Hawaii

No state law restricts puberty blockers, cross-sex hormones or surgery for minors.

Act 059 (HB 1875, 2026), effective 1 July 2026

As of 13 Oct 2026, Hawaii has not announced whether it will pay for puberty blockers and cross-sex hormones for minors with state money after the federal Medicaid and CHIP cutoff.

42 C.F.R. 441.800–802, 457.476 (91 Fed. Reg. 52406)

State-employee health plans pay for sex-change procedures with taxpayer money.

HMSA Active Benefits – Hawaii Employer-Union Health Benefits Trust Fund (eutf.hawaii.gov)

No state law keeps males out of girls' sports.

No state law identified (statute review, Oct 2026)

No state law keeps males out of women's and girls' bathrooms and changing rooms.

No state law identified (statute review, Oct 2026)

No state law requires schools to tell parents if their child socially transitions at school.

No state law identified (statute review, Oct 2026)

No state law on gender-identity lessons; local school boards decide.

No state law identified (statute review, Oct 2026)

No state law defines male and female by biology.

No state law identified (statute review, Oct 2026)

Birth-certificate sex changed with clinician statement; licence sex changed by self-declaration. 'X' marker offered.

New Birth Certificate for Sex Designation Change – Vital Records (health.hawaii.gov)

This state shields providers and patients from out-of-state investigations and lawsuits over these procedures for minors.

Act 059 (HB 1875, 2026), effective 1 July 2026

No state law restricts adults or public funding for adult sex-change procedures.

No state law identified (statute review, Oct 2026)

No special right for detransitioners to sue.

No state law identified

Initial placement by legal sex, followed by an individualized review.

DCR Policy ADM.08.08 (PREA)

No active bills (checked 13 Oct 2026). The 2026 regular session has adjourned (or the legislature does not meet in 2026), so 2025-26 bills are no longer moving. LegiScan search linked.

LegiScan search, checked 13 Oct 2026 (adjourned legislature)

Plaintiff in Illinois v. HHS (D. Mass., filed 2 Sept 2026) challenging the CMS funding rule.

Complaint, Illinois v. HHS, No. 1:26-cv (D. Mass., filed 2 Sep 2026)

1 July 2026: Act 059 shield expansion took effect.

BILLS ENACTED BY THE HAWAII STATE LEGISLATURE, Regular Session of 2026, as of July 15, 2026 (lrb.hawaii.gov)