We have organized the research evidence that documents the effects of anti-LGBTQ+ legislation and policies on LGBTQ+ people and their families.  These papers document the effects of many forms of anti-LGBTQ+ policies including attacks on: adoption rights; bathroom bills; counseling discrimination; data collection on LGBTQ+ demographics; discrimination protections; education; fertility care; healthcare; international policies; marriage equality; parental rights; school climate; equal services provisions; and the state of LGBTQ+ adults and youth in the US. It documents harm in the form of health and mental health costs, as well as other forms of harm (e.g., school absenteeism, suicide attempts). It has examined people of differing sexualities, gender, races, ethnicities, and ages. To note, harm has been found even when anti-LGBTQ+ legislation was not expected to pass and didn’t pass (e.g., Horne et al., 2022)—so evidence has indicated that debates on LGBTQ+ rights themselves have constituted harm. 

To access or learn more about any study: You can click on the DOI link at the end of each citation, which will take you to the websites of the journals listed below. You can scroll down or search for the terms listed above.

Please feel free to distribute this webpage to others working to communicate the harm that these policies cause: www.lgbtqmentalhealth.com/legislation.

Abreu, R. L., Sostre, J. P., Gonzalez, K. A., Lockett, G. M., & Matsuno, E. (2022). “I am afraid for those kids who might find death preferable”: Parental figures’ reactions and coping strategies to bans on gender affirming care for transgender and gender diverse youth. Psychology of Sexual Orientation and Gender Diversity, 9(4), 500– 510. https://doi.org/10.1037/sgd0000495

Research has documented that parental figures of trans and gender diverse (TGD) youth often struggle with fear, grief, and stress as a result of antitransgender oppression. However, there is a dearth of research about how parental figures of TGD youth are impacted by antitransgender state and federal laws and bills. The present study aimed to explore parental figures’ reactions and coping strategies with recent proposed and enacted laws and bills in the United States restricting access to gender-affirming healthcare for TGD youth. A sample of 138 parental figures of TGD youth who currently or previously lived in the United States participated in an online survey where they shared their reactions and coping strategies as a result of current antitransgender laws and bills. Thematic analysis revealed four themes depicting participants' cognitive reactions, including: (a) violation of rights, (b) increased stigma, (c) decreased quality of healthcare, and (d) support for child’s journey. Also, three themes emerged about participants’ emotional reactions, including: (a) fear and anxiety, (b) anger, and (c) relief. Additionally, participants shared narratives about how they are coping with these antitransgender laws and bills, including: (a) activism and advocacy, (b) educating others, (c) seeking support from communities/groups, and (d) relocation and avoidance. Recommendations for practitioners such as debunking incorrect information about trans healthcare when working with parental figures are discussed.

Abreu, R. L., Sostre, J. P., Gonzalez, K. A., Lockett, G. M., Matsuno, E., & Mosley, D. V. (2022). Impact of gender-affirming care bans on transgender and gender diverse youth: Parental figures’ perspective. Journal of Family Psychology, 36(5), 643–652. https://doi.org/10.1037/fam0000987

Transgender and gender diverse (TGD) youth in the United States are met with systemic barriers that affect their physical and mental health. Recent scholarship has found that TGD youth have been negatively impacted as a result of antitransgender federal, state, and local laws and bills. Given the crucial role of parental figures in the well-being of TGD youth (e.g., supporting their child’s health-care decisions), parents can provide important insight about the experiences of their children as they navigate the effects of antitransgender legislation. This study aimed to explore parental figures’ perceptions of how bans on gender affirming care affect their TGD child and parental figures’ advice for legislators/policymakers regarding the impact of these laws and bills on the well-being of TGD youth. Responses to an online survey with 134 self-identified parental figures of TGD youth were analyzed. Thematic analysis revealed five themes regarding the impact that these antitransgender laws and bills have on TGD youth, including (a) depression and suicidal ideation/risk of suicide, (b) anxiety, (c) increased gender dysphoria, (d) decreased safety and increased stigma, and (e) lack of access to medical care. Parental figures also provided direct feedback to legislators/policymakers regarding the impact of these laws and bills on the well-being of TGD youth, including (a) transgender youth health is not a political issue, (b) decriminalize gender affirming medical care, (c) decrease discrimination and violence against

transgender people, and (d) become educated on transgender health-care issues. Recommendations for research and practice are discussed.

