{"id":634925,"date":"2025-10-03T01:01:00","date_gmt":"2025-10-03T05:01:00","guid":{"rendered":""},"modified":"2025-10-17T17:05:31","modified_gmt":"2025-10-17T21:05:31","slug":"health-policy-101-lgbtq-health-policy","status":"publish","type":"post","link":"https:\/\/www.kff.org\/lgbtq\/health-policy-101-lgbtq-health-policy\/","title":{"rendered":"LGBTQ+ Health Policy"},"content":{"rendered":"<div\n\tclass=\"no-sidebar wp-block-kff-shared-content--blank-slate wp-block-kff-shared-content\">\n\t\n\n<section class=\"wp-block-kff-shared-content-main\">\n\t\t\t\t<div class=\"wp-block-kff-shared-content-main__content__inner\">\n\t\t\n\n<div class=\"wp-block-group has-background is-layout-constrained wp-block-group-is-layout-constrained\" style=\"background-color:#004b87;margin-top:0;margin-bottom:0\">\n<figure class=\"wp-block-image size-large is-resized\" id=\"content\"><img loading=\"lazy\" decoding=\"async\" height=\"292\" width=\"1024\" src=\"https:\/\/www.kff.org\/wp-content\/uploads\/2024\/05\/KFF_SF_Office_Timeline_Norman_22.jpg?w=1024\" alt=\"\" class=\"wp-image-620520\" style=\"object-fit:cover;width:1280px;height:366px\" srcset=\"https:\/\/www.kff.org\/wp-content\/uploads\/sites\/7\/2024\/05\/KFF_SF_Office_Timeline_Norman_22.jpg 2280w, https:\/\/www.kff.org\/wp-content\/uploads\/sites\/7\/2024\/05\/KFF_SF_Office_Timeline_Norman_22.jpg?resize=300,86 300w, https:\/\/www.kff.org\/wp-content\/uploads\/sites\/7\/2024\/05\/KFF_SF_Office_Timeline_Norman_22.jpg?resize=768,219 768w, https:\/\/www.kff.org\/wp-content\/uploads\/sites\/7\/2024\/05\/KFF_SF_Office_Timeline_Norman_22.jpg?resize=1024,292 1024w, https:\/\/www.kff.org\/wp-content\/uploads\/sites\/7\/2024\/05\/KFF_SF_Office_Timeline_Norman_22.jpg?resize=1536,439 1536w, https:\/\/www.kff.org\/wp-content\/uploads\/sites\/7\/2024\/05\/KFF_SF_Office_Timeline_Norman_22.jpg?resize=2048,585 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n<h1 class=\"has-text-align-center has-link-color wp-elements-5c15f29beec0071bb8fddc48a7dd2909 wp-block-post-title has-text-color has-white-color\">LGBTQ+ Health Policy<\/h1>\n\n\n<div class=\"wp-block-group is-layout-constrained wp-block-group-is-layout-constrained\" style=\"padding-bottom:var(--wp--preset--spacing--d-2)\">\n<p class=\"has-text-align-center has-white-color has-text-color has-link-color wp-elements-7c1d3bb9906c023897dc89ad629ea11d wp-block-paragraph\">Published: October 8, 2025<\/p>\n\n\n\n<div class=\"wp-block-group is-content-justification-center is-nowrap is-layout-flex wp-container-core-group-is-layout-306bcb0f wp-block-group-is-layout-flex\" style=\"margin-bottom:var(--wp--preset--spacing--d-3)\">\n<p class=\"has-neutral-100-color has-text-color has-link-color wp-elements-b2da8e61e4ed828fdca3c7e4d5300f1b wp-block-paragraph\"><strong>Health Policy 101<\/strong>: <\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-outline is-style-outline--1\"><a class=\"wp-block-button__link wp-element-button\" href=\"\/other-health\/health-policy-101-introduction\/#content\">Introduction<\/a><\/div>\n\n\n\n<div class=\"wp-block-button is-style-outline is-style-outline--2\"><a class=\"wp-block-button__link wp-element-button\" href=\"\/other-health\/health-policy-101-introduction\/#content\">All Chapters<\/a><\/div>\n\n\n\n<div class=\"wp-block-button is-style-outline is-style-outline--3\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/files.kff.org\/attachment\/Health-Policy-101-LGBTQ-Health-Policy.pdf\">Download this Chapter<\/a><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-group alignfull is-content-justification-center is-nowrap is-layout-flex wp-container-core-group-is-layout-0b04241b wp-block-group-is-layout-flex\" style=\"padding-top:var(--wp--preset--spacing--d-3);padding-bottom:var(--wp--preset--spacing--d-3)\">\n<div class=\"wp-block-kff-shared-authors\">\n\t\t<h2 class=\"wp-block-kff-shared-authors__title\">\n\t\tKFF Authors:\t<\/h2>\n\t\t<div class=\"wp-block-kff-shared-authors__list\">\n\t\t\t\t\t\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/person\/lindsey-dawson\/\" class=\"wp-block-kff-shared-authors__author\">\n\t\t\t\t\t\t\t\t\t\t\t<img\n\t\t\t\t\t\t\tsrc=\"https:\/\/www.kff.org\/wp-content\/uploads\/sites\/7\/2014\/09\/Dawson-Lindsey.jpg?w=150&#038;h=150&#038;crop=1\"\n\t\t\t\t\t\t\talt=\"Lindsey Dawson\"\n\t\t\t\t\t\t\tclass=\"wp-block-kff-shared-authors__image\"\n\t\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t\t\tLindsey Dawson\t\t\t\t<\/a>\n\t\t\t\n\t\t\t\t\t\t\t<span class=\"wp-block-kff-shared-authors__seperator\">,<\/span>\n\t\t\t\t\t\t\t\t\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/person\/jennifer-kates\/\" class=\"wp-block-kff-shared-authors__author\">\n\t\t\t\t\t\t\t\t\t\t\t<img\n\t\t\t\t\t\t\tsrc=\"https:\/\/www.kff.org\/wp-content\/uploads\/sites\/7\/2013\/03\/Jennifer-Kates.png?w=150&#038;h=150&#038;crop=1\"\n\t\t\t\t\t\t\talt=\"Jennifer Kates\"\n\t\t\t\t\t\t\tclass=\"wp-block-kff-shared-authors__image\"\n\t\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t\t\tJennifer Kates\t\t\t\t<\/a>\n\t\t\t\n\t\t\t\t\t\t\t<span class=\"wp-block-kff-shared-authors__seperator\">,<\/span>\n\t\t\t\t\t\t\t\t\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/person\/alex-montero\/\" class=\"wp-block-kff-shared-authors__author\">\n\t\t\t\t\t\t\t\t\t\t\t<img\n\t\t\t\t\t\t\tsrc=\"https:\/\/www.kff.org\/wp-content\/uploads\/sites\/7\/2022\/12\/Montero-Alex.jpg?w=150&#038;h=150&#038;crop=1\"\n\t\t\t\t\t\t\talt=\"Alex Montero\"\n\t\t\t\t\t\t\tclass=\"wp-block-kff-shared-authors__image\"\n\t\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t\t\tAlex Montero\t\t\t\t<\/a>\n\t\t\t\n\t\t\t\t\t\t\t<span class=\"wp-block-kff-shared-authors__seperator\">,<\/span>\n\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t<span class=\"wp-block-kff-shared-authors__seperator\">\n\t\t\t\t\tand\t\t\t\t<\/span>\n\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/person\/ashley-kirzinger\/\" class=\"wp-block-kff-shared-authors__author\">\n\t\t\t\t\t\t\t\t\t\t\t<img\n\t\t\t\t\t\t\tsrc=\"https:\/\/www.kff.org\/wp-content\/uploads\/sites\/7\/2016\/01\/Kirzinger-Ashley.jpg?w=150&#038;h=150&#038;crop=1\"\n\t\t\t\t\t\t\talt=\"Ashley Kirzinger\"\n\t\t\t\t\t\t\tclass=\"wp-block-kff-shared-authors__image\"\n\t\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t\t\tAshley Kirzinger\t\t\t\t<\/a>\n\t\t\t\n\t\t\t\t\t\t<\/div>\n<\/div>\n\n<\/div>\n\n\n<div class=\"wp-block-kff-common-guided-content\">\n\t\n\t<div class=\"guided-content-container\">\n\t\t<nav class=\"guided-content-guide single-section\" aria-labelledby=\"search-jump-to-heading\">\n\t\t\t<h2 id=\"search-jump-to-heading\" class=\"screen-reader-text\">Jump To:<\/h2>\n\t\t\t<p class=\"guide-section-heading\">Table of Contents<\/p>\t\t\t<ul class=\"guided-content-guide-sections\" style=\"--section-highlight-color: #a973b1\" aria-labelledby=\"search-jump-to-heading\" role=\"list\">\n\t\t\t\t\t<li class=\"guide-entry\" id=\"guide-entry-table-of-contents-introduction\">\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-eyebrow\"><\/p>\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-heading\">\n\t\t\t\t\t\t\t\t\t<a   href=\"#introduction\" class=\"guide-entry-heading__desktop  \">Introduction<\/a>\n\t\t\t\t\t\t\t\t\t<a   href=\"#introduction\" class=\"guide-entry-heading__mobile  \"><\/a>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t<\/li><li class=\"guide-entry\" id=\"guide-entry-table-of-contents-sex-sexual-orientation-and-gender-identity\">\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-eyebrow\"><\/p>\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-heading\">\n\t\t\t\t\t\t\t\t\t<a   href=\"#sex-sexual-orientation-and-gender-identity\" class=\"guide-entry-heading__desktop  show-on-mobile\">Sex, Sexual Orientation, and Gender Identity<\/a>\n\t\t\t\t\t\t\t\t\t<a   href=\"#sex-sexual-orientation-and-gender-identity\" class=\"guide-entry-heading__mobile  show-on-mobile\">Sex, Orientation, Gender Identity<\/a>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t<\/li><li class=\"guide-entry\" id=\"guide-entry-table-of-contents-who-are-lgbtq-people\">\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-eyebrow\"><\/p>\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-heading\">\n\t\t\t\t\t\t\t\t\t<a   href=\"#who-are-lgbtq-people\" class=\"guide-entry-heading__desktop  show-on-mobile\">Who Are LGBTQ+ People?<\/a>\n\t\t\t\t\t\t\t\t\t<a   href=\"#who-are-lgbtq-people\" class=\"guide-entry-heading__mobile  show-on-mobile\">Who Are LGBTQ+ People?<\/a>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t<\/li><li class=\"guide-entry\" id=\"guide-entry-table-of-contents-stigma-amp-discrimination\">\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-eyebrow\"><\/p>\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-heading\">\n\t\t\t\t\t\t\t\t\t<a   href=\"#stigma-discrimination\" class=\"guide-entry-heading__desktop  show-on-mobile\">Stigma &amp; Discrimination<\/a>\n\t\t\t\t\t\t\t\t\t<a   href=\"#stigma-discrimination\" class=\"guide-entry-heading__mobile  show-on-mobile\">Stigma &amp; Discrimination<\/a>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t<\/li><li class=\"guide-entry\" id=\"guide-entry-table-of-contents-health-coverage-and-access\">\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-eyebrow\"><\/p>\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-heading\">\n\t\t\t\t\t\t\t\t\t<a   href=\"#health-coverage-and-access\" class=\"guide-entry-heading__desktop  show-on-mobile\">Health Coverage and Access<\/a>\n\t\t\t\t\t\t\t\t\t<a   href=\"#health-coverage-and-access\" class=\"guide-entry-heading__mobile  show-on-mobile\">Coverage &amp; Access<\/a>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t<\/li><li class=\"guide-entry\" id=\"guide-entry-table-of-contents-lgbtq-people-s-health-today\">\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-eyebrow\"><\/p>\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-heading\">\n\t\t\t\t\t\t\t\t\t<a   href=\"#lgbtq-peoples-health-today\" class=\"guide-entry-heading__desktop  show-on-mobile\">LGBTQ+ People&#039;s Health Today<\/a>\n\t\t\t\t\t\t\t\t\t<a   href=\"#lgbtq-peoples-health-today\" class=\"guide-entry-heading__mobile  show-on-mobile\">LGBTQ+ People\u2019s Health Today<\/a>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t<\/li><li class=\"guide-entry\" id=\"guide-entry-table-of-contents-best-practices-for-competent-care\">\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-eyebrow\"><\/p>\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-heading\">\n\t\t\t\t\t\t\t\t\t<a   href=\"#best-practices-for-competent-care\" class=\"guide-entry-heading__desktop  show-on-mobile\">Best Practices for Competent Care<\/a>\n\t\t\t\t\t\t\t\t\t<a   href=\"#best-practices-for-competent-care\" class=\"guide-entry-heading__mobile  show-on-mobile\">Best Practices<\/a>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t<\/li><li class=\"guide-entry\" id=\"guide-entry-table-of-contents-gender-affirming-care\">\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-eyebrow\"><\/p>\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-heading\">\n\t\t\t\t\t\t\t\t\t<a   href=\"#gender-affirming-care\" class=\"guide-entry-heading__desktop  show-on-mobile\">Gender Affirming Care<\/a>\n\t\t\t\t\t\t\t\t\t<a   href=\"#gender-affirming-care\" class=\"guide-entry-heading__mobile  show-on-mobile\">Gender Affirming Care<\/a>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t<\/li><li class=\"guide-entry\" id=\"guide-entry-table-of-contents-policy-impact\">\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-eyebrow\"><\/p>\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-heading\">\n\t\t\t\t\t\t\t\t\t<a   href=\"#policy-impact\" class=\"guide-entry-heading__desktop  show-on-mobile\">Policy Impact<\/a>\n\t\t\t\t\t\t\t\t\t<a   href=\"#policy-impact\" class=\"guide-entry-heading__mobile  show-on-mobile\">Policy Impact<\/a>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t<\/li><li class=\"guide-entry\" id=\"guide-entry-table-of-contents-future-outlook\">\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-eyebrow\"><\/p>\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-heading\">\n\t\t\t\t\t\t\t\t\t<a   href=\"#future-outlook\" class=\"guide-entry-heading__desktop  show-on-mobile\">Future Outlook<\/a>\n\t\t\t\t\t\t\t\t\t<a   href=\"#future-outlook\" class=\"guide-entry-heading__mobile  show-on-mobile\">Future Outlook<\/a>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t<\/li><li class=\"guide-entry\" id=\"guide-entry-table-of-contents-resources\">\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-eyebrow\"><\/p>\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-heading\">\n\t\t\t\t\t\t\t\t\t<a   href=\"#resources\" class=\"guide-entry-heading__desktop  show-on-mobile\">Resources<\/a>\n\t\t\t\t\t\t\t\t\t<a   href=\"#resources\" class=\"guide-entry-heading__mobile  