When Parents Disagree on Gender-Affirming Care in Illinois

 Posted on October 30, 2025 in Family Law

As discussions regarding gender identity and gender-affirming care grow in intensity across the nation, Illinois has emerged as a state that explicitly protects access to gender-affirming care. Those same protections, however, can create difficult legal questions when divorced or separated parents disagree about treatment for their minor child. Under Illinois family law, decision-making authority over medical care is determined in parenting plans or under the allocation of parental responsibility (750 ILCS 5/602.7) judgments.

Despite this, disputes over gender-affirming therapy, puberty blockers, or social transition test the limits of parental rights and the child’s best interests. Should you find yourself in such a position, being aware of the evolving legal protections under Illinois law is crucial. An experienced Kane County, IL family law attorney can help you navigate these issues, always looking out for your child’s best interests.

Who Makes Decisions for a Minor in Illinois?

The allocation of parental responsibilities is found under the Illinois Marriage and Dissolution of Marriage Act. Medical decision-making is one of the four primary parental responsibility categories, which include:

• Medical decisions
• Educational decision
• Religious decisions
• Extracurricular activity decisions

Courts may allocate joint decision-making, determining that both parents will work together to make major decisions, or may grant one parent final say. When parents share decision-making, all serious disputes must be resolved through mediation or court intervention. The preferences of older teens may carry some weight in court evaluations under 750 ILCS 5/602.7(a)(2), which discusses the wishes of the child.  

Where Does Illinois Stand on Gender-Affirming Care?

Illinois passed the Gender-Affirming Health Care Protections Act, which shields providers and families from out-of-state enforcement actions that criminalize or restrict gender-affirming care. Gender-affirming care may include social transition support, counseling, hormone therapy, and, in rare cases, surgery. Neighboring states like Indiana and Missouri have bans or parental interference statutes that often conflict with Illinois orders when families relocate or share custody across state lines.

What Happens When Parents Disagree About Gender-Affirming Care for Their Child?

When divorced or separated parents cannot reach an agreement regarding gender-affirming care for their child (assuming the parents share medical decision-making responsibilities), the court may intervene. Courts will prioritize the child’s best interests rather than what either parent wants, although the parents’ wishes will be heard. The court may rely on expert opinions from licensed therapists who specialize in gender identity, endocrinologists, and the child’s primary care doctor.

The court may require parents to participate in mediation to help them work through any disagreements, especially when the child’s well-being is at stake. The child’s age, maturity, and consistency in gender identity expression will be taken into consideration, and evidence of harm or benefit related to affirming or denying treatment will be presented.

How Illinois’ "Shield Law" Can Prevent Enforcement of Out-of-State Orders That Seek to Restrict Care

Parents who share the allocation of parental responsibilities must agree on the treatment, or the court will make the final decision. The ultimate goal is to determine what course of action is best for the physical and mental health of the child. Courts must avoid moral or political influence, relying heavily on expert opinions and/or guardian ad litem recommendations.

Illinois’ "shield law" prevents enforcement of out-of-state subpoenas or custody orders seeking to restrict care that is legal in Illinois. If one parent moves to a more restrictive state, Illinois courts may retain jurisdiction to protect access to care. Parents should always avoid vague "joint" clauses. It should be clearly specified which parent has the final say in disputes involving specialized medical care.

Contact a St. Charles, IL Family Attorney

If you and your co-parent disagree about your child’s access to gender-affirming care, the outcome will hinge on the maturity of your child, evolving Illinois law, and the parenting plan in place. These are complex, emotionally charged disputes that require a highly skilled Kane County, IL parenting plan lawyer from Mirabella, Kincaid, Frederick & Mirabella, LLC. MKFM Law serves family law clients at their offices in DeKalb County, DuPage County, and Kane County. Call 630-665-7300 to schedule your initial attorney meeting.