In recent years, a number of state legislatures considered bills that would restrict access to multiuser restrooms, locker rooms, and other sex-segregated facilities (bathroom bills) on the basis of a definition of sex or gender consistent with sex assigned at birth—also known as biological sex. In nearly every state the proposed legislation was not passed and did not become law.

A recent ruling from the United States Court of Appeals for the Third Circuit (in Philadelphia) allowed transgender students to use bathrooms and locker rooms that are consistent with the students' gender identities, as opposed to the sex they were determined to have at birth. The plaintiffs—a group of high school students who identify as being the same sex they were determined to have at birth (cisgender)—alleged that the school’s bathroom and locker room policy violated their constitutional rights of bodily privacy, as well as Title IX, and Pennsylvania tort law.

The Third Circuit Court of Appeals determined that the presence of transgender students in the locker and restrooms is no more offensive to Constitutional or Pennsylvania privacy law interests than the presence of the other students who are not transgender, and that their presence does not infringe on the plaintiffs' rights under Title IX. This ruling from the Third Circuit Court of Appeals is the law in a limited geographic area, as the United States Supreme Court declined to hear the case.

In Iowa, there has been no recent legislation passed that restricts access to multiuser restrooms, locker rooms, and other sex-segregated facilities based on biological sex. The state has not enacted 'bathroom bills' that define access to these facilities on the basis of sex assigned at birth. The ruling from the United States Court of Appeals for the Third Circuit, which is not binding in Iowa as it falls under a different circuit, upheld the rights of transgender students to use facilities consistent with their gender identity. This ruling also found that the presence of transgender students in such facilities does not violate the constitutional rights of bodily privacy or Title IX protections of cisgender students. While this sets a precedent, it is not directly applicable in Iowa unless the Eighth Circuit Court of Appeals, which covers Iowa, or the United States Supreme Court, decides similarly in a case that would affect Iowa law.