to such care are needed. This note thus proposes that state legislatures codify the World Professional Association for Transgender Health’s (“WPATH”) Standard of Care (“SOC”) guidelines as the north star for the delivery of gender-affirming care in their states. Legislatively codifying the WPATH SOC guidelines would provide a bulwark against attacks on transgender rights, preserving access at the state level.

Link to Note