The landscape for transgender rights and access to gender-affirming care in the United States and the United Kingdom has shifted dramatically in the summer of 2025, marked by new legal rulings, evolving government guidance, and mounting political scrutiny. As the U.S. Supreme Court, federal agencies, and state boards weigh in, the impact is being felt not just in courtrooms and legislative chambers, but in hospitals, schools, and police stations—places where real people’s lives are being directly affected.
In May 2025, the National Police Chiefs Council (NPCC) in the UK issued ‘interim guidance’ to all police forces on how to conduct searches of transgender detainees, according to Netpol. This move came on the heels of a Supreme Court decision that rolled back certain protections for trans people. The NPCC’s guidance is intended as a stopgap measure until the Equality & Human Rights Commission releases statutory Codes of Practice later this year. Yet, its implementation has raised immediate questions. Netpol, a network monitoring policing practices, is now gathering reports from trans individuals about whether police forces are respecting their right to request that searches be conducted by an officer of their “lived gender”—that is, the gender they identify as, rather than their “biological sex.”
Concerns have been raised about whether these rights are being ignored or inconsistently applied. Some individuals have reported being subjected to intimate searches by officers of the same “biological sex,” even without consent, or being asked to provide identification to “prove” their gender. Others have allegedly been required to sign written authorizations for searches by officers not matching their “biological sex,” forcing them to disclose deeply personal information. Netpol is encouraging anyone affected to come forward, offering legal support for those seeking to challenge the guidance in court.
Across the Atlantic, the legal and political battles over transgender rights have reached a fever pitch. On June 18, 2025, the U.S. Supreme Court upheld a Tennessee law banning certain medical care—specifically treatments for gender dysphoria, gender identity disorder, or gender incongruence—for minors. As reported by K-12 Dive, this landmark decision has had ripple effects far beyond Tennessee. The U.S. Department of Education’s Office of Civil Rights (OCR) quickly began citing the Supreme Court’s ruling in its own findings related to transgender students’ access to school athletics and facilities.
On June 25, 2025, the OCR found that the California Department of Education and the California Interscholastic Federation violated Title IX by discriminating against girls and women after allowing transgender students to compete on girls’ sports teams. The department’s news release stated, “On June 18, 2025, the Supreme Court upheld a Tennessee law banning certain medical care for minors related to treating ‘gender dysphoria, gender identity disorder, or gender incongruence.’ In so holding, the Supreme Court acknowledged that a person’s identification as ‘transgender’ is distinct from a person’s ‘biological sex.’”
Just a month later, on July 27, the OCR issued a similar finding against five large Northern Virginia school districts, including Fairfax County Public Schools, for allowing transgender students to access facilities that matched their gender identities. These moves have left Title IX experts scratching their heads. Kayleigh Baker, an advisory board member for the Association of Title IX Administrators, commented, “There has been a little bit of a selective stretching. The four corners of the Supreme Court opinions have sort of been extrapolated and sort of merged together with this administration’s interpretation in a couple of arenas. And it seems like this is another one of those.”
The Trump administration’s approach echoes previous administrations’ use of Supreme Court decisions to guide education civil rights policy. For example, the Biden administration applied the Bostock v. Clayton County decision—which protected LGBTQ+ workers from sex discrimination—to Title IX protections for students. However, critics note that the Trump administration’s use of the Skrmetti decision (the Supreme Court case in question) is more subtle, embedding its interpretation in investigation announcements rather than issuing broad guidance. Notably, Skrmetti does not directly address whether discrimination against transgender students is sex-based discrimination under Title IX, leaving the legal landscape unsettled.
Meanwhile, the U.S. Justice Department has ramped up its scrutiny of gender-affirming care providers. On June 11, 2025, the department sent a subpoena to Children’s Hospital of Philadelphia requesting detailed information about transgender patients, including names, dates of birth, Social Security numbers, addresses, and parent/guardian information. Attorney General Pam Bondi revealed on July 9 that more than 20 subpoenas had been sent to doctors and clinics providing gender-affirming care for transgender youth, as part of investigations into healthcare fraud and false statements. The requests, which also sought personnel files, intake procedures, and insurance billing codes, have alarmed advocates.
Jennifer Levi, GLAD Law’s senior director of Transgender and Queer Rights, told the Associated Press, “It turns doctor-patient confidentiality into government surveillance.” The chilling effect has been immediate: at least eight major hospitals and hospital systems announced in July that they were stopping or restricting gender-affirming care, even in states where it remains legal. Children’s Hospital of Philadelphia has not publicly curtailed care, but Penn Medicine, a frequent referral partner, said in May it would no longer perform surgeries on patients under 19.
Since 2021, at least 27 states have enacted laws restricting or banning gender-affirming care for minors. The Supreme Court’s June 2025 decision affirmed states’ rights to impose such restrictions under certain circumstances. Now, the Alaska State Medical Board is set to consider a resolution on August 22 that would deem doctors who perform gender-affirming care on minors as engaging in unprofessional conduct. The board’s draft statement could label such practitioners as “grossly negligent and therefore subject to disciplinary sanctions.”
President Trump has further escalated the issue by signing executive orders defining sex as strictly male or female and unchangeable, and seeking to end federal funding for gender-affirming care for anyone under 19. He has also moved to bar transgender individuals from military service and restrict transgender athletes’ participation in sports competitions. The administration has released documents questioning the medical standards for transgender youth, suggesting a preference for talk therapy over medical interventions.
For many healthcare providers, the growing legal uncertainty and risk of government investigation have led to changes in policy, even where state laws have not changed. Democratic state officials are suing the Trump administration, alleging that its actions are designed to intimidate providers and halt care. Jennifer Levi summed up the prevailing sentiment in the medical community: “It’s chilling.”
As the Supreme Court prepares to hear cases next term that could set national precedent on transgender athletic participation and access to facilities in public schools, many district leaders are left in limbo. Kayleigh Baker advises them to consult local counsel, since the application of Title IX may now vary by state law rather than federal precedent. “I don’t think based solely off of the Skrmetti decision that districts need to jump into any changes,” she said.
With statutory guidance pending in the UK and the U.S. Supreme Court poised to rule on key questions, the coming months will likely prove pivotal for transgender rights. For now, the patchwork of policies, investigations, and legal challenges leaves many transgender individuals and their families navigating a maze of uncertainty, fear, and hope.
