How Does Your State Rank On “The Civil Rights Issue Of Our Time”?

In 2010, Vice President Joe Biden made headlines when he said that transgender discrimination is "the civil rights issue of our time." And, while there are still many civil rights battles to be fought, this past year has included incredible advances in turning American attention to not just transgender rights, but transgender life. Jill Soloway's Transparent, about a family learning that their father is transgender, has been a huge success. Congressman Mike Honda of California has openly supported his transgender granddaughter. Baby steps, but steps nonetheless. Most importantly, the trans community itself is finally beginning to be able to bring its experiences and voices to the forefront: Laverne Cox was on the cover of TIME; Janet Mock’s memoir, Redefining Realness, hit the bestseller list, and social media lit up with voices, opinions, and narratives that hardly seemed possible to discuss openly just a few years ago. Influencers like Kate Bornstein and Parker Molloy have become valued for their social commentary on and reactions to trans representations in media and pop culture. But, it's not all good. According to a report from the National Center for Transgender Equality and the National Gay and Lesbian Task Force, the transgender community, as compared to the cis population, has higher rates of unemployment, is more likely to live in poverty, and suffers adverse job outcomes and discrimination. It's beyond being second-class citizens — it's a systematic denial of basic human rights. “There are stories of amazing acceptance, but the amount of bias and stigma is really kind of mind-blowing,” says Amy Whelan of the National Center For Lesbian Rights (NCLR), an organization on the forefront of trans issues. While there have been breakthroughs on the national stage, trans people everywhere still face massive prejudice and hurdles in their day-to-day lives. This map and the stories that accompany it are a snapshot of transgender life in America: what it’s like to live as a trans person in each of the 50 states — from the most livable ones (California, Vermont) to the least inviting (South Dakota, Mississippi). We gave each state a ranking — and, for context, added anecdotes or news moments relating to the community in that state. We looked for stories that span a vast range of issues; they are by no means the definitive story for any one state. There are uplifting stories from states with next to no legal protections for trans residents, and hate crimes that occur in the most progressive of cities. Together, these dispatches begin to paint a picture of how many stories are out there, and why they should matter to all of us. —Mike Albo Our methodology:
We started with four categories: Work & School: Do the state's laws protect trans workers and students from discrimination?
Health Care: Is there access to insurance that covers trans-related health care, and hospitals that don’t discriminate?
Safety: Does the state have hate-crime laws that include gender identity?
Community: How easy does the state make daily life for a trans person? This includes discrimination laws covering restaurants and bars, anti-bullying legislation, and rules for changing the gender of drivers’ licenses and official documents.

For each category, states were given a numerical score. Those scores were weighted to reflect how important that category is, and then the category scores were added up to get a state's total score. We ranked each state by its score to get the map above and our ranking, below.

We used data and maps from the NCLR, Transgender Law Center, Human Rights Campaign, the MAP project, the ACLU, and other organizations who are fighting for gender equality — along with our own research. (If you a full deep-dive into how we did it, click here.) Read our full Trans America series here Check out the list in order, from best to worst — or click on a state below to see how it stacks up.

California is the clear winner when it comes to trans livability in the U.S. One place where the state shines is in acknowledging the egregious employment inequality that trans people face. For example, the Transgender Economic Empowerment Initiative (TEEI), based in San Francisco, is a collaboration between The Transgender Law Center, the San Francisco LGBT Center, and the Jewish Vocational Service. According to its website, it is “the nation’s first coordinated program to transform the economic health of transgender communities by turning around the high rates of unemployment and creating stability for transgender people and their families.” The initiative offers job training, career fairs, mentoring workshops, and more. Rating: Very Good
Protected by statewide non-discrimination laws, California’s trans population has good access to health care: Over three-quarters of the state’s healthcare facilities don’t discriminate based on gender identity, and with a population nearing 40 million, that means a lot of people are getting the treatment they need. The state also won points for the strength of its trans communities, especially in the big cities; San Francisco and LA are home to some of the safest and most accommodating enclaves of gender-nonconforming people in the country. Total: 97/100

With its state-wide laws banning trans discrimination in schools, housing, and public spaces, it’s no surprise this reliably liberal New England state is one of the most welcoming to transgender and gender-nonconforming citizens, especially when it comes to education. For example, the University of Vermont recently added gender-neutral options to its record-keeping software. “Vermont is at the forefront in recognizing the next step in identity politics: the validation of a third gender,” writes reporter Julie Scelfo in The New York Times. Rating: Very Good
Vermont’s scores were nearly perfect across the board. In addition to good legal protections, the state is home to a number of advocacy groups that support trans people. Outright Vermont, one such group, started with a focus on gay rights in the late ‘80s and has since widened its mission to support the trans community. Total: 96/100

Washington’s transgender community is supported both legally and through the state’s network of nonprofits. One group doing great work is the excellently named Center for Gender Sanity based in Bellingham, WA. The organization’s aim is to help people come out and transition in the workplace — and to help often clueless (if well-intentioned) HR departments and management support their trans employees.