show-on-mobile\">Resources<\/a>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t<\/li><li class=\"guide-entry\" id=\"guide-entry-table-of-contents-citation\">\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-eyebrow\"><\/p>\n\t\t\t\t\t\t\t\t<p class=\"guide-entry-heading\">\n\t\t\t\t\t\t\t\t\t<a   href=\"#citation\" class=\"guide-entry-heading__desktop  show-on-mobile\">Citation<\/a>\n\t\t\t\t\t\t\t\t\t<a   href=\"#citation\" class=\"guide-entry-heading__mobile  show-on-mobile\">Citation<\/a>\n\t\t\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t\t\t<\/li>\t\t\t<\/ul>\n\t\t<\/nav>\n\t\t<div class=\"guided-content-sections\">\n\t\t\t\n<div class=\"wp-block-kff-common-guided-content-section\" id=\"table-of-contents\">\n\t<header class=\"gc-section-header\">\n\t\t<h2 class=\"screen-reader-text\">Table of Contents<\/h2>\n\t<\/header>\n\n\t<div class=\"gc-section-entries\">\n\t\t\n<div class=\"wp-block-kff-common-guided-content-entry\" id=\"table-of-contents-introduction\">\n\t<header class=\"gc-entry-header\">\n\t\t<div class=\"gc-entry-header-container\">\n\t\t\t<h3 class=\"gc-entry-heading shareable-unit-title\" tabindex=\"-1\">\n\t\t\t\tIntroduction\t\t\t<\/h3>\n\n\n\t\t\t<div class=\"gc-entry-meta\">\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"gc-entry-direct-link\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/wp-json\/wp\/v2\/posts\/634925?entry=table-of-contents-introduction\" class=\"clipboard\">\n\t\t\t\t<span class=\"screen-reader-text\">\n\t\t\t\t\t\t\t\t\t\tCopy link to Introduction\t\t\t\t<\/span>\n\t\t\t<\/a>\n\t\t\t<div class=\"confirmation-message\" aria-live=\"polite\" aria-atomic=\"true\"><\/div>\n\t\t<\/div>\n\t<\/header>\n\n\t<div class=\"gc-entry-content shareable-unit-description\">\n\t\t\n\n<p class=\"wp-block-paragraph\">The share of individuals identifying as LGBTQ+ in the United States has <a href=\"https:\/\/news.gallup.com\/poll\/611864\/lgbtq-identification.aspx\">increased<\/a> over time, rising from just 4% in 2012 to 8% in 2023. In addition, support for same-sex marriage has also grown (27% in 1996 v. <a href=\"https:\/\/news.gallup.com\/poll\/1651\/gay-lesbian-rights.aspx\">69%<\/a> as of 2024) and fewer believe there should be less acceptance for LGBTQ+ people (26% in 2001 v. 8% in 2020). Increases in identity and acceptance have been punctuated by several Supreme Court decisions providing new civil rights for LGBTQ+ people. Still, widespread stigma and discrimination persist for many LGBTQ+ people, including in health care as well as across a range of social institutions. These experiences can fuel significant health care disparities among LGBTQ+ people, challenging well-being and affecting health outcomes. Further, LGBTQ+ rights and health care access have become <a href=\"https:\/\/www.kff.org\/other\/issue-brief\/half-of-all-u-s-states-limit-or-prohibit-youth-access-to-gender-affirming-care\/\">increasingly politicized<\/a> at the federal and state levels, especially when it comes to young people.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">All people\u2019s health and health care experiences are informed by the socioeconomic context in which they live, including the policy environment. Federal and state policy can facilitate or impede access to health care for LGBTQ+ people. At the federal level, there have been both expansions as well as restrictions in protections and access over time and across presidential administrations, including the second Trump administration. Starting on the first day of his second term, President Trump began to issue numerous executive actions, several of which directly address or affect health programs, efforts, or policies designed to meet the health needs of LGBTQ+ people. These include <a href=\"https:\/\/www.kff.org\/other\/fact-sheet\/overview-of-president-trumps-executive-actions-impacting-lgbtq-health\/\">actions<\/a> that seek to limit data collection, lessen civil rights protections, restrict access to care, and remove acknowledgement of diverse sexual and gender identities. At the state level, there has been a rapid increase in the number of laws and policies impacting LGBTQ+ people\u2019s health, especially, though not exclusively, that of young people. An increasing number of legal challenges to federal and state laws may ultimately decide access to care and the extent to which protections remain. This chapter provides an overview of LGBTQ+ people\u2019s identities, experiences with health and health care, and the related health policy landscape.<\/p>\n\n\n\n<div class=\"wp-block-group has-background is-layout-constrained wp-container-core-group-is-layout-8bd8dac6 wp-block-group-is-layout-constrained\" style=\"background-color:#e5e5e5;margin-top:var(--wp--preset--spacing--50);margin-bottom:var(--wp--preset--spacing--50);padding-top:var(--wp--preset--spacing--40);padding-right:var(--wp--preset--spacing--40);padding-bottom:var(--wp--preset--spacing--40);padding-left:var(--wp--preset--spacing--40)\">\n<p class=\"has-text-align-center wp-block-paragraph\"><strong><strong>A Note on Language<\/strong><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Throughout this chapter, whenever possible, we use the term LGBTQ+ to represent the full spectrum of non-heterosexual, non-cisgender people. Additionally, people who are asexual, questioning, or intersex are sometimes included under the LGBTQ+ umbrella. However, at times, the reader may encounter differences in terminology (e.g., LGBT, LGB, etc.). In these circumstances, we use language to reflect the specific data being cited. It is important to note that the language used to describe LGBTQ+ people has evolved considerably over time and will likely continue to do so.<\/p>\n<\/div>\n\n\t<\/div>\n<\/div>\n\n\n<div class=\"wp-block-kff-common-guided-content-entry\" id=\"table-of-contents-sex-sexual-orientation-and-gender-identity\">\n\t<header class=\"gc-entry-header\">\n\t\t<div class=\"gc-entry-header-container\">\n\t\t\t<h3 class=\"gc-entry-heading shareable-unit-title\" tabindex=\"-1\">\n\t\t\t\tSex, Sexual Orientation, and Gender Identity\t\t\t<\/h3>\n\n\n\t\t\t<div class=\"gc-entry-meta\">\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"gc-entry-direct-link\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/wp-json\/wp\/v2\/posts\/634925?entry=table-of-contents-sex-sexual-orientation-and-gender-identity\" class=\"clipboard\">\n\t\t\t\t<span class=\"screen-reader-text\">\n\t\t\t\t\t\t\t\t\t\tCopy link to Sex, Sexual Orientation, and Gender Identity\t\t\t\t<\/span>\n\t\t\t<\/a>\n\t\t\t<div class=\"confirmation-message\" aria-live=\"polite\" aria-atomic=\"true\"><\/div>\n\t\t<\/div>\n\t<\/header>\n\n\t<div class=\"gc-entry-content shareable-unit-description\">\n\t\t\n\n<p class=\"wp-block-paragraph\">The concepts of sex, gender, and sexual orientation are discreet. However, they are often thought of as interrelated and dependent on one another, though their actual relationship is more diverse and complex:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"wp-block-list-item\"><strong>Sex<\/strong> is often described as one\u2019s biological categorization of being male or female based on anatomical, hormonal, and genetic factors. At birth, individuals are typically assigned a sex based on external genitalia. While sex is often thought of as a binary, as many as 1.7% of the population has been <a href=\"https:\/\/nap.nationalacademies.org\/download\/25877\">estimated<\/a> to have some intersex trait, with population estimates of people with anatomical variations being lower (less than 0.5% of the population).<\/li>\n\n\n\n<li class=\"wp-block-list-item\"><strong>Gender identity <\/strong>is an individual\u2019s sense or experience of being male, female, transgender (trans), non-binary, gender non-conforming, or something else. Gender identity may or may not align with the sex that was assigned at birth. Gender expression is the public expression of gender identity, which may occur through attire, body characteristics (e.g., hair), voice, etc. Gender expression may or may not align with traditional assumptions related to sex or gender identity.<\/li>\n\n\n\n<li class=\"wp-block-list-item\"><strong>Sexual orientation <\/strong>refers to emotional, romantic or sexual attraction to other people, often in relationship to one\u2019s own sex and\/or gender identity.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">While many people and institutions historically considered these three concepts to be inseparably linked and linear (e.g., assigned the male sex at birth, identifies as male, and is attracted to women), there is wide variation in how these concepts relate, and they can be dynamic over time.<\/p>\n\n\t<\/div>\n<\/div>\n\n\n<div class=\"wp-block-kff-common-guided-content-entry\" id=\"table-of-contents-who-are-lgbtq-people\">\n\t<header class=\"gc-entry-header\">\n\t\t<div class=\"gc-entry-header-container\">\n\t\t\t<h3 class=\"gc-entry-heading shareable-unit-title\" tabindex=\"-1\">\n\t\t\t\tWho Are LGBTQ+ People?\t\t\t<\/h3>\n\n\n\t\t\t<div class=\"gc-entry-meta\">\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"gc-entry-direct-link\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/wp-json\/wp\/v2\/posts\/634925?entry=table-of-contents-who-are-lgbtq-people\" class=\"clipboard\">\n\t\t\t\t<span class=\"screen-reader-text\">\n\t\t\t\t\t\t\t\t\t\tCopy link to Who Are LGBTQ+ People?\t\t\t\t<\/span>\n\t\t\t<\/a>\n\t\t\t<div class=\"confirmation-message\" aria-live=\"polite\" aria-atomic=\"true\"><\/div>\n\t\t<\/div>\n\t<\/header>\n\n\t<div class=\"gc-entry-content shareable-unit-description\">\n\t\t\n\n<p class=\"wp-block-paragraph\">It is <a href=\"https:\/\/news.gallup.com\/poll\/656708\/lgbtq-identification-rises.aspx\">estimated<\/a> that 9.3% of U.S. adults identify as LGBTQ+, as of 2024, nearly triple the share in 2012 (3.5%), and LGBTQ+ identity is expected to continue to increase over time. This increase may reflect changes in behavior and desire, and an increased willingness to self-identify and disclose as societal acceptance has grown. Indeed, these two factors are likely interrelated. LGBTQ+ identity is strongly associated with age; younger generations self-identify at higher rates than older generations (23% of those aged 18-27 identify as LGBTQ+ compared to just 2% among those aged 79 and older). In addition, as of 2023, about 1 in 4 high school students <a href=\"https:\/\/www.cdc.gov\/yrbs\/supplementary-tables\/index.html\">identifies<\/a> as LGBQ+. As the LGBTQ+ population ages and new generations identify at higher rates, it is expected that the share of adults who identify as LGBTQ+ will increase as well.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">As such, the LGBTQ+ population is younger than the U.S. population overall. Almost half (47%) of LGBT adults are under age 30, compared to 18% of non-LGBT adults. Just 6% are 65 or older, compared to nearly one-quarter (24%) of non-LGBT adults (see Figure 1). LGBT adults are also more likely to have lower incomes and be living on less than $40,000 per year than non-LGBT adults (42% v. 33%), which may reflect their lower age. (See Table 1.)<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 1081px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/aImGa\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/aImGa\/full.png\"\n\t\t\talt=\"Demographics of LGBT and Non-LGBT Adults \"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">Within the LGBTQ+ community, identity is complex and multifaceted. Among adults who <a href=\"https:\/\/news.gallup.com\/poll\/656708\/lgbtq-identification-rises.aspx\">identify<\/a> as LGBTQ+, the majority identify as bisexual (56%), a finding driven by younger adults, followed by gay (21%), and lesbian (15%). Smaller shares identify as transgender (14%), pansexual (1%), or in some other way (5%).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It is estimated that&nbsp;over <a href=\"https:\/\/williamsinstitute.law.ucla.edu\/publications\/trans-adults-united-states\/\">2.8 million <\/a>adults and youth (over 13 years old) living in the U.S. identify as transgender or trans, which translates to 1% of all those 13 and older.&nbsp;A <a href=\"https:\/\/www.kff.org\/mental-health\/poll-finding\/kff-the-washington-post-trans-survey\/\">2023 KFF\/Washington Post Survey<\/a> of a nationally representative sample of transgender adults in the U.S shows the trans adult population is younger than the larger cisgender adult population, with the majority of trans adults under the age of 35, echoing trends seen in the larger LGBTQ+ population. Additionally, most (70%) trans adults identify as lesbian, gay, or bisexual, compared to one in ten cisgender adults. Trans adults and cisgender adults do not notably differ when it comes to race and ethnicity or income. (See Table 2.)