APA Resolution on Opposing Discriminatory Laws, Policies, and Practices Aimed at LGBTQ+ Persons: (505852021-001). (2020). [Dataset]. https://doi.org/10.1037/e505852021-001 https://www.apa.org/about/policy/resolution-opposing-discriminatory-laws.pdf

While legislation and initiatives that discriminate against lesbians, gay men and bisexual people have been enacted for decades (Smith, 1997), there has been a dramatic increase in such enactments during the past several years. One form of these enactments has been legislation passed by states and other jurisdictions that restricts the rights of lesbians, gay men and bisexual people in a variety of spheres including limiting access to the rights and responsibilities of marriage, restricting parental rights, and constraining access to legal recourse in the face of discrimination. The other major form of restrictive legal enactments has been popular initiatives proposing amendments to state constitutions that also result in restrictions on marriage and/or parenting rights or recourse in the face of discrimination. Some of the laws resulting from such legislation or initiatives also place restrictions on the rights of same-sex couples to enter into contractual arrangements of various kinds (e.g., Davidoff, 2006; Gay marriage ban goes too far, 2006).

Arm, J. R., Horne, S. G., & Levitt, H. M. (2009). Negotiating connection to GLBT experience: Family members’ experience of anti-GLBT movements and policies. Journal of Counseling Psychology, 56(1), 82–96. https://doi.org/10.1037/a0012813

There have been numerous legislative initiatives to limit gay, lesbian, bisexual, and transgender (GLBT) people's rights at local, state, and national levels (G. M. Herek, 2006). Although research has focused on how GLBT people are affected by these initiatives, to date no research has explored the impact of this legislation upon the families of origin of GLBT people. This qualitative study sought to explore this topic. Through use of grounded theory methodology (B. G. Glaser & A. L. Strauss, 1967), 10 family members of GLBT people living in a state facing a marriage amendment to limit marriage to heterosexual couples were interviewed. All participants interviewed for this study were supportive of their GLBT relative. The results of this study reflected that anti-GLBT movements and policies affected participants' personal relationships, mental and physical health, perspectives about their country and government, and hopes about the future. Movements and policies shaped personal identity and beliefs for some participants. The clusters, underlying categories and a core category of this study, Negotiating My Connection to GLBT experience, are described with implications for counseling psychologists and other mental health professionals.

Australian Psychological Society. (n.d.) Tips for psychologists working with LGBTQI+ people and communities during the marriage equality debate [Fact Sheet]. The Australian Psychological Society Limited. https://psychology.org.au/getmedia/78e53d5b-2d60- 49ad-b55a-dfc8832fdd4c/aps-tips-for-psychologists-working-with-lgbtqi- amended.pdf

Building the capacity of psychologists and others to work effectively with LGBTQI+ clients is very important, and particularly so in the aftermath of the marriage equality postal survey and debates in Parliament. Whilst the passing of marriage equality legislation in Australia is an extremely welcome outcome, the damaging nature of the debate and the campaigning it involved has been detrimental to the health and wellbeing of many LGBTQI+ people and families. A number of agencies reported an increased demand for psychological support services from members of the LGBTQI+ community.

Bochicchio, L., Carmichael, A. J., Veldhuis, C., & Stefancic, A. (2023). What we lose when we 'don’t say gay’: Generational shifts in sexual identity and gender. Social Work, 68(2), 159–165. https://doi.org/10.1093/sw/swad006

At a time when anti-LGBTQ+ legislation is on the rise in more than a dozen states across the United States, social work providers and researchers must be acutely aware of the ways in which their practice may unintentionally invalidate the identities of LGBTQ+ youth. Concurrently, language used in the LGBTQ+ youth community to describe both sexual identity and gender has moved away from monosexual and binary labels toward nonmonosexual and nonbinary descriptions. The adoption of such language, in practice and in research, is a simple step toward

combatting invalidation in the social work field. This commentary explores the expansion of identity labels through the lens of a study conducted across four leading LGBTQ+ agencies in New York and New Jersey with youth and staff. Authors review data that demonstrate the evolution of labels and argue that adopting these terms in practice and research will have fruitful and affirming effects on access to care, treatment attrition, and the design and quality of research in and for the LGBTQ+ community. This shift in language must be comprehensively addressed to ensure that practice and research continue to adopt and advocate for ways to affirm LGBTQ+ people, particularly given the recent onslaught of anti-LGBTQ+ legislation.