Rating: Very Good
Washington state was an early adopter of transgender rights, including gender identity in its housing, school, and anti-bullying laws. And, 92% of its hospitals include transgender people in their patient bills of rights. Total: 89/100

Oregon just took a huge step toward providing equal medical care to its low-income transgender community. In January, the state expanded its Medicaid program to cover trans-related procedures, like hormone therapy, puberty suppression, and gender-reassignment surgery. Medicaid is the biggest provider of health care to poor Americans, and though it’s federally funded, states have lots of power to determine who is eligible and for what. Ariel Smits, MD, who directs the state’s Health Evidence Review Commission, told NPR that the measure will have a trickle-down effect, improving health overall. "People with gender dysphoria that did not receive treatment had a much higher rate of hospitalizations or ER visits or doctor visits for depression and anxiety,” she said. “But, folks [who] received the treatment that they felt was adequate for their gender dysphoria had an almost normal rate of depression and anxiety compared to the general population." Rating: Very Good
With its employment policies and sensitivity in regards to school regulations, anti-bullying, and housing, Oregon joins California and Washington State to create a healthy, supportive environment all along the west coast. Let’s call it the Trans Coast. Total: 88/100

Colorado has established itself as a progressive front-runner in recent years, with its laws on gay rights, marijuana, and gun-control — and trans rights are no exception. We got a particularly encouraging example of the state’s growing acceptance of gender nonconforming people people last September. Scarlett Lenh, a 16-year-old who lives in Colorado Springs, came out before her junior year and began attending school as a young woman. Just a few weeks later, she was accepting a tiara as homecoming princess. “I was like, even if I don't win, I've already helped a lot of people [learn] that they can be themselves,” Lenh told news channel KRDO. “But, I won, and I can't stop smiling.” Rating: Very Good
Colorado continues to shatter its “square” image, enacting protections for transgender people in all our criteria. With all its progressive social policies, the state is leading the way in the Southwestern U.S. Total: 86/100

Illinois is the top Midwestern state on our list, and one reason is the healthcare access it gives its trans citizens. Last July, the state’s insurance department asked all private insurance carriers to comply with the non-discrimination policies of the Affordable Care Act, the Illinois Human Rights Act, and the Illinois Mental Health Parity Act. “Together, these laws prohibit discrimination against transgender persons because of their actual or perceived gender identity or health conditions,” says the bulletin. Advocacy groups cheered the ruling, calling it a big step toward ridding the state of discrimination against trans people and their right to health care. Essentially, this means many insurance plans sold in Illinois are forbidden from discriminating against trans people — and must provide them with coverage for the same medical treatment available to cisgender policyholders. Rating: Good
Illinois not only possesses protections across the board for trans people, but it is breaking new legislative ground in providing them with health care and health insurance protections. Total: 79/100

Here’s an example of secure, statewide gender-identity legislation at work: In 2014, Maine’s Supreme Judicial Court became the first in the country to make it illegal to force a trans student to use a bathroom assigned to a gender with which they don’t identify. The case was brought by Nicole Maines, a high school student. “I wouldn’t wish my experience on another trans person,” she told reporters after the ruling, per the Bangor Daily News. “I hope [the court] understand[s] how important it is for students to be able to go to school and get an education, have fun, make friends, and not have to worry about being bullied by students or the administration — and to be accepted for who they are." Rating: Good
With its statewide laws banning discrimination in housing, schools, and public accommodation, Maine remains a welcoming environment for LGTBQ people. Total: 79/100

Even the highest ranking states fail in some areas; one of the most common ones is rights and services for prisoners. In Connecticut, a trans girl (whose name isn’t being released because she’s a minor) spent more than a month in solitary confinement without criminal charges. The girl, who was seriously abused in multiple situations, largely due to her gender identity, ended up in solitary confinement because the system deemed her case “difficult to manage.” The girl remains in the prison system, though recent attention — and support from the likes of Janet Mock and Harvey Fierstein — may have improved the conditions in which she’s being held. Her experience highlights some of the unique challenges that trans kids face. “I need to deal with the trauma I’ve experienced,” she wrote in an affidavit, printed by the New York Times. “This prison cannot do that for me.”

Rating: Good
With near-perfect scores in all other categories, Connecticut ends up in 8th place because only about half the state’s residents have access to a trans-friendly healthcare provider. Total: 78/100 Correction: A previous version of this list incorrectly ranked Connecticut in 12th.

One small but significant story of progress out of one of the top states in the Midwest for trans rights: In December, Minnesota’s State High School League overwhelmingly voted to let all female-identified students play on girls’ sports teams in the state. (Boys teams are already open to students of all genders). The decision was reached after what a local paper describes as “months of emotional debate.”

