Skip to content
Search

Latest Stories

Top Stories

Anti-LGBTQ+ policies harm the health of not only LGBTQ+ people, but all Americans

Opinion

Anti-LGBTQ+ policies harm the health of not only LGBTQ+ people, but all Americans

Courts across the nation are debating whether LGBTQ+ people should be protected from discrimination.

In 2024, state legislatures introduced an all-time record of 533 bills targeting LGBTQ+ populations. These policies create a patchwork of legal landscapes that vary widely between and within states, affecting aspects of everyday life ranging from how kids learn and play to where adults live and work.

All of these policies have implications for the health of not only LGBTQ+ people but also the general public.


I am a health policy researcher who studies how state and federal legislation affect public health. Research has shown that the social determinants of health – the opportunities and resources that affect how people live, learn, play, work and age – play a significant role in LGBTQ+ well-being. Newly published work from my colleagues and I show how anti-LGBTQ+ public policies can have lasting effects on everyone’s health.

Existing policies and LGBTQ+ health

Same-sex marriage provides a clear example of the direct and indirect ways public policies affect LGBTQ+ health.

Most people in the U.S. have health insurance through their employer, which usually offers coverage for employees and their family, including a spouse and children. A landmark 2015 study found that health coverage significantly increased for adults in same-sex marriages after its legalization in New York state. After same-sex marriage was legalized nationwide, a follow-up study also showed an increase in health insurance coverage among gay and lesbian couples.

Even among single LGBTQ+ people who did not get married, same-sex marriage may have also improved their health by improving social attitudes toward LGBTQ+ people overall. Researchers found that gay and bisexual men, regardless of whether they were single or married, spent less on medical visits, mental health visits and overall health care spending after Massachusetts legalized same-sex marriage in 2004.

Understand new developments in science, health and technology, each week
Get the newsletter Massachusetts was the first state to legalize same-sex marriage. Victoria Arocho/AP Photo

Access to gender-affirming care provides another example of how public policies affect the health of LGBTQ+ people.

A 2020 national study of nearly 30,000 transgender and nonbinary people found that suicide attempts and mental health hospitalizations declined in states that passed policies requiring private insurers to equally cover services they already provide for cisgender people for transgender people. No other studies directly analyze how policies regulating access to care affect the health of trans and nonbinary people.

However, a large body of clinical research supports the health benefits of gender-affirming care. A randomized clinical trial and prospective study found that starting gender-affirming hormone therapy reduced depression and suicidality in transgender and nonbinary people. Several recent systematic reviews analyzing 124 peer-reviewed studies conducted over the past 50 years also found that gender-affirming surgery and hormone therapy improved quality of life and mental health.

Policies outside health affect LGBTQ+ well-being

Policies outside of health care – such as nondiscrimination, education and workplace protections – also affect LGBTQ+ well-being.

For example, transgender and nonbinary people living in states with policies that specifically include gender identity in hate crime and discrimination protections reported better mental health than those in states without protections. Similarly, LGBTQ+ students in schools with designated safe spaces reported lower rates of suicidal thoughts.

However, the surge in anti-LGBTQ+ policies in the U.S., initially focusing on youth, has significantly increased polarization between and within states. For example, while 17 states have implemented guidances to make schools safer and more inclusive for transgender youth, 25 states have banned transgender youth from using bathrooms and playing on sports teams that align with their gender. Meanwhile, South Dakota and Missouri have enacted laws to preempt progressive schools and districts from adding LGBTQ+ student protections and supportive resources.

The Trump administration is also actively targeting resources that support LGBTQ+ students by reducing funding to schools that offer these programs.

Inclusive spaces can help support the health of LGBTQ+ students. Jessica Hill/AP Photo

In 2020, the Supreme Court ruled 6-3 in Bostock v. Clayton County that federal sex-based nondiscrimination protections in the workplace included discrimination based on gender identity and sexual orientation. Researchers found that LGBTQ+ older adults with co-workers supportive of their gender and sexuality experienced less workplace conflict and cognitive health problems compared with those who did not.

The Trump administration is working to restrict the scope of federal antidiscrimination protections to exclude LGBTQ+ people.

Harms of emerging anti-LGBTQ policies

Emerging anti-LGBTQ+ policies could also have consequences for large swaths of the population beyond LGBTQ+ people.

In 2025, the Supreme Court will hear Braidwood v. Becerra, a case arguing that requiring employers to cover PrEP – a once-a-day pill that is highly effective at preventing HIV infection – as part of the insurance plan they offer employees violates their religious freedom. Texas District Judge Reed O’Connor agreed that mandating PrEP coverage requires the plaintiffs to “facilitate and encourage homosexual behavior.”

O'Connor ruled in 2023 to overturn the Affordable Care Act’s requirement that insurers fully cover preventive care. He argues this can be done on the grounds that the U.S. Preventive Services Task Force – a group of physicians and researchers that evaluates the quality and efficacy of preventive services – is unconstitutional. This legal challenge puts free coverage of mammograms, vaccinations and other preventive services into limbo for millions of Americans.

The Trump administration has taken down CDC pages providing information about HIV.

The Trump administration has scrubbed federal web pages of resources, programs and documents that reference gender and LGBTQ+ people. This order includes removing datasets that have been continuously updated since the 1980s to track public health issues such as homelessness, bullying in schools, and smoking and drinking, likely because they include LGBTQ+ demographic information.

