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 New Hampshire, there has been no 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. Instead, New Hampshire's laws tend to be more inclusive of transgender rights. For instance, New Hampshire law prohibits discrimination on the basis of gender identity in employment, housing, and public accommodations, which would include restroom access (RSA 354-A). While the ruling from the United States Court of Appeals for the Third Circuit is not binding in New Hampshire, as it falls under the jurisdiction of the First Circuit, it is indicative of a trend in federal courts towards recognizing the rights of transgender students to use facilities that correspond with their gender identity. This ruling also suggests that the presence of transgender individuals in sex-segregated facilities does not violate the constitutional rights of cisgender individuals, nor does it infringe upon rights protected by Title IX.