Rating: Good
Minnesota is one of the top-ranking states off the coasts, coming in just behind Illinois in the Midwest. It scores well in all the big categories, except for health care.
Total: 71/100

In 2012, Massachusetts signed into law the Transgender Equal Rights Act, which prohibits discrimination against trans people in employment, housing, education, and lending. The bill also expands the state’s definition of hate crimes to include trans people. Last year, Governor Deval Patrick signed a different measure that banned private insurance companies from excluding procedures relating to gender dysphoria. Rating: Good
Massachusetts received perfect scores in the work and school categories, as well as safety. But, it ended up at the bottom of the top 10 because of lower scores on community and healthcare access, especially outside cities like Boston. Total: 71/100

Last fall, the University of Northern Iowa elected trans student Steven Sanchez as homecoming queen. Sanchez was assigned “male” at birth but identifies as female as well as male. Steven’s is a great story from a state that’s historically been ahead of the (Midwestern) curve of on cultural issues; Iowa was the first state in the Midwest, and fourth overall, to adopt marriage equality. “Sanchez, who as a child endured relentless bullying, said the moment left him speechless,” reported USA Today. The crowd "erupted in applause when his name was read.” Steven said, “I never would have thought years ago that I'd be standing on a stage, people cheering for me because they voted me homecoming queen. It was unbelievable." Rating: Good
Iowa’s big loss was in safety: The state does not have a hate-crime law that includes gender identity. Total: 70/100

For trans Americans, daily indignities can seriously hurt quality of life. In 2010, Kelli Keawe, 50, a transgender woman and government employee in Hawaii, filed suit against the state, claiming that she’s been forbidden from using the women’s restroom at work — for the past nine years. Finally, last year, after nearly a decade, she was granted permission to use the restroom that matches her gender identity. That was when Keawe began experiencing bullying from her coworkers; she told Hawaii News Now that “messing [up] my desk turned into trashing my desk, [which] turned into hiding my work assignments.” Rating: Good
Hawaii was docked points for lacking laws that ban insurance discrimination — and the islands aren’t home to a single insurance provider that covers gender-reassignment surgery or trans-related care. Total: 70/100

A recent New Jersey success story shows how the state’s coming along. Rachel Pepe, who’s 13, was assigned “male” at birth, but has been transitioning with the support of her family. Last year, Pepe’s mother told Rachel’s middle school the student would be coming back as a girl. But, according to USA Today, “an official at Thorne Middle School told her Rachel must come back to school dressed as Brian,” her birth name, “and prepared to act like Brian.” The superintendent eventually determined that to be unlawful, and Rachel was allowed to return. While the family chose to send her to a different school after all the upheaval, Rachel’s story is still one that would have been unimaginable a generation ago

Rating: Good
New Jersey protects its trans residents with anti-discrimination and hate-crime laws. It just loses out because of less-than-perfect healthcare access. Total: 70/100

Like most of its neighboring states, Delaware has laws banning discrimination in employment and public housing. But, it lacks protections for incarcerated trans people (which, unfortunately, most other states also lack). One recent example is the case of “Kai,” a trans man in the prison system who’s trying to change his name. The man, born Lakisha Lavette Short, is in a women’s prison and, so far, two courts have refused his request — though the ACLU is now helping him try to take his case to the Delaware Supreme Court. Currently, the state only allows prisoners to change names for religious reasons.

Rating: Good
Setting aside examples like the one above, Delaware deserves its “good” ranking; the state’s laws do an above-average job of protecting members of its trans communities.
Total: 70/100

Rhode Island was an early adopter of trans-rights legislation: in 2001, it became just the second state to enact a law banning discrimination on the basis of gender identity. And, the state is making huge strides in eliminating the bureaucracy involved in changing one’s gender marker. As of 2014, the state no longer requires trans people have gender-reassignment surgery before changing their birth certificate — an important step, since there are many different ways to transition, and not all trans people seek surgery. Rating: Good
Rhode Island sits near the top of this 50-state list because the majority of the state’s healthcare facilities prohibit discrimination against trans people. Total: 65/100

In October of 2014, Maryland joined the ranks of states with anti-trans discrimination laws (pertaining to housing, employment, and public accommodations) on the books. “We’ve taken one step closer to ensuring that all Marylanders are protected from discrimination under the law,” Gov. Martin O’Malley told The Washington Blade. Rating: Good
Maryland deserves its “good” rating, but there’s still work to be done: The state’s law bans discrimination against gender identity in the areas mentioned above, but not in schools. The state also has no laws banning insurance discrimination. Total: 61/100