<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 696px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/rpvft\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/rpvft\/full.png\"\n\t\t\talt=\"Demographics of Transgender and Cisgender Adults  \"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">Most trans adults, or about 6 in 10, describe themselves as \u201ctrans, gender non-conforming\u201d or \u201ctrans, nonbinary,\u201d while smaller shares say they would describe themselves as a \u201ctrans woman\u201d (22%) or a \u201ctrans man\u201d (12%). (See Figure 1.)<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 236px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/PNBcT\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/PNBcT\/full.png\"\n\t\t\talt=\"Identities Among Trans Adults\"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">In addition to sexual orientation and gender identity, the lives of people who are LGBTQ+ are also shaped and informed by a range of other intersectional sociodemographic factors, including race\/ethnicity, income, geography, educational opportunities, language, citizenship status, disability status, and other variables, which, together, affect health access and outcomes in both positive and negative ways.<\/p>\n\n\n\n<div id=\"data-collection-box\" class=\"wp-block-group has-background is-layout-constrained wp-container-core-group-is-layout-8bd8dac6 wp-block-group-is-layout-constrained\" style=\"background-color:#e5e5e5;margin-top:var(--wp--preset--spacing--50);margin-bottom:var(--wp--preset--spacing--50);padding-top:var(--wp--preset--spacing--40);padding-right:var(--wp--preset--spacing--40);padding-bottom:var(--wp--preset--spacing--40);padding-left:var(--wp--preset--spacing--40)\">\n<p class=\"has-text-align-center wp-block-paragraph\"><strong><strong>Data Collection<\/strong><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Having an understanding of who the LGBTQ+ community is, what challenges they face, what their health needs are, and how those differ from non-LGBTQ+ people allows policymakers, providers, and others to better meet the community\u2019s needs. While the share of people who identify as LGBTQ+ has increased over time, the community is still a relatively small share of the overall population (approximately 8%). This makes representative data collection more difficult, particularly for sub-group analysis, since obtaining a representative sample of a small population requires a relatively larger sample size, which can be both challenging to obtain and costly. In addition to methodological challenges, in many cases, researchers, systems, and surveys simply haven\u2019t asked about sexual orientation and gender identity. While the federal government had been moving towards greater data collection on sexual orientation and gender identity, some of that has been reversed in the second Trump administration and it is still not routine in state and local surveys, or in health systems, providers\u2019 offices and employment, among other settings.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">How data are collected is also important for reaching and understanding the needs and experiences of LGBTQ+ people. Best practice suggests data should be collected in ways that align with <a href=\"https:\/\/www.nationalacademies.org\/our-work\/measuring-sex-gender-identity-and-sexual-orientation-for-the-national-institutes-of-health#sectionPublications\">tested standards<\/a>, conducted in culturally sensitive ways (accompanied by adequate training), secured responsibly, and then used to improve the lives of the people it represents. (See section on <a href=\"#policy-impact\">policy impact<\/a> on LGBTQ+ people\u2019s health.)<\/p>\n<\/div>\n\n\t<\/div>\n<\/div>\n\n\n<div class=\"wp-block-kff-common-guided-content-entry\" id=\"table-of-contents-stigma-amp-discrimination\">\n\t<header class=\"gc-entry-header\">\n\t\t<div class=\"gc-entry-header-container\">\n\t\t\t<h3 class=\"gc-entry-heading shareable-unit-title\" tabindex=\"-1\">\n\t\t\t\tStigma &amp; Discrimination\t\t\t<\/h3>\n\n\n\t\t\t<div class=\"gc-entry-meta\">\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"gc-entry-direct-link\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/wp-json\/wp\/v2\/posts\/634925?entry=table-of-contents-stigma-amp-discrimination\" class=\"clipboard\">\n\t\t\t\t<span class=\"screen-reader-text\">\n\t\t\t\t\t\t\t\t\t\tCopy link to Stigma &amp; Discrimination\t\t\t\t<\/span>\n\t\t\t<\/a>\n\t\t\t<div class=\"confirmation-message\" aria-live=\"polite\" aria-atomic=\"true\"><\/div>\n\t\t<\/div>\n\t<\/header>\n\n\t<div class=\"gc-entry-content shareable-unit-description\">\n\t\t\n\n<p class=\"wp-block-paragraph\">Many LGBTQ+ people report having experienced stigma and discrimination in health care and other social institutions due to their actual or perceived sexual orientation, gender identity, and\/or gender expression.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.kff.org\/racial-equity-and-health-policy\/poll-finding\/lgbt-adults-experiences-with-discrimination-and-health-care-disparities-findings-from-the-kff-survey-of-racism-discrimination-and-health\/\">KFF polling<\/a> has shown that LGBT adults face higher rates of discrimination and unfair treatment in their daily lives compared to others, with about two-thirds (65%) saying they have experienced at least one type of discrimination at least a few times in the past year, compared to four in ten non-LGBT adults. (See Figure 2.). These experiences are higher among LGBT adults who are younger and lower income.<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 450px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/fnRmR\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/fnRmR\/full.png\"\n\t\t\talt=\"LGBT Adults Are More Likely Than Non-LGBT Adults to Report Discrimination in Their Daily Lives  \"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.kff.org\/report-section\/kff-the-washington-post-trans-survey-trans-in-america\/\">The KFF\/Washington Post Trans survey<\/a> found that many trans adults say they feel discriminated against at least \u201csometimes\u201d due to their gender identity or expression, with trans adults of color even more likely to report multiple types of discrimination, including because of their race or ethnicity, income level or education, or sexual orientation, reflecting how discrimination can cut across intersecting identities. (See Figure 3.)<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 369px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/AcJI5\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/AcJI5\/full.png\"\n\t\t\talt=\"Two-Thirds Of Trans Adults Feel Discriminated Against Because Of Their Gender Identity Or Expression, With More Trans Adults Of Color Reporting Multiple Forms Of Discrimination \"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">Experiences of stigma and discrimination also occur in health care settings, in part because pathologizing LGBTQ+ identity, behavior, and desire has a long <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp2407068\">history<\/a> in medicine. Indeed, much of the early language of LGBTQ+ identity has its origins in 19<sup>th<\/sup>-century psychiatry, which defined LGBTQ+ people in opposition to heterosexual people (and health). The early medical literature promotedthe idea that individuals with LGBTQ+ behavior or desire needed treatment, a notion that persisted for more than a century in dominant medical literature and, in 1952, homosexuality was defined as a psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders&nbsp;(DSM), the tool for classifying mental health conditions in the United States; it was not removed as such until 1974 (though as a <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4695779\/\">compromise<\/a> APA added \u201csexual orientation disturbance\u201d as diagnosis which was then replaced with \u201cego dystonic homosexuality\u201d which was not removed until 1987.) While mainstream medicine has evolved from the view of needing to treat LGBTQ+ identity as a medical or psychological disorder, stigma and discrimination within medicine persist.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.kff.org\/racial-equity-and-health-policy\/poll-finding\/lgbt-adults-experiences-with-discrimination-and-health-care-disparities-findings-from-the-kff-survey-of-racism-discrimination-and-health\/\">KFF polling<\/a> shows that 6 in 10 LGBT adults report at least one of several negative experiences with a health care provider in the past three years \u2013 about twice the share of non-LGBT adults who report this. (See Figure 4.)<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 488px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/eAYPq\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/eAYPq\/full.png\"\n\t\t\talt=\"LGBT Adults Are Twice as Likely as Non-LGBT Adults to Report Negative Experiences With a Health Care Provider During Recent Visits \"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">Additionally, <a href=\"https:\/\/www.kff.org\/mental-health\/poll-finding\/kff-the-washington-post-trans-survey\/\">about 3 in 10<\/a> trans adults say they have had to teach a doctor or other health care provider about trans people to receive appropriate care, had a doctor refuse to acknowledge their preferred gender identity, or been asked unnecessary or invasive questions about their gender identity that were unrelated to their care. (See Figure 5.)<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 531px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/sYiV8\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/sYiV8\/full.png\"\n\t\t\talt=\"Around Three In Ten Trans Adults Say They&#039;ve Had To Teach A Doctor About Trans People To Get Appropriate Care, Had A Doctor Refuse To Acknowledge Their Gender Identity\"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">Experiences of stigma, discrimination, and mistreatment based on sexual orientation or gender identity occur in multiple non-health care environments and institutions as well, and these also negatively affect health and well-being. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Hate crimes, <a href=\"https:\/\/www.justice.gov\/hatecrimes\/learn-about-hate-crimes#hatecrime\">defined<\/a> as \u201cbias against people or groups with specific characteristics that are defined by the law,\u201d have negative effects on health, including both physical and psychological harm, and LGBTQ+ people are more likely to experience hate crimes than non-LGTBQ+ people. <a href=\"https:\/\/www.justice.gov\/hatecrimes\/hate-crime-statistics\">According to the FBI<\/a>, in 2023, more than 1 in 5 hate crimes (23%) were related to being LGBTQ+<strong>. <\/strong>In 2022, of crimes related to being LGBTQ+, 17% were based on sexual orientation and 4% on gender identity, accounting together for 2,416 crimes in total. Hate crimes against gay men accounted for nearly half (45%) of these, followed by crimes against a combined group of LGBT people (26%), and then transgender people (14%). A smaller share was reported against lesbians (8%), gender non-conforming people (5%), bisexual people (1%), and heterosexual people (1%). (Notably, whether a hate crime gets reported to the FBI and how it is defined are highly variable, so these statistics are likely an underrepresentation of actual crimes that occur.) (See Figure 6.) LGBT+ people are also <a href=\"https:\/\/williamsinstitute.law.ucla.edu\/publications\/anti-lgbt-victimization-us\/\">nine times more likely<\/a> to self-report that they have experienced a hate crime than non-LGBT+ people.<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 830px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/WO83Y\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/WO83Y\/full.png\"\n\t\t\talt=\"LGBTQ Related Hate Crimes Reported to the FBI, 2022\"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">Sexual violence, in particular, is a common experience among LGBTQ+ people relative to non-LGBTQ+ people and is especially high among bisexual women and gay and bisexual men. Bisexual women <a href=\"https:\/\/www.cdc.gov\/nisvs\/documentation\/nisvsreportonsexualidentity.pdf?CDC_AAref_Val=https:\/\/www.cdc.gov\/violenceprevention\/pdf\/nisvs\/nisvsReportonSexualIdentity.pdf?ACSTrackingID=USCDC_1104-DM114435&amp;ACSTrackingLabel=CDC%2520Releases%2520the%2520National%2520Intimate%2520Partner%2520and%2520Sexual%2520Violence%2520Survey%2520(NISVS)&amp;deliveryName=USCDC_1104-DM114435\">report<\/a> higher lifetime experiences with rape, other sexual violence and stalking, and lesbian women report higher rates of sexual violence and unwanted sexual contact across their lifetimes than heterosexual women. Gay and bisexual men <a href=\"https:\/\/www.cdc.gov\/nisvs\/documentation\/nisvsreportonsexualidentity.pdf?CDC_AAref_Val=https:\/\/www.cdc.gov\/violenceprevention\/pdf\/nisvs\/nisvsReportonSexualIdentity.pdf?ACSTrackingID=USCDC_1104-DM114435&amp;ACSTrackingLabel=CDC%2520Releases%2520the%2520National%2520Intimate%2520Partner%2520and%2520Sexual%2520Violence%2520Survey%2520(NISVS)&amp;deliveryName=USCDC_1104-DM114435\">report<\/a> higher rates of sexual violence, unwanted sexual experiences, and sexual coercion than heterosexual men, with gay men also reporting higher rates of stalking across their lifetimes than heterosexual men.