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 Massachusetts, there are no 'bathroom bills' that have been passed into law that restrict access to multiuser restrooms and locker rooms on the basis of biological sex. The state has laws and policies that protect the rights of transgender individuals to use facilities consistent with their gender identity. For instance, the Massachusetts Public Accommodation Law prohibits discrimination on the basis of gender identity in public places, which includes access to restrooms and locker rooms. Additionally, the Massachusetts Department of Elementary and Secondary Education has issued guidance that supports the right of transgender students to use facilities that correspond to their gender identity. While the ruling from the United States Court of Appeals for the Third Circuit is not binding in Massachusetts, as it is outside of the Third Circuit's jurisdiction, it aligns with the inclusive approach Massachusetts has taken regarding the rights of transgender individuals in public accommodations.