At number 17, Nevada is the second-highest ranking Southwestern state, behind Colorado. Last June, Lauren Alex Scott — a trans woman and an Air Force vet — won the Republican nomination for a seat in the state’s legislature. She ultimately lost to Democrat State Assemblyman Michael Sprinkle, but her candidacy was historic; if she had won, she would have become the first openly transgender state legislator to serve in the United States. Rating: Good
Nevada scored well in most categories other than health care, where we awarded it 5/30. Residents have access to no insurance companies that include trans-related procedures or that ban gender-identity discrimination. Total: 56/100

Santa Fe is a progressive hub in the middle of the state of New Mexico. The capital’s mayor just proposed gender-neutral bathrooms — for the entire city, including private businesses. The openly gay mayor, Javier Gonzales, says the measure is meant to send a message of acceptance to trans people, especially youth. Rating: Good
New Mexico has a statewide anti-discrimination bill that includes trans people, plus a hate-crime law that includes gender identity, but the state loses points for healthcare access. Total: 51/100

This month, a man was arrested for beating a trans woman to death. Islan Nettles (who was 21 at the time of her death) was walking with friends in Harlem nearly two years ago. They were accosted by a group of about seven men who catcalled them. Then, when the men realized Nettles and her friends were trans, they reportedly became enraged, launching homophobic slurs and eventually attacking the three women. Nettles was severely wounded and died days later. The case, which went without an arrest for years, became a rallying point for protests against the disproportionately high rates of violence trans people face. It’s also a reminder that anti-trans violence exists everywhere, even in our progressive East Coast cities.

Rating: Bad
Despite the liberal reputation of its biggest city, New York has our list’s first zero, for work and school. New York’s employment laws don’t consider gender identity a protected category, meaning your employer could legally fire you for for being trans. Total: 38/100

Throughout this survey, there are instances of local communities adding protection for their trans communities — support that doesn’t exist on a state level. In North Carolina, the city of Greensboro just became the first in the state to adopt a sweeping measure (which passed the City Council unanimously) banning trans discrimination. The ordinance protects trans people in all city employment and services and supports gender-nonconforming individuals who are buying or renting housing. It’s a story that highlights how uneven rights for trans people can be, even within the same state — but also how progress is being made, town by town.

Rating: Bad
The first Southern state on our list, North Carolina lost out to many of its Northern neighbors — but it feels downright welcoming to its transgender residents in comparison to the rest of the South. Total: 30/100

Michigan has no state laws protecting the rights of transgender people, but one student is fighting anyway. A 14-year-old, whose name is being kept off the record because of his age, claims he was severely bullied at several different schools around Belleville, MI, for his gender identity — and now has filed suit. His lawyer, James Rasor, told the local Fox affiliate that the boy was verbally taunted, physically beaten, and forced to use his birth name. "This case is about changing the playing field for LGBT youth in schools," the lawyer said. "This is so that all kids can go to school and get an atmosphere free from bullying so that they can learn and maximize their potential." Rating: Very Bad
Michigan got our first “very bad” ranking for its transgender rights: There are no statewide laws banning discrimination based on gender identity in work or school, and few protections in any other areas. Total: 27/100

One of the most basic but important steps in a trans person’s transition is changing their name and gender on official documents. But, the steps required to get that done vary from state to state, with some presenting strange obstacles. A North Dakota statute requires trans people to present documented evidence of a “sex conversion operation,” in the form of an affidavit from a doctor, along with a court order — at which point the new birth certificate shall be issued and the old one “shall be then placed in a special file.” However, North Dakota is not one of the several states that outright ban a change. Rating: Very Bad
One of our four criteria — community — takes into account things like this: Are the state’s laws sympathetic to an ordinary transgender person, or seemingly designed to make something like a document change challenging? ND seems like the latter. Total: 20/100

Missouri includes gender identity in its hate-crime laws — but that’s pretty much it. However, there have been some small but encouraging stories of progress throughout the state. The University of Missouri just announced that its main campus in Columbia will start offering gender-neutral housing for nonconforming students. And, The Advocate reported last year on a trans elementary student whose transition was handled with comparative grace by his school’s administrators. Parents "received a letter Friday informing them that one of the students — formerly known as Adam — was transgender, and would be returning to school as a girl who wanted to be known by a different name from that point forward. The letter also included a note apparently intended to discourage bullying, reminding students to treat everyone ‘as they would like to be treated.’” Rating: Very Bad
Missouri’s hate-crime law — noted above — is a nice exception to the state’s otherwise lacking protections. Total: 20/100

The one highlight of reading about the state’s transgender rights is reading about the groups that are tirelessly fighting for them. Next week, on March 10, Tennessee Equality Project is organizing its Advancing Equality Day on the Hill, when activists will gather in Nashville to meet with elected officials and advocate for LGBT equality — for the 11th year running. Rating: Very Bad
The first state to get zeroes in three categories (work and school, safety, and community), Tennessee also gets the dubious distinction of being the first on our list where state documentation simply can’t be changed. Total: 18/100