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Transgender people also face higher rates of <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32673114\/\">intimate partner violence<\/a> and are more likely to be the victim of a <a href=\"https:\/\/williamsinstitute.law.ucla.edu\/press\/ncvs-trans-press-release\/\">violent crime<\/a>, with <a href=\"https:\/\/transequality.org\/sites\/default\/files\/docs\/usts\/USTS-Full-Report-Dec17.pdf\">surveys<\/a> finding that trans people report high rates of violence across a range of measures. KFF <a href=\"https:\/\/www.kff.org\/report-section\/kff-the-washington-post-trans-survey-trans-in-america\/\">polling shows<\/a> that a majority of trans adults (64%) say they have been verbally attacked and 1 in 4 say they have been physically attacked because of their gender identity, gender expression, or sexual identity. The share of trans adults who have been physically attacked because of their gender identity increases to 31% among trans people of color.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Young LGBTQ+ people are also impacted by higher rates of bullying and violence, including sexual violence, compared to non-LGBTQ+. LGBTQ+ high school students report <a href=\"https:\/\/www.cdc.gov\/yrbs\/dstr\/index.html\">higher rates<\/a> of being bullied than non-LGBTQ+ students, with LGBTQ+ students about twice as likely as non-LGBTQ+ students to report that they have been bullied on school property (29% v. 16%) or to report electronic bullying (25% v. 13%). Additionally, LGBTQ+ high school students are twice as likely to report having been injured or threatened with a weapon at school compared to non-LGBTQ+ students (14% v. 7%). Experiences with sexual violence generally (20% v. 8%) and forced sex in particular (17% v. 6%) were also more common among LGBTQ+ high school students than non-LGBTQ+ high school students. (See Figure 7.)<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 568px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/kVDYJ\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/kVDYJ\/full.png\"\n\t\t\talt=\"Experience of Bullying, Violence, and Sexual Violence Among High School Students, by Sexual Orientation, 2024\"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">LGBTQ+ people\u2019s disproportionate experiences of maltreatment, stigma, and discrimination can have a significant and <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2072932\/\">negative impact<\/a> on present and future <a href=\"https:\/\/psycnet.apa.org\/doiLanding?doi=10.1037%2Fvio0000218\">mental health<\/a><strong>.<\/strong> Indeed, LGBT adults who had recent experiences with at least one form of discrimination in the past year are more likely to <a href=\"https:\/\/www.kff.org\/racial-equity-and-health-policy\/poll-finding\/lgbt-adults-experiences-with-discrimination-and-health-care-disparities-findings-from-the-kff-survey-of-racism-discrimination-and-health\/\">report<\/a> feeling always or often lonely (42% v. 15%), depressed (38% v. 21%) or anxious (65% v. 34%) than those who rarely or never experienced discrimination in daily life. Additionally, larger shares of LGBT women, younger LGBT adults, and lower-income LGBT adults <a href=\"https:\/\/www.kff.org\/racial-equity-and-health-policy\/poll-finding\/lgbt-adults-experiences-with-discrimination-and-health-care-disparities-findings-from-the-kff-survey-of-racism-discrimination-and-health\/\">report<\/a> regular feelings of anxiety, loneliness, or depression. While other underlying factors beyond discrimination may contribute to these differences, the relationship between feelings of loneliness, anxiety, and depression and experiences with discrimination among LGBT adults remains significant even after controlling for race\/ ethnicity, education, income, gender, and age (see section on mental health below). (See Figure 8.)<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 530px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/KyXIa\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/KyXIa\/full.png\"\n\t\t\talt=\"LGBT Adults Who Experience Discrimination Are More Likely Than Those Who Do Not to Report Feeling Anxious, Lonely, or Depressed \"\n\t\t\/>\n<\/div>\n\n\n\t<\/div>\n<\/div>\n\n\n<div class=\"wp-block-kff-common-guided-content-entry\" id=\"table-of-contents-health-coverage-and-access\">\n\t<header class=\"gc-entry-header\">\n\t\t<div class=\"gc-entry-header-container\">\n\t\t\t<h3 class=\"gc-entry-heading shareable-unit-title\" tabindex=\"-1\">\n\t\t\t\tHealth Coverage and Access\t\t\t<\/h3>\n\n\n\t\t\t<div class=\"gc-entry-meta\">\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"gc-entry-direct-link\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/wp-json\/wp\/v2\/posts\/634925?entry=table-of-contents-health-coverage-and-access\" class=\"clipboard\">\n\t\t\t\t<span class=\"screen-reader-text\">\n\t\t\t\t\t\t\t\t\t\tCopy link to Health Coverage and Access\t\t\t\t<\/span>\n\t\t\t<\/a>\n\t\t\t<div class=\"confirmation-message\" aria-live=\"polite\" aria-atomic=\"true\"><\/div>\n\t\t<\/div>\n\t<\/header>\n\n\t<div class=\"gc-entry-content shareable-unit-description\">\n\t\t\n\n<p class=\"wp-block-paragraph\">Overall, LGBT people report similar rates of being uninsured as non-LGBT people (9% v. 10%). LGBT adults, who are notably both younger and lower income than the general population, have higher rates of Medicaid coverage (25% v. 15%) and lower rates of Medicare coverage (8% v. 22%). They are slightly more likely to be covered by private insurance than non-LGBT adults (57% v. 51%). (See Figure 9.)<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 468px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/KYjbK\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/KYjbK\/full.png\"\n\t\t\talt=\"Insurance Coverage Among LGB+ and Non-LGB+ Adults, 2023-2024\"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">Research has found that having a usual source of care is associated with increased use of&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2518015\/\">preventive care<\/a>&nbsp;and&nbsp;<a href=\"https:\/\/www.pewresearch.org\/hispanic\/2008\/08\/13\/iii-utilization-of-a-usual-health-care-provider-and-satisfaction-with-health-care\/\">better health outcomes<\/a>, but LGBT people are more likely to report not having a usual source of care than non-LGBT people (19% v. 12%). (From <a href=\"https:\/\/www.kff.org\/racial-equity-and-health-policy\/poll-finding\/lgbt-adults-experiences-with-discrimination-and-health-care-disparities-findings-from-the-kff-survey-of-racism-discrimination-and-health\/\">KFF\u2019s Survey of Racism, Discrimination, and Health<\/a>). One <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC9287429\/\">study<\/a> found that LGBTQ people were more likely to lack access to providers, delay care, face issues taking medications due to cost, and have fewer routine checkups than heterosexual cisgender people.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.kff.org\/report-section\/lgbt-adults-experiences-with-discrimination-and-health-care-disparities-findings\/#:~:text=Larger%20shares%20of%20LGBT%20adults,16%25).\">KFF polling<\/a> has also found that many LGBT adults say negative health care experiences have affected their willingness to seek care, their health care coverage, and their physical health.&nbsp;For example, LGBT adults are significantly more likely than non-LGBT adults to report that having a negative health care experience in the last three years caused their health to get worse (24% v. 9%), made them less likely to seek health care (39% v. 15%), or caused them to switch health care providers (36% v. 16%).<\/p>\n\n\t<\/div>\n<\/div>\n\n\n<div class=\"wp-block-kff-common-guided-content-entry\" id=\"table-of-contents-lgbtq-people-s-health-today\">\n\t<header class=\"gc-entry-header\">\n\t\t<div class=\"gc-entry-header-container\">\n\t\t\t<h3 class=\"gc-entry-heading shareable-unit-title\" tabindex=\"-1\">\n\t\t\t\tLGBTQ+ People&#8217;s Health Today\t\t\t<\/h3>\n\n\n\t\t\t<div class=\"gc-entry-meta\">\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"gc-entry-direct-link\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/wp-json\/wp\/v2\/posts\/634925?entry=table-of-contents-lgbtq-people-s-health-today\" class=\"clipboard\">\n\t\t\t\t<span class=\"screen-reader-text\">\n\t\t\t\t\t\t\t\t\t\tCopy link to LGBTQ+ People&#039;s Health Today\t\t\t\t<\/span>\n\t\t\t<\/a>\n\t\t\t<div class=\"confirmation-message\" aria-live=\"polite\" aria-atomic=\"true\"><\/div>\n\t\t<\/div>\n\t<\/header>\n\n\t<div class=\"gc-entry-content shareable-unit-description\">\n\t\t\n\n<p class=\"wp-block-paragraph\">While in some areas, the health experiences of LGBTQ+ people mirror those of non-LGBTQ+ people, in other areas, LGBTQ+ people face disparities in health outcomes due to their sexual orientation and gender identity, as well as other factors such as race\/ethnicity, class, nationality, and age. Disparities related to mental health, substance use, and sexual health are especially apparent, and LGBTQ+ people also experience certain chronic conditions at higher rates than heterosexual and cisgender people. In some cases, these are driven by social factors such as the biosocial impact of experiencing stigma and discrimination, higher rates <a>of <\/a><a href=\"https:\/\/web.archive.org\/web\/20240926192401\/https:\/www.cdc.gov\/nchs\/data\/nhis\/sexual_orientation\/ASI_2018_STWebsite_Tables-508.pdf\">alcohol use and smoking<\/a>, and obesity. They may also stem from fear of engaging with the health system, including from past experiences of discrimination, which may lead to forgoing routine screening or needed care.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">There may also be a link between health care access, competency, and affordability (discussed above) and the ability to detect, control and treat disease. For example, <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/36757703\/\">research<\/a> has found that transgender and gender-diverse people are both less likely to receive cancer screenings and also have a higher incidence of HIV- and HPV-associated cancers.<\/p>\n\n\n\n<div class=\"wp-block-group is-layout-constrained wp-block-group-is-layout-constrained\" style=\"padding-top:var(--wp--preset--spacing--30);padding-bottom:var(--wp--preset--spacing--30)\">\n<h4 id=\"overall-health-status\" class=\"wp-block-heading has-heading-5-font-size\">Overall Health Status<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Despite being a younger population, a group traditionally reporting higher levels of well-being, LGBT people are more likely to <a href=\"https:\/\/www.kff.org\/racial-equity-and-health-policy\/poll-finding\/lgbt-adults-experiences-with-discrimination-and-health-care-disparities-findings-from-the-kff-survey-of-racism-discrimination-and-health\/\">report<\/a> being in fair or poor physical health than non-LGBT people (26% v. 19%).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">LGBT+ people also <a href=\"https:\/\/www.kff.org\/report-section\/lgbt-peoples-health-status-and-access-to-care-issue-brief\/\">report<\/a> that they are managing chronic conditions and living with disabilities that impact daily life at higher rates than non-LGBT+ people. Half (50%) of LGBT+ people reported that they had an ongoing health condition that requires regular monitoring, medical care, or medication, compared with 45% of non-LGBT+ people. Additionally, one-quarter (25%) of LGBT+ people reported having a disability or chronic disease that keeps them from participating fully in work, school, housework, or other activities, compared with 16% of non-LGBT+ people.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Likewise, a larger share of LGBT+ people <a href=\"https:\/\/www.kff.org\/report-section\/lgbt-peoples-health-status-and-access-to-care-issue-brief\/\">report<\/a> taking at least one prescription medication on a regular basis than non-LGBT+ people (62% v. 55%). This includes more than half (54%) of young LGBT+ adults (ages 18 to 24) who reported regularly taking a prescription compared to just over one-third (36%) of non-LGBT+ adults in the same age group.