The administration has also ordered federal health agencies to retract scientific research that may be inclusive of LGBTQ+ people by searching for specific keywords, such as “gender.” The National Science Foundation is also screening active scientific research projects that use words like “women,” “trauma” and “disability.” Removing this data not only hamstrings public health research and programming for LGBTQ+ populations, but also restricts it for all Americans.

These decisions are in stark contrast to countries such as England, Wales, New Zealand and Australia, which have collected or are planning to collect LGBTQ+ demographic data as part of their national census. Including LGBTQ+ people in demographic data reflects best practices that were outlined in the Federal Evidence Agenda on LGBTQI+ Equity issued under the Biden administration. These guidelines have since been removed.

Far-reaching consequences

The rapid escalation of anti-LGBTQ+ policies in recent years is already taking its toll on youth, with negative news coverage of LGBTQ+ issues causing spikes in suicidal thoughts.

These policies also have far-reaching consequences for the broader public. Rigorous and long-standing research demonstrates that LGBTQ+-inclusive policies support safer communities and stronger economies for everyone, while exclusionary laws worsen and limit access to essential services.

Ongoing legal battles and policy shifts will shape the future of LGBTQ+ rights, with rippling effects on public health, workplace protections and health care access for all Americans.

Anti-LGBTQ+ policies harm the health of not only LGBTQ+ people, but all Americans was originally published by The Conversation and is shared with permission.

Dr. Tran is an Assistant Professor of Health Policy and Administration (HPA) in the School of Public Health at the University of Illinois at Chicago.

Read More

Yes, They Are Trying To Kill Us
Provided

Yes, They Are Trying To Kill Us

In the rush to “dismantle the administrative state,” some insist that freeing people from “burdensome bureaucracy” will unleash thriving. Will it? Let’s look together.

A century ago, bureaucracy was minimal. The 1920s followed a worldwide pandemic that killed an estimated 17.4–50 million people. While the virus spread, the Great War raged; we can still picture the dehumanizing use of mustard gas and trench warfare. When the war ended, the Roaring Twenties erupted as an antidote to grief. Despite Prohibition, life was a party—until the crash of 1929. The 1930s opened with a global depression, record joblessness, homelessness, and hunger. Despair spread faster than the pandemic had.

Keep ReadingShow less
Millions Could Lose Housing Aid Under Trump Plan

Photo illustration by Alex Bandoni/ProPublica. Source images: Chicago History Museum and eobrazy

Getty Images

Millions Could Lose Housing Aid Under Trump Plan

Some 4 million people could lose federal housing assistance under new plans from the Trump administration, according to experts who reviewed drafts of two unpublished rules obtained by ProPublica. The rules would pave the way for a host of restrictions long sought by conservatives, including time limits on living in public housing, work requirements for many people receiving federal housing assistance and the stripping of aid from entire families if one member of the household is in the country illegally.

The first Trump administration tried and failed to implement similar policies, and renewed efforts have been in the works since early in the president’s second term. Now, the documents obtained by ProPublica lay out how the administration intends to overhaul major housing programs that serve some of the nation’s poorest residents, with sweeping reforms that experts and advocates warn will weaken the social safety net amid historically high rents, home prices and homelessness.

Keep ReadingShow less
Trump’s Ultimatums and the Erosion of Presidential Credibility

Donald Trump

YouTube

Trump’s Ultimatums and the Erosion of Presidential Credibility

On Friday, October 3rd, President Donald Trump issued a dramatic ultimatum on Truth Social, stating this is the “LAST CHANCE” for Hamas to accept a 20-point peace proposal backed by Israel and several Arab nations. The deadline, set for Sunday at 6:00 p.m. EDT, was framed as a final opportunity to avoid catastrophic consequences. Trump warned that if Hamas rejected the deal, “all HELL, like no one has ever seen before, will break out against Hamas,” and that its fighters would be “hunted down and killed.”

Ordinarily, when a president sets a deadline, the world takes him seriously. In history, Presidential deadlines signal resolve, seriousness, and the weight of executive authority. But with Trump, the pattern is different. His history of issuing ultimatums and then quietly backing off has dulled the edge of his threats and raised questions about their strategic value.

Keep ReadingShow less
From Fragility to Resilience: Fixing America’s Economic and Political Fault Lines

fractured foundation and US flag

AI generated

From Fragility to Resilience: Fixing America’s Economic and Political Fault Lines

This series began with a simple but urgent question: What’s gone wrong with America’s economic policies, and how can we begin to fix them? The story so far has revealed not only financial instability but also deeper structural weaknesses that leave families, small businesses, and entire communities far more vulnerable than they should be.

In the first two articles, “Running on Empty” and “Crash Course,” we examined how middle-class families, small businesses, and retirees are increasingly caught in a web of debt and financial uncertainty. We also examined how Wall Street’s speculative excesses, deregulation, and shadow banking have pushed the financial system to the brink. Finally, we warned that Donald Trump’s economic agenda doesn’t address these problems—it magnifies them. Together, these earlier articles painted a picture of a system skating on thin ice, where even small shocks could trigger widespread crisis.

Keep ReadingShow less