Utah recently tried to enact a similar bathroom law to those cropping up in other states. State House member Mark Kennedy’s bill aims to prevent students — in the bill’s language — from using a bathroom “that does not correspond to the student's phenotype.” Rep. Kennedy told a local newspaper that he’d read about legislation in California that would let students use the bathroom for the gender they identify with, and was just trying to protect Utahans from the same fate. Rating: Very Bad
Utah’s pretty much a long list of zeroes: no housing or employment protection on the basis of gender identity, nor any insurance or hospital laws preventing anti-trans discrimination. The state allows document changes, but only with a court order. Total: 18/100

Some good news out of a not-too-highly-ranking state: In January, newly elected Governor Tom Wolf announced his cabinet, naming as physician general Dr. Rachel Levine. If she’s confirmed by the state senate, Dr. Levine will become the highest-ranked transgender woman in Pennsylvania state-government history. In addition to her work as a doctor, Levine is also on the board of a LGBT advocacy group, Equality Pennsylvania. Rating: Very Bad
Lacking most basic legal protections for trans people, Pennsylvania is the second-worst-ranking Northeastern state, just a few notches above New Hampshire. Total: 17/100

In states like Texas, which doesn’t have LGBT anti-discrimination laws, trans people have often sought protection under federal law. In July of 2014, a Texas woman, Leyth O. Jamal, filed a sex-discrimination lawsuit against her employer, Saks Fifth Avenue in Katy, TX. Jamal says she was forced to use the men’s bathroom, and was mocked by co-workers who insisted on using male pronouns, before being fired. Saks’ particularly terrible response? They have the right to discriminate against her, since “transsexuals are not a protected class under Title VII” of the Civil Rights Act of 1964. That’s far from true: The Equal Employment Opportunity Commission ruled in 2012 that Title VII forbids anti-trans discrimination, and court decisions have been mixed. (Also, "transsexuals"? Come on, Saks.)

Rating: Very Bad
In keeping with its reputation as the epicenter of American conservatism, Texas lacks most basic legal rights for trans Americans. But, the state is also home to more liberal cities; Dallas, for example, passed a city law banning discrimination based on gender identity or expression. Total: 17/100

A significant step in a person’s transition is getting consistent, legal affirmation of their correct identity through the changing of legal documents such as birth certificates and passports. Of course, every state has different barriers, and some have no laws one way or the other.
Last year marked a milestone in Indiana, when a court of appeals gave a trans man a new (correctly gendered) birth certificate. “The 26-year-old applicant will now have legal documents that consistently identify his gender with an ‘M,’” wrote Zack Ford at Think Progress, “which could very well protect him from being profiled as suspicious or denied access to various government services.” It's worth nothing the process, while ultimately successful, took over 18 months. Rating: Very Bad
Like many of the states on this portion of the list, Indiana lacks legal protections for trans people in work and school, and has no gender-identity-inclusive hate-crime or bullying laws. Total: 17/100

Of all the “bathroom laws” we’ve seen — and they’re popping up in states across the country — this one might be the worst. In January of this year, a Kentucky state senator filed a bill to make schools offer “separate, private areas designated for use by students based on their biological sex.” And, the kicker? The law also says that if students see a non-cis person in their bathroom, they can sue the school for $2,500. The Senate passed the bill in late February, and it now heads to the House. Rating: Very Bad
With proof of surgery provided, a trans Kentuckian can have their documents changed. In terms of rights for trans folks, that’s pretty much it. Total: 16/100

One place where New Hampshire is doing well is in protecting its trans students: A 2010 revision to its anti-bullying law includes gay and trans youth. Advocacy group GLAD called it “one of the strongest” in the country. In 2013, perhaps as a sign the laws are working, a trans teen won homecoming king at his Concord, NH high school. Rating: Very Bad
New Hampshire is the only New England state that doesn’t have a nondiscrimination law that pertains to gender identity, although it does have laws protecting individuals based on sexual orientation, gender, race, creed, marital status, and disability. The state also lost big points for its lack of trans-friendly healthcare options. Total: 16/100

Florida is home to a fantastic trans ally. In November 2014, Congresswoman Ileana Ros-Lehtinen, a Republican, came out publicly in support of her transgender son, Rodrigo. “As parents, we wanted to make sure that Rigo understood that we’re totally fine with it...we wanted to make sure that he was safe,” she said, in a televised interview. Ros-Lehtinen is a history-maker in her own right as the first Cuban-American woman to be elected to Congress. Rating: Very Bad
A number of cities and towns in the third most populous state have individual ordinances banning discrimination based on gender identity, but there are no statewide bills protecting workers or students. Total: 15/100 A Florida bill that would make it a crime to use a bathroom that doesn’t match your birth gender is currently gaining traction in that state — R29 is teaming up with the ACLU to stop it. Learn more here.

