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 Pennsylvania, there has been consideration of 'bathroom bills' that would restrict access to multiuser restrooms and locker rooms based on biological sex at birth, but such legislation has not been passed into law. A significant legal development occurred with a ruling from the United States Court of Appeals for the Third Circuit, which has jurisdiction over Pennsylvania. This court ruled that transgender students are allowed to use bathrooms and locker rooms consistent with their gender identities. The ruling came after cisgender students filed a lawsuit claiming that their constitutional rights and Title IX protections were violated by the presence of transgender students in sex-segregated facilities. The Third Circuit found that the inclusion of transgender students does not violate constitutional privacy rights or Title IX. This decision stands as the law within the Third Circuit's jurisdiction, which includes Pennsylvania, as the U.S. Supreme Court declined to review the case.