[3] In 2004, it became the first U.S. state to grant marriage licenses to same-sex couples after the decision in Goodridge v. Department of Public Health, and the sixth jurisdiction worldwide, after the Netherlands, Belgium, Ontario, British Columbia, and Quebec.

[4] State law bans discrimination on the basis of sexual orientation and gender identity in employment, housing, public accommodations, credit and union practices.

In addition, same-sex couples are allowed to adopt, and transgender people may change their legal gender without undergoing sex reassignment surgery.

[8] Massachusetts has still not legislatively repealed its defunct sodomy ban, and the common-law gay panic defense usage within the state courts, as of December 2024; despite being regarded as a Democratic Party stronghold.

[9][10] In Commonwealth v. Balthazar, in 1972, the Massachusetts Supreme Judicial Court ruled that the statute which prohibited "any unnatural and lascivious act with another person" was inapplicable to "private, consensual conduct of adults".

[18] Presently, Massachusetts does not restrict private sexual behavior between consenting adults, as these laws are permanently enjoined by Commonwealth v. Balthazar and Lawrence v. Texas.

In January 2024, a bill unanimously passed the Massachusetts Senate to repeal the archaic 400 year old laws criminalizing gay sex.

[21] On July 26, 2012, the SJC ruled in Elia-Warnken v. Elia that the state recognizes a civil union established in a different jurisdiction as the equivalent of marriage.

[24][25] The state rescinded those regulations in April 1990 as part of an out-of-court settlement of a suit brought by Gay & Lesbian Advocates & Defenders (GLAD) and the American Civil Liberties Union (ACLU), following a five-year campaign by an ad hoc group formed around the issue, Foster Equality.

[31] In March 2006, Catholic Charities of Boston announced it would no longer provide adoption services because it could not comply with Massachusetts law prohibiting discrimination against homosexuals.

[32] In February 2011, Massachusetts Health Commissioner John Auerbach announced plans by the end of March to standardize birth certificates, formerly designed by each city or town, by providing hospitals with electronic forms with fields labeled "mother/parent" and "father/parent".

"[33] On August 1 2024, the Massachusetts General Court unanimously passed a bill to recognise and implement legal parentage from both IVF and surrogacy - regardless of marital status.

[45][46] In October 2016, however, anti-transgender activists submitted the minimum number of signatures necessary, to the Secretary of the Commonwealth, to put the law up for repeal on a statewide ballot measure.

In June 2012, on instructions from Worcester's Roman Catholic Bishop Robert McManus, diocesan officials declined to sell a property owned by the diocese to a same-sex couple and in July lied about what happened when questioned about the sale.

[53][54] In August 2024, a bill officially passed the Massachusetts General Court (the state Legislature) to prevent discrimination of LGBTI individuals within nursing homes.

[56] The state defines a hate crime as "any criminal act coupled with overt actions motivated by bigotry and bias, including, but not limited to, a threatened, attempted or completed overt act motivated at least in part by racial, religious, ethnic, handicap, gender or sexual orientation prejudice, or which otherwise deprives another person of his constitutional rights by threats, intimidation or coercion, or which seek to interfere with or disrupt a person's exercise of constitutional rights through harassment or intimidation.

[65][66] In September 2021, the Massachusetts Senate passed a bill to allow gender X (alongside male and female) on an individual's birth certificate.

[69][70][71] In October 2020, Boston Children's Hospital announced they would stop performing clitoroplasties and vaginoplasties in intersex infants without meaningful conversation and consent from the child.

An engrossed bill was enacted on April 4, 2019, and awaited consideration by Massachusetts Governor Charlie Baker, who indicated he was "inclined to support" such legislation.

[80] According to a 2017 Public Religion Research Institute (PRRI), 80% of Massachusetts residents supported same-sex marriage, whereas 13% were opposed and 7% were undecided.