<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-group is-layout-constrained wp-block-group-is-layout-constrained\" style=\"padding-top:var(--wp--preset--spacing--30);padding-bottom:var(--wp--preset--spacing--30)\">\n<h4 id=\"chronic-conditions\" class=\"wp-block-heading has-heading-5-font-size\">Chronic Conditions<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Studies have found disparities in certain <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC9287429\/\">chronic conditions<\/a> among LGBTQ+ people, including reports of higher rates of <a href=\"https:\/\/web.archive.org\/web\/20240929152109\/https:\/www.cdc.gov\/diabetes\/risk-factors\/diabetes-risk-lgbtq.html\">diabetes<\/a> among lesbians and gay and bisexual men and higher rates of <a href=\"https:\/\/nap.nationalacademies.org\/download\/25877\">cardiovascular diseases and cancers<\/a> in certain populations. One <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2211335522001887\">study<\/a> found LGBTQ+ survey respondents were more likely to report having asthma, arthritis, diabetes, kidney disease, hypertension, cardiovascular disease, heart attack, stroke, and chronic obstructive pulmonary disease (COPD) than non LGBTQ+ respondents.<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-group is-layout-constrained wp-block-group-is-layout-constrained\" style=\"padding-top:var(--wp--preset--spacing--30);padding-bottom:var(--wp--preset--spacing--30)\">\n<h4 id=\"hiv-and-stis\" class=\"wp-block-heading has-heading-5-font-size\">HIV and STIs<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">There are significant HIV and STI-related disparities among gay and bisexual men, other men who have sex with men, and transgender women compared to other groups and the population as a whole. These disparities may arise for a range of reasons, including sexual networks, differences in behavior, and biological or social factors. In addition, increased incidence of HIV and STIs can, in turn, put these groups at higher risk for other comorbid conditions like other STIs and certain cancers. Nearly three-quarters (71%) of people diagnosed with HIV in 2022 were gay and bisexual men or other men who have sex with men, and of those, young Black and Latino men were disproportionately represented. (See Figure 10.)<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 900px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/q47gq\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/q47gq\/full.png\"\n\t\t\talt=\"Nearly Three-Quarters of HIV Diagnoses in 2022 Were Among Gay and Bisexual Men and Other Men Who Have Sex with Men, Most Were Among Black and Hispanic Men\"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">A <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6301428\/\">meta-analysis estimated<\/a> that 14% of transgender women and 3% of transgender men are HIV positive. Black and Hispanic transgender women are disproportionately impacted, with prevalence estimates of 44% and 26%, respectively.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Among those seeking care at STD clinics, gay and bisexual men are more likely to test positive for gonorrhea and chlamydia than women or heterosexual men. An <a href=\"https:\/\/www.cdc.gov\/sti-statistics\/annual\/summary.html\">estimated<\/a> 58% of cases of primary and secondary syphilis reported among men with known sex of sex partners in 2023 were among gay and bisexual men and other men who have sex with men, and cases have increased significantly over the past decade. Additionally, the 2022 <a href=\"https:\/\/www.kff.org\/other\/issue-brief\/key-questions-about-the-current-u-s-monkeypox-outbreak\/\">mpox outbreak<\/a> occurred almost exclusively among gay and bisexual men and other men who have sex with men, with Black and Hispanic men being especially impacted. While data are limited on gender identity and STIs, studies have <a href=\"https:\/\/www.cdc.gov\/std\/treatment-guidelines\/trans.htm\">indicated<\/a> that incidence and prevalence levels of gonorrhea and chlamydia among transgender women are similar to those among cisgender gay and bisexual men.<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-group is-layout-constrained wp-block-group-is-layout-constrained\" style=\"padding-top:var(--wp--preset--spacing--30);padding-bottom:var(--wp--preset--spacing--30)\">\n<h4 class=\"wp-block-heading has-heading-5-font-size\" id=\"mental-health\">Mental Health and Substance Use<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">LGBTQ+ people face greater mental health challenges and disparities than non-LGBTQ+ people, including in accessing mental health care. The drivers of these disparities are complex and may relate, in part, to widespread experiences of stigma and discrimination (as described above). Current attempts to institute anti-LGBTQ+ policies in many states and communities may contribute to poor mental health <a href=\"https:\/\/t.co\/DE8Gfv8aWQ\">outcomes<\/a> and increase the need for care.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">LGBT adults are more likely than non-LGBT adults to <a href=\"https:\/\/www.kff.org\/report-section\/lgbt-adults-experiences-with-discrimination-and-health-care-disparities-findings\/?utm_campaign=KFF-Polling-Surveys&amp;utm_medium=email&amp;_hsenc=p2ANqtz-_AUFn0EZO1bZ4QTUHGhKArBB1nNlqbHE-GW1-8Pnsk6W2YWL3y2wgSghRC7F2Jj6kJR1kU0aC208gov487Q4glaPiHyWOZEJjXMTjy28InmkMrtlM&amp;_hsmi=300829184&amp;utm_content=300829184&amp;utm_source=hs_email\">describe<\/a> their mental health and emotional well-being as either \u201cfair\u201d or \u201cpoor\u201d (39% v. 16%). LGBT adults with household incomes below $40,000 are about twice as likely as LGBT adults with higher incomes to report fair or poor mental health (55% v. 27%), as are LGBT adults ages 18-29 compared to those ages 50 and older (56% v. 24%). Across racial and ethnic groups, about 4 in 10 Black (40%), Hispanic (35%) and White (41%) LGBT adults describe their mental health as fair or poor. (See Figure 11.)<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 734px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/6d7xp\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/6d7xp\/full.png\"\n\t\t\talt=\"Four in Ten LGBT Adults  Describe Their Mental Health as Fair or Poor, About Twice The Share of Non-LGBT Adults Who Report the Same \"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">More specifically, about half (54%) of LGBT adults <a href=\"https:\/\/www.kff.org\/report-section\/lgbt-adults-experiences-with-discrimination-and-health-care-disparities-findings\/?utm_campaign=KFF-Polling-Surveys&amp;utm_medium=email&amp;_hsenc=p2ANqtz-_AUFn0EZO1bZ4QTUHGhKArBB1nNlqbHE-GW1-8Pnsk6W2YWL3y2wgSghRC7F2Jj6kJR1kU0aC208gov487Q4glaPiHyWOZEJjXMTjy28InmkMrtlM&amp;_hsmi=300829184&amp;utm_content=300829184&amp;utm_source=hs_email\">report<\/a> feeling anxious either \u201calways\u201d or \u201coften\u201d in the past year, while a third report feeling lonely (33%) or depressed (32%) \u201calways\u201d or \u201coften\u201d \u2013 more than twice the shares of non-LGBT adults who report the same. As noted earlier, those who experienced recent discrimination were more likely to report these feelings than those who did not.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">LGB adults also <a href=\"https:\/\/web.archive.org\/web\/20250124232810\/https:\/www.samhsa.gov\/data\/sites\/default\/files\/reports\/rpt41899\/2022NSDUHLGBBrief061623.pdf\">report<\/a> having serious thoughts of suicide, making a suicide plan, or attempting suicide at higher rates than non-LGB adults, with disparities especially pronounced among bisexual adults<strong>.<\/strong> LGB adults also <a href=\"https:\/\/web.archive.org\/web\/20250124232810\/https:\/www.samhsa.gov\/data\/sites\/default\/files\/reports\/rpt41899\/2022NSDUHLGBBrief061623.pdf\">report<\/a> higher rates of substance use and substance use disorder (SUD) than non-LGB adults, with rates especially high among bisexual adults.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.kff.org\/report-section\/kff-the-washington-post-trans-survey-trans-in-america\/\">KFF\u2019s polling<\/a> of trans adults shows that many struggle with serious mental health issues, including 4 in 10 (43%) who say they have had suicidal thoughts in the past year. Trans adults are about six times as likely as cisgender adults to say they have engaged in self-harm in the past year, and more than twice as likely to say they have had an eating disorder in the past year or had suicidal thoughts in the past year. (See Figure 12.)<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 401px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/Ci2fn\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/Ci2fn\/full.png\"\n\t\t\talt=\"Many Trans Adults Say They Struggle With Serious Mental Health Issues Compared To Smaller Shares Of Cisgender Adults\"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">Mental health disparities are especially significant among young LGBTQ+ people<strong>. <\/strong>In 2023, more than half (53%) of LGBTQ+ high school students <a href=\"https:\/\/www.cdc.gov\/yrbs\/dstr\/index.html\">reported<\/a> poor mental health in the past 30 days compared to 1 in 5 (21%) non-LGBTQ+ students and more than twice as many reported persistent feelings of sadness or hopelessness over the past year (65% among LGBTQ+ students compared to 31% among non-LGBTQ+ students). In addition, 41% of LGBTQ+ high school students reported having seriously considered suicide during the past year, with 20% having attempted suicide, rates that are substantially higher than for non-LGBTQ+ students (13% and 6%, respectively). (See Figure 13.)<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 462px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/6jKsq\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/6jKsq\/full.png\"\n\t\t\talt=\"Mental Health Experiences of High School Students, by LGBQ+ Identity, 2023\"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">Substance use <a href=\"https:\/\/www.cdc.gov\/yrbs\/dstr\/index.html\">rates were also higher<\/a> among LGBTQ+ high school students than their non-LGBTQ+ peers.LGBTQ+ students and students with any same-sex partners were more likely to engage in a range of substance use behaviors than their peers, including use of alcohol, marijuana, any illicit drug, vaping, and prescription opioids.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In addition to higher reported rates of mental health challenges, LGBT people, particularly those in fair or poor mental health and younger adults, <a href=\"https:\/\/www.kff.org\/racial-equity-and-health-policy\/poll-finding\/lgbt-adults-experiences-with-discrimination-and-health-care-disparities-findings-from-the-kff-survey-of-racism-discrimination-and-health\/\">report<\/a> greater challenges accessing mental health care and are more likely to report forgoing needed mental health care than non-LGBT adults. About half (46%) of LGBT adults say there was a time in the past three years when they thought they might need mental health services but didn\u2019t get them, more than twice the share of non-LGBT adults who say so (20%). Reported challenges to care include affordability and accessibility of providers, including finding a provider who can relate to their background and experiences.<\/p>\n<\/div>\n\n\t<\/div>\n<\/div>\n\n\n<div class=\"wp-block-kff-common-guided-content-entry\" id=\"table-of-contents-best-practices-for-competent-care\">\n\t<header class=\"gc-entry-header\">\n\t\t<div class=\"gc-entry-header-container\">\n\t\t\t<h3 class=\"gc-entry-heading shareable-unit-title\" tabindex=\"-1\">\n\t\t\t\tBest Practices for Competent Care\t\t\t<\/h3>\n\n\n\t\t\t<div class=\"gc-entry-meta\">\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"gc-entry-direct-link\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/wp-json\/wp\/v2\/posts\/634925?entry=table-of-contents-best-practices-for-competent-care\" class=\"clipboard\">\n\t\t\t\t<span class=\"screen-reader-text\">\n\t\t\t\t\t\t\t\t\t\tCopy link to Best Practices for Competent Care\t\t\t\t<\/span>\n\t\t\t<\/a>\n\t\t\t<div class=\"confirmation-message\" aria-live=\"polite\" aria-atomic=\"true\"><\/div>\n\t\t<\/div>\n\t<\/header>\n\n\t<div class=\"gc-entry-content shareable-unit-description\">\n\t\t\n\n<p class=\"wp-block-paragraph\">Access to competent and inclusive health care that meets the needs of LGBTQ+ people can improve engagement with the health system and, ultimately, health outcomes.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The American Medical Association (AMA) <a href=\"https:\/\/www.ama-assn.org\/delivering-care\/population-care\/creating-lgbtq-friendly-practice\">provides<\/a> recommended standards of practice with LGBTQ patients and resources to help make medical practices LGBTQ-friendly, such as including posters, brochures, and other materials that are LGBTQ-inclusive, revising intake materials to be affirming and inclusive, and participating in further provider education.