Throughout this survey, small islands of progress pop up in the most unlikely places. Like in Little Rock, the capital of deeply conservative Arkansas. Last November, Police Chief Kenton Buckner announced a new set of guidelines to improve how his department treats gender-nonconforming folks. The guidelines mandate that officers call people by their chosen names and prohibit offensive language, as well as asks departments to educate themselves about trans issues. Policing is an area in need of guidelines like these: A national study from 2012 found that trans people experience more than three times as much police violence as cisgender people.

Rating: Very Bad
Arkansas got a 3/30 for non-discriminatory and trans-friendly health care — one of the lowest scores on our list. Total: 15/100

The people of Appleton, WI, a city of about 70,000, recently elected their first trans city council member — and the first openly trans person to hold office in Wisconsin. The councilman, Gypsy Vered Meltzer, for his part, is just trying to focus on his job: “I’m focused on the issues rather than myself, and look forward to the day when this isn't as interesting of a topic," Meltzer told a local paper. "It's important to get more young people involved in politics. As someone who's part of various subcultures, I want to show everyone that the door's open — come on in and be part of local government.”
Rating: Very Bad
Like most states near it on this list, Wisconsin has no statewide anti-discrimination bill covering trans people at work or school, nor does it include gender identity in its hate-crime legislation. Total: 14/100

Compared to issues such as hate-crime bills and employment laws, bathroom discrimination can seem minor, but often, it’s the quotidian difficulties that can be the most wearing for trans people. In 2013, Arizona became one of a number of states that tried to pass a law concerning bathroom use: State Senator John Kavanagh (then an Arizona House member), introduced a bill that would make it a crime for transgender people to use the bathroom that matches their gender identity. The bill briefly became national news, prompted backlash from trans-rights organizations, and was eventually back-burnered — hopefully for good. Rating: Very Bad
Like most states in this portion of the list, Arizona offers virtually no legal protections for its trans community. Total: 14/100

One of the challenges in creating a survey like this is accounting for all the instances in daily life when gender-nonconforming people encounter discrimination. One — which didn’t make our official criteria, but matters nonetheless — is sports. Virginia’s High School League just voted unanimously to let kids play on teams that match their chosen gender — joining at least 10 other states with similar policies. "It is a reality that there are transgender students who are interested in participating in athletics," Ken Tilley, the organization’s executive director, told The Richmond Times-Dispatch. While this move is well-intentioned, it’s got some big flaws: It’s only open to students who’ve undergone complete sex reassignment surgery — something not all trans people want, but also something even fewer will have the resources and support to complete in high school. Students must compete in the gender on their birth certificate — and the state only grants birth-certificate changes to those who’ve undergone the medical procedure of sex reassignment.

Rating: Very Bad
While the Commonwealth of Virginia has no anti-discrimination policies for lesbian, gay, bisexual, and transgender people, there’s one bright spot: The state’s governor, Terry McAuliffe, signed an executive order in January 2014 prohibiting discrimination based on gender identity and sexual orientation for state employees. Total: 14/100

At many U.S. universities, trans students have two housing options: live with the wrong gender or find your own place. But, next fall, the University of Nebraska-Lincoln will start offering gender-neutral housing. (Schools like NYU and American University already do.) They’re starting small — with just a couple suites — but it’s a big, symbolic step toward making gender-nonconforming students feel like they belong. “This is all about what those students need to be successful at UNL,” UNL director of housing administration Sue Gildersleeve told the Omaha World-Herald. “We want to do what we can in housing to provide an environment for them to have that success, just like any other student.” Rating: Very Bad
The City of Omaha protects its residents against employment discrimination on the basis of gender identity, but that’s pretty much the only place in the state you’ll find such protections. Total: 13/100

Stories of abuse and mistreatment of trans prisoners are common — like this sadly typical incident from Georgia. In May 2014, the Southern Poverty Law Center issued a formal complaint to the Georgia prison system for refusing hormones to a trans inmate. Ashley Diamond, who went to prison in 2012, had been on hormones for over 15 years when they were refused to her, and she suffered medical consequences as a result. Diamond, who compared her treatment to refusing to give a diabetic insulin, has experienced “physical illness, depression, and suicidal thoughts” since her incarceration, according to the SPLC. Rating: Very Bad
If it weren’t for Atlanta, where a city ordinance prohibits discrimination on the basis of gender identity, Georgia would be even lower on this list. Total: 12/100

