LGBTQ+ Healthcare Under Threat Amid Deteriorating Policy Environment

State of LGBTQ Health™ Third Annual National Survey Assesses the Current Landscape of LGBTQ+ Healthcare Amid a Rapidly Evolving Policy Environment

FOR IMMEDIATE RELEASE
October 22, 2025

Washington, D.C. — Healthcare professionals reveal that increasing emotional exhaustion among service providers and fear among patients experiencing threats to gender-affirming care are exposing deeper systemic deficits that remain under-recognized in most current responses to LGBTQ+ health equity. Findings from the National Coalition for LGBTQ Health State of LGBTQ Health™ Third Annual National Survey provide a timely snapshot of health service delivery amid a rapidly deteriorating policy environment.

Key findings show:

• Fear of stigma and deep-seated institutional distrust remain major barriers to care for LGBTQ+ communities, undermining access and eroding confidence in the health system and government.
• Widespread threats to gender-affirming care are fueling fear among patients, as providers brace for further reduction in access due to weakening policy protections and looming cuts to Medicare and Medicaid.
• An escalating mental health crisis is overwhelming LGBTQ+ communities, with high rates of depression, anxiety, and suicidal ideation compounded by a critical shortage of behavioral health providers.
• Increasing emotional exhaustion among LGBTQ+ service providers signals a workforce under significant strain and threatens the stability and sustainability of care for marginalized communities.
• The political environment is undermining essential LGBTQ+ healthcare, with providers reporting increased pressure, policy-driven care restrictions, and growing concern over the long-term impact on workforce retention and patient well-being.

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Beneath the Surface of LGBTQ+ Health

The 2025 survey reveals the fractures widening beneath a political landscape buckling under rollbacks, funding cuts, and mounting legal hostility. What’s visible—state bans, rescissions, and unraveling safety nets—is only the surface; beneath it lies data shaped by fear, distrust, and fatigue. These issues expose the widening rifts within LGBTQ+ health and care.

“This year’s findings show that LGBTQ+ health providers are not just under pressure, they’re under siege,” said Scott Bertani, Director of Advocacy at the Coalition. “As legal protections erode and funding vanishes, the care environments themselves are being destabilized. What we are hearing in this survey is not just concern. It is a clear signal that the system is under real strain.”

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Intersecting Barriers to Gender-Affirming Care: Disruptions Across the Patient Journey

Individuals seeking gender-affirming care encounter intersecting clinical, structural, and policy barriers that collectively impede access. Limited provider capacity, inadequate insurance coverage, and restrictive legislation compound to disrupt continuity of care and delay essential services. Addressing these multi-level challenges in an integrated manner is critical to advancing equitable and comprehensive gender-affirming care. 

The cumulative effects of federal and state rollbacks, coupled with structural disinvestment in LGBTQ+ health infrastructure, are not just abstract risks; they are operational threats to the very care environments this survey reflects. In the absence of governmental and institutional support, providers across the country are struggling to support their LGBTQ+ clients and patients, reporting stalled programming and burdensome restrictions on essential services, increasing lost-to-care rates, and declining workforce morale.

The report on the State of LGBTQ+ Health™ Third Annual National Survey documents the shifting realities faced by frontline providers and community-based organizations and will inform the development of timely training and advocacy resources to strengthen the workforce as they navigate this challenging landscape.

Read the Report

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