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Similarly, the American Psychiatric Association also provides <a href=\"https:\/\/www.psychiatry.org\/getmedia\/1dd0b752-8791-49d0-b8a1-c73d853bd610\/Best-Practices-LGBTQ-Patients.pdf\">guidance<\/a>, including acknowledgment of the role the association played in perpetuating stigma for LGBTQ+ people in the past and guiding practitioners to not make assumptions about sexual orientation or gender identity in gathering medical information, reminding providers that families can be helped to move towards more acceptance of LGBTQ+ children to improve their mental health, and explicitly coming out against \u2018conversion or reparative\u2019 therapy. Indeed, the use of \u201cconversion therapy\u201d is condemned among all major health groups, <a href=\"https:\/\/d3dkdvqff0zqx.cloudfront.net\/groups\/apaadvocacy\/attachments\/USJS-Final-Version.pdf\">28 of which signed a 2023 joint statement<\/a> against its use, stating that such interventions are both ineffective and harmful, and about <a href=\"https:\/\/www.lgbtmap.org\/equality-maps\/conversion_therapy\">half of states<\/a> have enacted a ban on coverage therapy for minors.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Other <a href=\"https:\/\/www.lgbtqiahealtheducation.org\/wp-content\/uploads\/Providing-Inclusive-Services-and-Care-for-LGBT-People.pdf\">resources<\/a> highlight the importance of language use in caring for LGBTQ+ people, including when it comes to how sexual orientation and gender are discussed and described and how patients are addressed with respect to names and pronoun use. Leadership \u201cbuy-in\u201d and the role of LGBTQ+ champions are also <a href=\"https:\/\/www.lgbtqiahealtheducation.org\/wp-content\/uploads\/2021\/05\/Ten-Strategies-for-Creating-Inclusive-Health-Care-Environments-for-LGBTQIA-People-Brief.pdf\">highlighted<\/a>, as are the benefits of inclusive policies. Data collection used to improve health outcomes, staff training, and partnering locally with the LGBTQ+ community are also <a href=\"https:\/\/www.lgbtqiahealtheducation.org\/wp-content\/uploads\/2021\/05\/Ten-Strategies-for-Creating-Inclusive-Health-Care-Environments-for-LGBTQIA-People-Brief.pdf\">noted<\/a> as ways to be a more affirming practice.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Providing health care services or competent referrals for health services that are disproportionately needed by the LGBTQ+ community is another way to offer inclusive care. This might include behavioral health services, STI care and screening, or inclusive family planning services. Another such service is gender affirming care (see below).<\/p>\n\n\t<\/div>\n<\/div>\n\n\n<div class=\"wp-block-kff-common-guided-content-entry\" id=\"table-of-contents-gender-affirming-care\">\n\t<header class=\"gc-entry-header\">\n\t\t<div class=\"gc-entry-header-container\">\n\t\t\t<h3 class=\"gc-entry-heading shareable-unit-title\" tabindex=\"-1\">\n\t\t\t\tGender Affirming Care\t\t\t<\/h3>\n\n\n\t\t\t<div class=\"gc-entry-meta\">\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"gc-entry-direct-link\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/wp-json\/wp\/v2\/posts\/634925?entry=table-of-contents-gender-affirming-care\" class=\"clipboard\">\n\t\t\t\t<span class=\"screen-reader-text\">\n\t\t\t\t\t\t\t\t\t\tCopy link to Gender Affirming Care\t\t\t\t<\/span>\n\t\t\t<\/a>\n\t\t\t<div class=\"confirmation-message\" aria-live=\"polite\" aria-atomic=\"true\"><\/div>\n\t\t<\/div>\n\t<\/header>\n\n\t<div class=\"gc-entry-content shareable-unit-description\">\n\t\t\n\n<p class=\"wp-block-paragraph\" id=\"affirming-care\">Gender affirming care is a model of care which <a href=\"https:\/\/opa.hhs.gov\/sites\/default\/files\/2023-08\/gender-affirming-care-young-people.pdf\">includes<\/a> a spectrum of \u201cmedical, surgical, mental health, and non-medical services for transgender and nonbinary people\u201d aimed at affirming and supporting an individual\u2019s gender identity.Gender affirmation is <a href=\"https:\/\/www.kff.org\/report-section\/kff-the-washington-post-trans-survey-trans-in-america\/\">highly individualized<\/a>. Not all trans people seek the same types of gender affirming care or services and some people choose not to use medical services as a part of their transition. Gender affirming care is tailored to an individual\u2019s needs across the lifespan.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Virtually all major U.S. medical associations support youth access to gender affirming care, including the&nbsp;<a href=\"https:\/\/www.ama-assn.org\/press-center\/press-releases\/ama-reinforces-opposition-restrictions-transgender-medical-care\">American Medical Association<\/a>,&nbsp;<a href=\"https:\/\/publications.aap.org\/pediatrics\/article\/142\/4\/e20182162\/37381\/Ensuring-Comprehensive-Care-and-Support-for\">American Academy of Pediatrics<\/a>, and the&nbsp;<a href=\"https:\/\/www.apa.org\/news\/press\/releases\/2022\/02\/report-parents-transgender-children\">American Psychological Association<\/a>, among&nbsp;<a href=\"https:\/\/transhealthproject.org\/resources\/medical-organization-statements\/\">others<\/a>. In particular, these groups point to the&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/35212746\/\">evidence<\/a>&nbsp;demonstrating that medically necessary gender affirming care enhances mental health outcomes for transgender youth, including by reducing suicidal ideation. Professional guidance for gender affirming care, including for young people, is provided by the&nbsp;<a href=\"https:\/\/academic.oup.com\/jcem\/article\/102\/11\/3869\/4157558?login=false\">Endocrine Society<\/a>&nbsp;and the&nbsp;<a href=\"https:\/\/www.wpath.org\/publications\/soc\">World Professional Association for Transgender Health<\/a>, bodies that also support access to this care model.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">There is no one way to transition. KFF <a href=\"https:\/\/www.kff.org\/report-section\/kff-the-washington-post-trans-survey-trans-in-america\/\">polling finds<\/a> commonly utilized gender affirming activities are related to a social transition, such as changing the types of clothes worn (77%), changing hairstyles\/grooming habits (76%), or going by different pronouns (72%). Slightly fewer, but still a majority, of trans adults use a different name than the one on their birth certificate (57%). Fewer than half of trans adults report attending counseling or therapy as a part of their gender transition (38%) (which is sometimes a requirement for other gender affirming care), legally changing their name on identifying documents (24%), or using hormone treatments or puberty-blocking hormones (31%) Despite common rhetoric, surgical care is a rare component of gender affirming care, with just 16% of trans adults <a href=\"https:\/\/www.kff.org\/report-section\/kff-the-washington-post-trans-survey-trans-in-america\/\">reporting<\/a> having received gender-affirming surgery. While the number of young trans people using puberty blockers or hormone therapy has increased modestly in recent years, the overall number of those using these prescriptions remains fairly low and&nbsp;<a href=\"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2808707\">multiple<\/a>&nbsp;<a href=\"https:\/\/www.reuters.com\/investigates\/special-report\/usa-transyouth-data\/\">studies<\/a>&nbsp;have shown gender affirming surgery is extremely rare among minors.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\" id=\"affirming-care\">Lack of insurance coverage for gender affirming care is a barrier to receiving these services. KFF\u2019s <a href=\"https:\/\/www.kff.org\/report-section\/kff-the-washington-post-trans-survey-trans-in-america\/\">polling finds,<\/a> for example, that among trans adults with health insurance, about a quarter (27%) say their insurance covers gender affirming treatment or health care, while 14% say their health insurance does not cover this and 6 in 10 (58%) are unsure. One in 5 trans adults say they have had health insurance that would not cover gender affirming treatments or health care (22%). About 1 in 7 trans adults have changed jobs or health insurance in order to get gender affirming treatments or health care. (See Figure 14.)<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: 536px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/koCAX\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/koCAX\/full.png\"\n\t\t\talt=\"At Least One In Seven Trans Adults Say Their Health Insurance Would Not Cover Gender-Affirming Treatment Or They&#039;ve Been Refused Gender-Affirming Care\"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">Despite the evidence around the role gender affirming care can play in promoting well-being for young people and support from the medical community,\u00a0some have argued against this care claiming that the services are experimental and lack an evidence base or that young trans people commonly change their minds about their gender identity. The Trump administration, in particular, has moved to limit access to gender affirming care, particularly for youth, through <a href=\"https:\/\/www.kff.org\/other\/fact-sheet\/overview-of-president-trumps-executive-actions-impacting-lgbtq-health\/\">executive orders and other actions<\/a> (see discussion below).\u00a0The administration has also promoted <a href=\"https:\/\/www.kff.org\/the-monitor\/falsehoods-about-transgender-people-and-gender-affirming-care\/\">misinformation<\/a> about gender affirming care relating to issues like regret rates, how common surgical care is, and <a href=\"https:\/\/www.kff.org\/other\/fact-sheet\/overview-of-president-trumps-executive-actions-impacting-lgbtq-health\/\">conflating<\/a> it with female genital mutilation. It has stated that it will <a href=\"https:\/\/www.kff.org\/other\/fact-sheet\/overview-of-president-trumps-executive-actions-impacting-lgbtq-health\/\">seek to prohibit<\/a> providers receiving federal funding from providing certain gender affirming care services to minors. To date, more than\u00a0<a href=\"https:\/\/www.kff.org\/other\/dashboard\/gender-affirming-care-policy-tracker\/\" target=\"_blank\" rel=\"noreferrer noopener\">half (27) of US states<\/a> (as of July 2025) have enacted restrictions on gender affirming care for minors (discussed further below). As a\u00a0result, young people may be unable to get medically necessary care depending on where they live and the resources their families have. Research has demonstrated that young transgender people\u2019s mental health is negatively impacted when this care is denied, including leading to an increased risk of <a href=\"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2789423\" target=\"_blank\" rel=\"noreferrer noopener\">suicidality<\/a>. Further, claims around lack of evidence and regret are <a href=\"https:\/\/www.endocrine.org\/clinical-practice-guidelines\/gender-dysphoria-gender-incongruence\" target=\"_blank\" rel=\"noreferrer noopener\">not borne<\/a> out by the <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38436975\/\" target=\"_blank\" rel=\"noreferrer noopener\">data<\/a> and, in fact, the very same services are provided to young people in other medical circumstances without controversy.