The adverse impact of anti-LGBTQ+ policies on the health and well-being of not only LGBTQ+ individuals but also the general public in the United States is a pressing issue that cannot be ignored. In 2024, state legislatures introduced a record-breaking 533 bills targeting LGBTQ+ populations, creating a varied landscape of legal policies that impact everyday life, from children’s education and recreational activities to adults’ living and work environments. These policies have significant consequences for public health, affecting both direct and indirect aspects of daily living. As state and federal laws increasingly come under scrutiny, understanding the full scope of these measures and their health implications becomes crucial.
The Impact of Legalization of Same-Sex Marriage on Health
The legalization of same-sex marriage serves as a primary example of how inclusive policies can improve health outcomes for the LGBTQ+ community and beyond. Most Americans obtain health insurance through their employers, who generally offer coverage for employees and their families, including spouses and children. A landmark study conducted in 2015 revealed that the legalization of same-sex marriage in New York state led to a significant increase in health insurance coverage among adults in same-sex marriages. Following the nationwide legalization of same-sex marriage, subsequent research showed a similar uptick in coverage among gay and lesbian couples, highlighting the profound impact of inclusive policies.
Even single LGBTQ+ individuals who did not get married likely saw health improvements due to enhanced social attitudes toward the community. For instance, after Massachusetts legalized same-sex marriage in 2004, gay and bisexual men, whether single or married, spent less on medical visits and mental health services, demonstrating improved overall health care outcomes. This example underscores the broader societal benefits of inclusive policies, illustrating how legislation that promotes equality can lead to healthier and more vibrant communities. The positive ripple effects of same-sex marriage legalization extend beyond immediate health benefits, promoting a more accepting and cohesive society.
Access to Gender-Affirming Care
Access to gender-affirming care is critical for the health of LGBTQ+ people, offering not just physical benefits but also significant mental health improvements. A 2020 national study of approximately 30,000 transgender and nonbinary individuals found that suicide attempts and mental health hospitalizations declined in states that mandated private insurers to cover services for transgender people similarly to those provided for cisgender people. Despite the lack of studies directly analyzing the impact of policies regulating access to care on the health of transgender and nonbinary individuals, a substantial body of clinical research supports the health benefits of gender-affirming care.
A randomized clinical trial and prospective study indicated that starting gender-affirming hormone therapy reduced depression and suicidality among transgender and nonbinary individuals. Furthermore, several systematic reviews of 124 peer-reviewed studies conducted over the past 50 years consistently found improvements in quality of life and mental health outcomes among those receiving gender-affirming surgery and hormone therapy. These findings highlight the essential nature of access to gender-affirming care, showing tangible benefits that translate into better overall health outcomes for transgender individuals.
Nondiscrimination, Education, and Workplace Protections
Policies outside the direct realm of health care, such as those addressing nondiscrimination, education, and workplace protections, also significantly impact the well-being of LGBTQ+ individuals. For example, transgender and nonbinary people living in states with specific hate crime and discrimination protections for gender identity reported better mental health compared to those in states without similar protections. Similarly, LGBTQ+ students in schools with designated safe spaces exhibited lower rates of suicidal thoughts, demonstrating the profound impact of supportive environments on mental health.
However, the sharp rise in anti-LGBTQ+ policies in the U.S. has led to increased polarization both between and within states. While some states have implemented measures to make schools safer and more inclusive for transgender youth, others have imposed bans preventing transgender youth from using bathrooms or participating in sports teams that align with their gender identities. Additionally, states like South Dakota and Missouri have passed laws preventing progressive schools and districts from adding LGBTQ+ student protections and supportive resources. These conflicting policies contribute to a patchwork of experiences for LGBTQ+ individuals, highlighting the need for comprehensive and uniform protections.
The Role of Inclusive Workplace Policies
Empirical evidence supports that inclusive policies in the workplace benefit LGBTQ+ individuals by fostering supportive work environments and reducing discriminatory practices. For instance, the Supreme Court’s 2020 ruling in Bostock v. Clayton County affirmed that federal sex-based nondiscrimination protections encompass gender identity and sexual orientation. Researchers discovered that LGBTQ+ older adults with coworkers supportive of their gender and sexuality experienced less workplace conflict and fewer cognitive health problems compared to those lacking such support. This underscores the importance of inclusive workplace policies in promoting mental and physical well-being.
Nevertheless, the Trump administration has worked to limit the scope of federal antidiscrimination protections, aiming to exclude LGBTQ+ people. Emerging anti-LGBTQ+ policies present further risks, extending beyond the LGBTQ+ community to affect broader populations. For example, the Supreme Court is set to hear Braidwood v. Becerra in 2025, a case challenging the requirement for employers to cover PrEP, a daily pill highly effective in preventing HIV infection, on the grounds of religious freedom. Such cases underline the precarious nature of existing protections and the need for continued advocacy and vigilance to safeguard the rights and well-being of LGBTQ+ individuals.
Broader Societal Risks and Public Health Implications
The negative impact of anti-LGBTQ+ policies on the health and well-being of LGBTQ+ individuals, as well as the general public, is a significant issue in the United States that cannot be overlooked. In 2024, state legislatures introduced a record 533 bills aimed at LGBTQ+ populations, creating a diverse array of legal policies that affect everyday life. These range from children’s education and recreational activities to the living and work environments of adults. The repercussions of these policies are far-reaching, influencing both the direct and indirect aspects of daily living. As state and federal laws continue to face scrutiny, it is crucial to comprehend the full extent of these measures and their health implications. The dialogue around these issues is not just about legalities; it’s also about understanding the broader consequences on public health and societal well-being, emphasizing the need to address and mitigate these harmful impacts.