Everyone hates the DMV, but for trans Americans, it can be especially nightmarish. Two women in West Virginia recently tried to change their pictures and genders on their licenses. It didn’t go well: "[A manager] told me it was a DMV policy that people listed as male could not wear makeup," Kristen Skinner, one of the women, told CNN. "The manager referred to me as 'it' and told me to take off my makeup, wig, and fake eyelashes." Skinner, along with another woman, went to The Transgender Legal Defense & Education Fund for help — but state law doesn’t make it easy. To change a birth certificate, West Virginia requires a court order or a notarized doctor’s note proving sexual-reassignment surgery. Rating: Very Bad
Like its neighbors on the list, West Virginia doesn’t have much in the way of legal protection or rights for trans people — outside of a few towns with specific protections, like Charleston and Harpers Ferry. Total: 12/100

In Oklahoma, there are lawmakers actively fighting trans equality. One judge, Bill Graves, has twice tried to prevent trans people from changing their names, calling their efforts “fraudulent.” “[B]ased on the scientific evidence of DNA, a sex change cannot make a man a woman or a woman a man,” Graves wrote in a November 2012 ruling, as reported by the AP. Fortunately, Graves’ decisions have both been overruled by an appeals court. Unfortunately, these stories underscore just how much of an ordeal it can be for trans people in the state to have their chosen identity legally validated. Rating: Unacceptable
Across the board, Oklahoma offers zero or next-to zero support for transgender individuals when it comes to seeking employment, housing, or access to education and health care. Total: 12/100

Our focus in this survey was livability — daily life and its challenges for trans people. Sadly, the reality of anti-trans crimes is shocking. Last June, three people were arrested in Louisiana for allegedly keeping a trans woman chained up at their home. The details of the torture she reported are difficult to comprehend, including beatings, punishment, and being forced to sleep in a 3-by-5 wooden box. It’s not clear that the victim’s gender identity was related to her abuse, but if it were, it wouldn’t be covered by Louisiana’s hate-crime law. Rating: Very Bad
Except for the ordinances in New Orleans and Shreveport, Louisiana has no protections for transgender people (and few for lesbians, gays, and bisexuals) in employment, schools, or housing. Total: 12/100

Sometimes, the letter of the law matters less than the attitude and tolerance of whoever’s sitting behind the desk. Last year, a teenager in South Carolina says an official at the DMV forced him to remove his makeup so he’d look more masculine before taking a photo for his driver’s license. Chase Culpepper, 16, is gender-nonconforming, and while he wears makeup and has long hair, he still uses male pronouns. The issue at the DMV that day wasn’t legal — it was lack of sensitivity and education on the part of the people working there. Culpepper wasn’t trying to change his gender marker (which requires quite some legal hoop-jumping in SC) — only to have an ID that reflects the way he looks.

Rating: Very Bad
When it comes to seeking employment, housing, or access to education and health care, transgender people strike out in South Carolina. Total: 10/100

Even in South Dakota, where state laws leave trans people high and dry, there has been success in fighting discrimination on the federal level. In 2013, a transgender woman named Cori McCreery won a historic settlement. McCreery was fired from her job after coming out to her boss and announcing her intention to transition. Her case was supported by Lamda Legal, which helped her win a $50,000 settlement for wrongful termination, backed by the Equal Employment Opportunity Commission. The EEOC is a federal agency that enforces anti-discrimination laws with regard to employment, and has included gender identity policy since 2012. Rating: Unacceptable
Like last-place finisher Mississippi, South Dakota lacks basic protections in all categories. The state only avoids last place by having a slightly higher percentage of its population with access to health care with anti-discrimination laws. Total: 10/100

The entire country followed the heartbreaking story of the death of Ohio teen Leelah Alcorn late last year. Alcorn, who was 17, committed suicide by stepping into oncoming traffic after her parents told her they would refuse to acknowledge her transition. Alcorn left a note on her Tumblr, set to go live after she died. “Please don't be sad, it's for the better,” it reads. “The life I would've lived isn't worth living in… because I'm transgender.” Leelah also talked about her terrible experience with “conversion therapy” — the usually religiously motivated practice of trying to make gay and trans people straight or gender-conforming. Gay-rights activists have compared the practice to torture, but it’s only banned in New Jersey, California, and Washington D.C. But, Alcorn’s death ignited a movement; a White House petition for “Leelah’s Law,” banning conversion therapy, has received over 100,000 signatures, and a growing number of states are introducing legislation to halt the practice. Rating: Very Bad
Several cities in Ohio (including Cleveland and Cincinnati) have some degree of discrimination protection for trans people, but there’s no state law. It’s also one of just a few states to flatly disallow gender-marker changes on state IDs. Total: 9/100