\u00a0<\/p>\n\n\t<\/div>\n<\/div>\n\n\n<div class=\"wp-block-kff-common-guided-content-entry\" id=\"table-of-contents-policy-impact\">\n\t<header class=\"gc-entry-header\">\n\t\t<div class=\"gc-entry-header-container\">\n\t\t\t<h3 class=\"gc-entry-heading shareable-unit-title\" tabindex=\"-1\">\n\t\t\t\tPolicy Impact\t\t\t<\/h3>\n\n\n\t\t\t<div class=\"gc-entry-meta\">\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"gc-entry-direct-link\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/wp-json\/wp\/v2\/posts\/634925?entry=table-of-contents-policy-impact\" class=\"clipboard\">\n\t\t\t\t<span class=\"screen-reader-text\">\n\t\t\t\t\t\t\t\t\t\tCopy link to Policy Impact\t\t\t\t<\/span>\n\t\t\t<\/a>\n\t\t\t<div class=\"confirmation-message\" aria-live=\"polite\" aria-atomic=\"true\"><\/div>\n\t\t<\/div>\n\t<\/header>\n\n\t<div class=\"gc-entry-content shareable-unit-description\">\n\t\t\n\n<p class=\"wp-block-paragraph\" id=\"policy-impact\">Policymaking, including in health care, can both facilitate and hinder access to care and coverage, and ultimately, health outcomes, for LGBTQ+ people. Recent examples of how policymaking addresses LGBTQ+ people\u2019s health include:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Supreme Court of the United States (SCOTUS) Decisions: <\/strong>Several recent Supreme Court decisions have impacted the health and well-being of LGBTQ+ people. SCOTUS decisions regarding marriage equality have been particularly far reaching with both the <a href=\"https:\/\/www.law.cornell.edu\/supremecourt\/text\/12-307\"><em>Windsor<\/em><\/a> (2013) and <a href=\"https:\/\/www.law.cornell.edu\/supremecourt\/text\/14-556\"><em>Obergefell<\/em><\/a> (2015) decisions providing same-sex married couples with legal access to spousal health insurance benefits for the first time, among other changes. In&nbsp;<a href=\"https:\/\/www.supremecourt.gov\/opinions\/19pdf\/17-1618_hfci.pdf\"><em>Bostock<\/em><\/a> (2019), SCOTUS ruled that in the context of employment, discrimination based on sex encompasses sexual orientation and gender identity\u2014a decision that was subsequently used to support extending sex protections in health care to LGBTQ+ people (see discussion of Section 1557 below). In June 2025, in <a href=\"https:\/\/www.kff.org\/policy-watch\/what-are-the-implications-of-the-skrmetti-ruling-for-minors-access-to-gender-affirming-care\/\">United States v. Skrmetti<\/a>, SCOTUS ruled that a Tennessee law banning gender affirming care for minors did not violate the 14<sup>th<\/sup> Amendment\u2019s Equal Protection clause, allowing it and other similar laws to remain in place, resulting in a continued patchwork of access. On March 10, 2025, SCOTUS <a href=\"https:\/\/www.supremecourt.gov\/orders\/courtorders\/031025zor_7758.pdf\">granted certiorari<\/a> in <em>Chiles&nbsp;v. Salazar <\/em>and will review a challenge to Colorado&#8217;s conversion therapy ban for minors, assessing \u201cwhether a law that censors certain conversations between counselors and their clients based on the viewpoints expressed regulates conduct or violates the Free Speech Clause.\u201d&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"wp-block-list-item\"><strong>Section 1557: <\/strong>One area that has received significant attention over the last decade is <a href=\"https:\/\/www.kff.org\/affordable-care-act\/issue-brief\/the-biden-administrations-final-rule-on-section-1557-non-discrimination-regulations-under-the-aca\/\">Section 1557 of the Affordable Care Act (ACA).<\/a> Section 1557 prohibits discrimination on the basis of a range of factors, including sex, and applies to health programs and activities receiving federal financial assistance (referred to as covered entities). Specifically, it prevents covered entities from discriminating against certain protected groups in providing health care services, insurance coverage, and program participation. Across different Presidential administrations, lengthy rulemaking and court challenges have affected the application of Section 1557, particularly around whether sexual orientation and gender identity should be encompassed in sex protections. The Obama administration interpreted the statute to include protections on the basis of gender identity and sex-stereotyping, laying out specific protections for trans people, while the Trump administration removed such protections. The Biden administration has since restored and expanded on protections, including by also interpreting sex protections to protect against discrimination on the basis of sexual orientation, following the <em>Bostock<\/em> decision. As of May 2025, the Trump administration had not yet issued rulemaking on Section 1557, but <a href=\"https:\/\/www.kff.org\/other\/fact-sheet\/overview-of-president-trumps-executive-actions-impacting-lgbtq-health\/\">multiple executive orders<\/a> suggest that the administration will view sex narrowly, laying the groundwork for removing explicit protections for LGBTQ+ people.<\/li>\n\n\n\n<li class=\"wp-block-list-item\"><strong>Mental Health: <\/strong>Policy can also positively or negatively impact the mental health of the LGBTQ+ community. For <a href=\"https:\/\/www.kff.org\/mental-health\/issue-brief\/utilization-of-the-988-suicide-crisis-lifelines-lgbtq-service\/\">example<\/a>, 988, the federally-mandated&nbsp;<a href=\"https:\/\/www.kff.org\/mental-health\/issue-brief\/taking-a-look-at-988-suicide-crisis-lifeline-implementation-one-year-after-launch\/\">suicide and crisis line<\/a>, supported by the Substance Abuse and Mental Health Services Administration (SAMHSA), historically included specific services to meet the needs of LGBTQ+ young people. While the service represented <a href=\"https:\/\/www.kff.org\/mental-health\/issue-brief\/growing-uncertainty-about-the-future-of-the-988-suicide-and-crisis-lifelines-lgbtqi-service\/\">10% of all contacts<\/a> to 988 funded by Congress, the Trump administration ended this service in July 2025. Under the Biden administration, SAMHSA released a \u201c<a href=\"https:\/\/web.archive.org\/web\/20250118010303\/https:\/www.samhsa.gov\/newsroom\/press-announcements\/20230331\/hhs-report-transgender-day-visibility\">road map<\/a>\u201d for supporting LGBTQ+ youth, an <a href=\"https:\/\/www.samhsa.gov\/grants\/grant-announcements\/fg-23-004\">LGBTQI+ Family Support Grant<\/a>&nbsp;providing nearly $2 million in funding for programs that address behavioral health for LGBTQ youth, and more than $5 million for&nbsp;\u201c<a href=\"https:\/\/www.samhsa.gov\/grants\/grants-dashboard?f%5B0%5D=by_nofo_number%3AFG-23-004#awards-tab\">Family Counseling and Support for Lesbian, Gay, Bisexual, Transgender, Queer\/Questioning, Intersex+ Youth and their Families<\/a>,\u201d and also funded the <a href=\"https:\/\/lgbtqequity.org\/\">Center of Excellence: LGBTQ+ Behavioral Health Equity<\/a> aimed at supporting \u201cimplementation of change strategies within mental health and substance use disorder treatment systems to address disparities impacting the LGBTQ+ community.\u201d The Biden administration <a href=\"https:\/\/web.archive.org\/web\/20241002181623\/https:\/www.hhs.gov\/about\/news\/2024\/04\/29\/biden-harris-administration-finalizes-rule-strengthen-protections-youth-child-welfare-system.html\">issued a rule<\/a> to better protect LGBTQ+ youth in foster care. In addition to federal efforts, some states are also electing to highlight and address the behavioral health needs of LGBTQ+ people, sometimes through the use of <a href=\"https:\/\/www.samhsa.gov\/sites\/default\/files\/behavioral-health-crisis-services-snapshot.pdf\">federal funds<\/a>. On the other hand, there is <a href=\"https:\/\/t.co\/DE8Gfv8aWQ\">evidence<\/a> that the promulgation of state laws and policies restricting access to LGBTQ+ health and other services negatively affects the mental health of the community. The Trump administration\u2019s approach to LGBTQ people\u2019s health has differed significantly. Following President Trump\u2019s campaign promises, the <a href=\"https:\/\/www.kff.org\/other\/fact-sheet\/overview-of-president-trumps-executive-actions-impacting-lgbtq-health\/\">administration has prioritized actions and policymaking aimed<\/a> at limiting young people\u2019s access to gender affirming care and, in some cases, denying existence of transgender people and fueling misinformation about transgender and intersex people and trans health care. The administration has reversed Biden-era agendas, roadmaps, and interpretations of civil rights protections regarding LGBTQ people\u2019s well-being. Collectively, these actions can have a negative impact on well-being and access to medically necessary best practice care.<\/li>\n\n\n\n<li class=\"wp-block-list-item\"><strong>Gender affirming care:<\/strong> As noted above, the Trump administration has <a href=\"https:\/\/www.kff.org\/other\/fact-sheet\/overview-of-president-trumps-executive-actions-impacting-lgbtq-health\/\">taken a range of actions<\/a> and made proposals to limit gender affirming care for minors, differing from the Biden administration which had supported access to this care on principles of equity and well-being. These orders have generally sought to restrict access to services, limit research related to gender diversity, and stated that the federal government will only acknowledge two sexes and will not recognize diverse gender identities, including transgender people. As of July 2025, most of these actions do not formally prohibit entities from providing care, but they have led to a climate of fear and a chilling effect, with many providers walking back gender affirming care services for minors. Actions that led to this include creating an FBI tip line to report clinicians providing surgical care to minors, detailed collection of personal and institutional information offering gender affirming care, issuing subpoenas, and explicitly stating that the administration is seeking to make providing gender affirming care to minors a violation of terms of condition for participation in the Medicare and Medicaid programs, among others. Further actions limiting access are expected, as is litigation challenging these restrictions. The administration also <a href=\"https:\/\/www.kff.org\/mental-health\/issue-brief\/u-s-department-of-health-and-human-services-report-on-pediatric-gender-dysphoria-and-gender-conversion-efforts\/\">released an evidence review<\/a> related to information about treatment of gender dysphoria, concluding that the quality of evidence on the effects of intervention is low, and evidence on harms is \u201csparse.\u201d It also states that there are significant risks and supports the use of psychotherapeutic approaches, including an approach termed \u201cexploratory therapy\u201d, which can include conversion therapy, departing from most U.S. medical associations. While the report has been used to promote restrictions, it has also faced criticism including for its approach to the review and promotion of misinformation, among other factors. Impacting both adults and minors, the administration also <a href=\"https:\/\/www.kff.org\/private-insurance\/issue-brief\/new-rule-proposes-changes-to-aca-coverage-of-gender-affirming-care-potentially-increasing-costs-for-consumers\/\">adopted a policy<\/a> that would not require broad financial protections in the individual market and small group health insurance marketplaces from applying to gender affirming care.<\/li>\n\n\n\n<li class=\"wp-block-list-item\"><strong>Data collection: <\/strong>(See also <a href=\"#data-collection-box\">callout box on data collection<\/a>.)Better understanding who the LGBTQ+ community is and what challenges they face allows policymakers, providers, and other individuals and groups to meet their needs better and provide care and coverage that is culturally competent. Addressing care needs may happen in the provider\u2019s office, at the health system level, or in the policy arena. Research on LGBTQ+ people and health has generally increased over time though that trend is currently reversing at the federal level. Both the Obama and Biden administrations implemented a range of efforts to improve collection and reporting of data on LGBTQ+ people. For example, in 2016, the NIH <a href=\"https:\/\/web.archive.org\/web\/20250107121212\/https:\/www.nimhd.nih.gov\/about\/directors-corner\/messages\/message_10-06-16.html\">designated<\/a> sexual and gender minorities (SGMs) as a health disparity population for research purposes. In doing so, NIH recognized the health disparities faced by this population and that \u201cthe extent and causes of health disparities are not fully understood, and research on how to close these gaps is lacking.\u201d Many federal surveys also began to ask sexual orientation and gender identity (SOGI) questions, including the Behavioral Risk Factor Surveillance System Survey, the National Survey on Drug Use, the National Health Interview Survey, and the Youth Risk Behavior Survey, though data collection was not routine and it was sometimes an optional variable for states or a restricted variable for researchers. The Biden administration also issued an <a href=\"https:\/\/www.whitehouse.gov\/briefing-room\/presidential-actions\/2022\/06\/15\/executive-order-on-advancing-equality-for-lesbian-gay-bisexual-transgender-queer-and-intersex-individuals\/\">executive order<\/a> calling for agencies to enhance routine collection of SOGI data to improve outcomes and address disparities, and an implementing roadmap in a <a href=\"https:\/\/web.archive.org\/web\/20250118002904\/https:\/www.whitehouse.gov\/briefing-room\/presidential-actions\/2022\/06\/15\/executive-order-on-advancing-equality-for-lesbian-gay-bisexual-transgender-queer-and-intersex-individuals\/\">Federal Evidence Agenda<\/a>. However, SOGI data collection has become politicized. The <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28453387\/\">first Trump administration<\/a> sought to roll back some of the activities of the Obama administration, and these efforts have intensified in President Trump\u2019s second term. On his first day in office President Trump rescinded the Biden-era executive order on data collection and <a href=\"https:\/\/www.kff.org\/other\/fact-sheet\/overview-of-president-trumps-executive-actions-impacting-lgbtq-health\/\">issued executive orders<\/a> taking a narrow view of sex and removing recognition of gender identity and limiting diversity, equity, inclusion, and accessibility (DEIA) activities in government programs, which led to limiting data collection efforts. A range of datasets, questionnaires, codebooks, reports, and other documents were removed from federal websites in the early days of the administration (some of which have been reposted due to a court order)and SOGI data collection in major surveys, including the <a href=\"https:\/\/www.npr.org\/2025\/02\/21\/nx-s1-5305265\/census-lgbtq-sogi-data-robert-santos\">Census<\/a>, have been discontinued to comply with executive orders. Beyond survey data, data collection is also limited by efforts to <a href=\"https:\/\/www.nbcnews.com\/nbc-out\/out-news\/trump-administration-axes-125m-lgbtq-health-funding-upending-research-rcna199175\">rescind<\/a> LGBTQ related <a href=\"https:\/\/www.whitehouse.gov\/fact-sheets\/2025\/04\/report-to-the-president-on-protecting-children-from-surgical-and-chemical-mutilation-executive-summary\/\">research funding<\/a>. Data collection efforts are also variable at state and health system levels and, if not reliant on federal funding, may be able to continue.<\/li>\n\n\n\n<li class=\"wp-block-list-item\"><strong>State and Local Policymaking: <\/strong>While federal policymaking plays an important role in individuals\u2019 lives, so too does state and local policymaking, perhaps, especially so in health care. Over the past few years, there has been a rash of policymaking addressing LGBTQ+ people\u2019s health. Policies have both aimed to expand protections and well-being for LGBTQ+ people and sought to restrict access to care or loosen antidiscrimination standards. For example, as of July 2025, <a href=\"https:\/\/www.kff.org\/other\/dashboard\/gender-affirming-care-policy-tracker\/\">over half of states<\/a> have enacted policies aimed at limiting or prohibiting youth access to gender affirming care and most of this policymaking took place within an <a href=\"https:\/\/www.kff.org\/other\/issue-brief\/half-of-all-u-s-states-limit-or-prohibit-youth-access-to-gender-affirming-care\/\">18-month period<\/a>&nbsp;. Other states have enacted <a href=\"https:\/\/www.lgbtmap.org\/equality-maps\/healthcare\/trans_shield_laws\">\u201crefuge laws\u201d<\/a> (also known as \u201cshield laws\u201d) that generally aim to protect individuals, families, and providers living in states where these bans have been enacted. State policymaking has also focused on LGBTQ+ people and access to services through private and public insurance coverage. For example, while <a href=\"https:\/\/www.lgbtmap.org\/equality-maps\/healthcare_laws_and_policies\">some states<\/a> expressly prohibit insurers from discriminating against people based on sexual orientation and gender identity, others are silent on the issue. Similarly, some <a href=\"https:\/\/www.lgbtmap.org\/equality-maps\/healthcare\/medicaid\">state Medicaid programs<\/a> explicitly cover gender affirming care, others have exclusions, and some have no clear policy; even those that do cover this care may not cover <a href=\"https:\/\/www.kff.org\/womens-health-policy\/issue-brief\/update-on-medicaid-coverage-of-gender-affirming-health-services\/\">all the services<\/a> an individual needs. About half of states have enacted <a href=\"https:\/\/www.lgbtmap.org\/equality-maps\/conversion_therapy\">laws banning conversion therapy<\/a> for minors, but the Supreme Court is set to hear a challenge to Colorado\u2019s ban in the fall of 2025. Finally, some LGBTQ+ related policy is not overtly health-related but has the potential to impact well-being. For example, <a href=\"https:\/\/www.lgbtmap.org\/equality-maps\/safe_school_laws\">preventing schools from adopting<\/a> LGBTQ+ anti-bullying policies or enacting <a href=\"https:\/\/www.lgbtmap.org\/equality-maps\/youth\/forced_outing\">laws that require school staff to out<\/a> transgender youth to their families stand to negatively impact health outcomes.<\/li>\n<\/ul>\n\n\t<\/div>\n<\/div>\n\n\n<div class=\"wp-block-kff-common-guided-content-entry\" id=\"table-of-contents-future-outlook\">\n\t<header class=\"gc-entry-header\">\n\t\t<div class=\"gc-entry-header-container\">\n\t\t\t<h3 class=\"gc-entry-heading shareable-unit-title\" tabindex=\"-1\">\n\t\t\t\tFuture Outlook\t\t\t<\/h3>\n\n\n\t\t\t<div class=\"gc-entry-meta\">\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"gc-entry-direct-link\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/wp-json\/wp\/v2\/posts\/634925?entry=table-of-contents-future-outlook\" class=\"clipboard\">\n\t\t\t\t<span class=\"screen-reader-text\">\n\t\t\t\t\t\t\t\t\t\tCopy link to Future Outlook\t\t\t\t<\/span>\n\t\t\t<\/a>\n\t\t\t<div class=\"confirmation-message\" aria-live=\"polite\" aria-atomic=\"true\"><\/div>\n\t\t<\/div>\n\t<\/header>\n\n\t<div class=\"gc-entry-content shareable-unit-description\">\n\t\t\n\n<p class=\"wp-block-paragraph\">Despite the increase in the share of people identifying as LGBTQ+ and in public support for LGBTQ+ relationships and protections against discrimination, LGBTQ+ people continue to face health disparities and worse health outcomes in several areas. In many cases, these are directly related to ongoing experiences of stigma, discrimination, and violence. Policy efforts to address health disparities among LGBTQ+ people, including those tied to experiences of stigma and discrimination, had increased over time but under the second Trump administration are reversing, with <a href=\"https:\/\/www.kff.org\/other-health\/overview-of-president-trumps-executive-actions-impacting-lgbtq-health\/\">numerous executive<\/a> <a href=\"https:\/\/www.kff.org\/lgbtq\/the-trump-administration-executive-order-on-gender-continues-to-reverberate\/\">branch actions<\/a> designed to limit access to care and remove protections for LGBTQ+ people. &nbsp;More generally, there has been growing partisanship in some areas of LGBTQ+ rights and access, particularly for LGBTQ+ youth, and a rise in the number of policies and laws that restrict access to recommended care. Monitoring these policies, the shifting legal landscape, and better understanding the actual experiences of LGBTQ+ people will help inform efforts to address and mitigate health disparities for this population moving forward.<\/p>\n\n\t<\/div>\n<\/div>\n\n\n<div class=\"wp-block-kff-common-guided-content-entry\" id=\"table-of-contents-resources\">\n\t<header class=\"gc-entry-header\">\n\t\t<div class=\"gc-entry-header-container\">\n\t\t\t<h3 class=\"gc-entry-heading shareable-unit-title\" tabindex=\"-1\">\n\t\t\t\tResources\t\t\t<\/h3>\n\n\n\t\t\t<div class=\"gc-entry-meta\">\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"gc-entry-direct-link\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/wp-json\/wp\/v2\/posts\/634925?entry=table-of-contents-resources\" class=\"clipboard\">\n\t\t\t\t<span class=\"screen-reader-text\">\n\t\t\t\t\t\t\t\t\t\tCopy link to Resources\t\t\t\t<\/span>\n\t\t\t<\/a>\n\t\t\t<div class=\"confirmation-message\" aria-live=\"polite\" aria-atomic=\"true\"><\/div>\n\t\t<\/div>\n\t<\/header>\n\n\t<div class=\"gc-entry-content shareable-unit-description\">\n\t\t\n\n<ul class=\"wp-block-list\">\n<li class=\"wp-block-list-item\"><a href=\"https:\/\/www.kff.org\/racial-equity-and-health-policy\/poll-finding\/lgbt-adults-experiences-with-discrimination-and-health-care-disparities-findings-from-the-kff-survey-of-racism-discrimination-and-health\/\">LGBT Adults\u2019 Experiences with Discrimination and Health Care Disparities: Findings from the KFF Survey of Racism, Discrimination, and Health<\/a><\/li>\n\n\n\n<li class=\"wp-block-list-item\"><a href=\"https:\/\/www.kff.org\/other\/fact-sheet\/overview-of-president-trumps-executive-actions-impacting-lgbtq-health\/\">Overview of President Trump\u2019s Executive Actions Impacting LGBTQ+ Health<\/a><\/li>\n\n\n\n<li class=\"wp-block-list-item\"><a href=\"https:\/\/www.kff.org\/other\/issue-brief\/trans-people-in-the-u-s-identities-demographics-and-wellbeing\/\">Trans People in the U.S.: Identities, Demographics, and Wellbeing<\/a><\/li>\n\n\n\n<li class=\"wp-block-list-item\"><a href=\"https:\/\/www.kff.org\/other\/dashboard\/gender-affirming-care-policy-tracker\/\">Policy Tracker: Youth Access to Gender Affirming Care and State Policy Restrictions<\/a><\/li>\n\n\n\n<li class=\"wp-block-list-item\"><a href=\"https:\/\/www.kff.org\/mental-health\/issue-brief\/mental-health-care-needs-and-experiences-among-lgbt-people\/\">Mental Health Care Needs and Experiences Among LGBT+ People<\/a><\/li>\n\n\n\n<li class=\"wp-block-list-item\"><a href=\"https:\/\/www.kff.org\/affordable-care-act\/issue-brief\/the-biden-administrations-final-rule-on-section-1557-non-discrimination-regulations-under-the-aca\/\">The Biden Administration\u2019s Final Rule on Section 1557 Non-Discrimination Regulations Under the ACA<\/a><\/li>\n<\/ul>\n\n\t<\/div>\n<\/div>\n\n\n<div class=\"wp-block-kff-common-guided-content-entry\" id=\"table-of-contents-citation\">\n\t<header class=\"gc-entry-header\">\n\t\t<div class=\"gc-entry-header-container\">\n\t\t\t<h3 class=\"gc-entry-heading shareable-unit-title\" tabindex=\"-1\">\n\t\t\t\tCitation\t\t\t<\/h3>\n\n\n\t\t\t<div class=\"gc-entry-meta\">\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\n\t\t<div class=\"gc-entry-direct-link\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/wp-json\/wp\/v2\/posts\/634925?entry=table-of-contents-citation\" class=\"clipboard\">\n\t\t\t\t<span class=\"screen-reader-text\">\n\t\t\t\t\t\t\t\t\t\tCopy link to Citation\t\t\t\t<\/span>\n\t\t\t<\/a>\n\t\t\t<div class=\"confirmation-message\" aria-live=\"polite\" aria-atomic=\"true\"><\/div>\n\t\t<\/div>\n\t<\/header>\n\n\t<div class=\"gc-entry-content shareable-unit-description\">\n\t\t\n\n<p class=\"wp-block-paragraph\">Dawson, L., Kates, J., Montero, A., and Kirzinger, A., LGBTQ+ Health Policy. In Altman, Drew (Editor), Health Policy 101, (KFF, October 2025) <a href=\"https:\/\/www.kff.org\/health-policy-101-lgbtq-health-policy\/\">https:\/\/www.kff.org\/health-policy-101-lgbtq-health-policy\/<\/a> (date accessed).<\/p>\n\n\t<\/div>\n<\/div>\n\n\t<\/div>\n<\/div>\n\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t<div class=\"post-footer\">\n\t<div class=\"post-footer__title\">More On<\/div>\n\t<div class=\"post-footer__links\">\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/topic\/lgbtq\/\">\n\t\t\t\tLGBTQ\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/topic\/other-health\/\">\n\t\t\t\tOther Health\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/topic\/public-opinion\/\">\n\t\t\t\tPublic Opinion\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/access-to-care\/\">\n\t\t\t\tAccess to Care\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/demographics\/\">\n\t\t\t\tDemographics\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/gender-identity\/\">\n\t\t\t\tGender Identity\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/health-status\/\">\n\t\t\t\tHealth Status\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/sexual-orientation\/\">\n\t\t\t\tSexual Orientation\t\t\t<\/a>\n\t\t\t<\/div>\n<\/div>\n\t\t\t<\/div>\n\t<\/section>\n\n\n\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>This Health Policy 101 chapter explores LGBTQ+ people\u2019s identities and demographics, their experiences with health and health care, including the significant disparities, and the related federal and state health policy landscape.<\/p>\n","protected":false},"author":155412937,"featured_media":637303,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"authors":[{"type":"foundation","id":127159,"name":""},{"type":"foundation","id":49444,"name":""},{"type":"foundation","id":548628,"name":""},{"type":"foundation","id":175242,"name":""}],"exhibits":[],"jetpack_post_was_ever_published":false,"ep_exclude_from_search":false,"_classifai_error":"","_classifai_text_to_speech_error":"","hide_from_search":false,"show_featured_image":false,"subheading":"","tag":"","search_keywords":"Health Policy 101","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"shortlink":"","footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[417697712,1035,63719],"tags":[632330,34947,155118268,1901641,579145448],"series":[],"partner":[],"program":[],"content-types":[579145486],"class_list":["post-634925","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lgbtq","category-other-health","category-public-opinion","tag-access-to-care","tag-demographics","tag-gender-identity","tag-health-status","tag-sexual-orientation","content-types-feature"],"yoast_head":"<!-- This site is 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