When laws don’t respect a person’s true identity, the damage can be far-reaching — even after death. Jennifer Gable, a trans woman from Boise, died at age 32. Friends who attended her funeral were faced with a surprise. Though Gable had lived openly as a woman for years, she lay in her casket dressed and styled to look as she did before her transition. Friends told The Idaho Statesman that she was never once referred to by her chosen name, Jennifer, in the ceremony — and her obituary used a picture from when she presented as male. The decision to bury Jennifer as a man seems to have come from her surviving kin, but it was made possible by Idaho’s law: The state will allow a person to change their name, but flatly rejects gender-marker changes. Rating: Unacceptable
There are nine cities in Idaho that include gender identity in their local anti-discrimination policies. But, on a statewide level, Idaho still sits near the bottom of this list — for its lack of statewide laws protecting trans people and for its outright ban on document changes. Total: 9/100

Alaska is in the bottom 10, but there has been some slow, creeping progress over the years. Lawmakers in the capital are making another attempt to pass laws that prohibit discrimination against gay, lesbian, bisexual, and transgender people — after previous attempts have failed. And, in a small step forward, the state stopped requiring proof of surgery from people trying to change their gender marker on their state IDs in 2012 — now only requiring a much less onerous certification from a doctor or counselor. Rating: Unacceptable
For its across-the-board lack of legislative initiative when it comes to transgender identity, Alaska sits low on this list. Total: 8/100

While some states march forward, Kansas is heading backward. In February, the state’s Republican governor Sam Brownback issued an executive order to get rid of discrimination protections on the basis of gender identity and sexual orientation. His predecessor, Democrat Kathleen Sebelius, signed the initial legislation in 2007. “Any such expansion of ‘protected classes’ should be done by the legislature and not through unilateral action," he said in a statement. Brownback’s move paves the way for continued discrimination in Kansas. Rating: Unacceptable
Across the board, Kansas offers zero support for transgender individuals when it comes to employment, housing, or education, and little by way of protected health care. Total: 8/100

Even in the states with the lowest scores, we can find people fighting for change. In 2009, in Mobile, AL, Lane Brock Galbraith founded LGBT Waves of Hope to advocate for gay, lesbian,and trans rights. Galbraith, a veteran, was living as a woman and identified as a lesbian. About five years later, he announced his desire to live as a man. “I wanted to tell somebody,” Galbraith said in an interview with The Washington Blade. “I work for this community [to] who[m] I constantly say, 'Live your truth.' So, I had to speak mine.” Galbraith and his group continue to hold educational meetings and advocacy sessions out of his house in Mobile.
Rating: Unacceptable
Alabama seems to be fighting tooth and nail to prevent marriage equality for gay couples, so it may not be surprising to learn that trans rights are even further behind. Total: 8/100

Every state, no matter how conservative, has its oasis. For Wyoming, which has no protections for trans people, it’s Jackson Hole, a liberal skiing town that is becoming a refuge for people who don’t conform to set gender roles. In May of 2014, the town council officially added LGBT discrimination protections to its employment policy. While the measure passed unanimously in Jackson, nowhere else in Wyoming has similar legislation. Rating: Unacceptable
Outside the single town of Jackson, basic rights — anti-discrimination laws at work, anti-bullying laws in school, and hate-crime legislation — are missing. Total: 8/100

The Big Sky state is pretty closed-minded when it comes to the rights of transgender people. A move by the state’s high school sports governing body to allow kids play on teams that match their chosen gender identity got shelved early this year. Opponents voiced familiar worries about locker rooms and infringing on local schools’ rights before board members decided the proposed policy didn’t have enough votes to pass. Rating: Unacceptable
Montana has a small smattering of anti-discrimination ordinances (including in Helena and Butte) that include gender identity, but nothing statewide. On employment and health care, the state earns straight zeroes. Total: 7/100

Mississippi is, perhaps expectedly, our last-place finisher. The ultra-conservative state is among those still actively putting anti-LGBT laws on the books — just last year, the governor signed into law a “religious freedom” bill that many see as legalizing discrimination. And, the state is home to the headquarters of vehemently anti-LGBT rights group the American Family Association. But, that doesn't mean there aren't stories that offer a little hope. Last fall, Nick Fulgham and Jessica Elliot were legally married in Mississippi — causing controversy since Nick is trans. He was legally declared a male earlier that year — and since MS law so clearly defines marriage as between a man and a woman, the couple's license was granted. Of course, the American Family Association instantly posted an article on their site accusing the couple of "biological fraud." The post explains,"Two lesbians getting married could not possibly be more illegal and unconstitutional anywhere in the United States than in Mississippi." Despite the pushback, the couple sounds happy. "Everyone has been fantastic," Jessica told a local outlet. "Nick and I love and stand behind each other, and will do whatever we have to so that we ensure our rights and prove we did everything legally. We aren't second-class citizens; we are people just like everyone else." Rating: Unacceptable
In our final list of criteria, Mississippi’s got a lot of zeroes: no hate-crime laws or anti-discrimination bills — and little or nothing in the rest of our categories. Total: 6/100
Want to read more stories about the lives and rights of transgender Americans? Check out our full Trans America series here.