Cahill, S. R., & Makadon, H. J. (2017). If They Don’t Count Us, We Don’t Count: Trump Administration Rolls Back Sexual Orientation and Gender Identity Data Collection. LGBT Health, 4(3), 171–173. https://doi.org/10.1089/lgbt.2017.0073

The Trump Administration recently removed sexual orientation and gender identity (SOGI) questions from a national aging survey and decided not to add a sexual orientation category and a transgender identity field to a national disability survey as planned. These actions have raised concerns that the major expansion of SOGI data collection on surveys and in clinical settings, which has occurred in recent years, may be under threat. SOGI data collection is essential to understand lesbian, gay, bisexual, and transgender (LGBT) health and the extent to which LGBT people access critical social services, including elder and disability services essential for living in community. Keywords: disparity, electronic health record, sexual orientation and gender identity data, survey.

Clark, V., Quinn, G. P., Sanchez, N. F., Domogauer, J., Scout, N. F. N., Schabath, M. B., & Brown, R. (2024). Recriminalizing LGBTQ + sexual practices: Impacts on cancer care and research. Gender Issues, 41(3). https://doi.org/10.1007/s12147-024-09333-9

Lesbian, gay, bisexual, transgender, queer/questioning, or other sexual and/or gender expansive identities (LGBTQ+) in the United States are facing an insurmountable reintroduction of discriminatory and stigmatizing policies and legislation (i.e., Zombie Laws) particularly those pertaining to sexual practices, minoritized sexual orientations and gender identities, and access to equitable healthcare. This has a particularly devastating effect on cancer-related care and outcomes. Therefore, a call to action among researchers, policymakers, and activists is needed to protect LGBTQ + rights and ensure gains continue to ameliorate cancer-related health disparities.

Fields, X., & Wotipka, C. M. (2022). Effect of LGBT anti-discrimination laws on school climate and outcomes for lesbian, gay, and bisexual high school students. Journal of LGBT Youth, 19(3), 307–329. https://doi.org/10.1080/19361653.2020.1821276

Lesbian, gay, bisexual, and transgender (LGBT) high school students face challenges that impede their academic, social, and emotional well-being. School policies that provide resources and protections for LGBT students mitigate these challenges and lead to better outcomes for LGBT students. At the same time, LGBT individuals face challenges in sectors like employment protection and hate crime prevalence, and many states have passed laws that expand protections for these adults. This paper aims to investigate the relationship between state-level, LGBT anti-discrimination policies, and high school student well-being by analyzing patterns of policy diffusion and the policies’ effects on four measures of students’ well-being: self-reported (1) experiences with bullying at school, (2) cyberbullying, (3) school absences due to feeling unsafe at school, and (4) grades. Using data from the Center for Disease Control’s Youth Risk Behavior Surveillance System and linear regression analysis with time and state fixed effects, the results of this analysis provide evidence on the benefits of expansive civil rights legislation for LGBT individuals and the spread of its externalities to students in the U.S. schools.

Fenton, M. P., Seegulam, V., Antoine, J., Pham, T. N., Morris, M. R., Boren, S., & Striley, C. W. (2024). Examining the relationship between proposed anti-lgbtq+ legislation and lgbtq+ college student mental health: Findings from the healthy minds study, 2021–2022. Journal of American College Health. https://doi.org/10.1080/07448481.2024.2382426

Objective: This study aimed to investigate the association between proposed anti-LGBTQ+ legislation and depressive symptoms among LGBTQ+ college students. Participants: Participants (N = 72,135) included LGBTQ+ college students (N = 21,466) from over 530 colleges and universities, including technical and community institutions, across the United States who took part in the Healthy Minds Study (HMS). Methods: Data on proposed anti-LGBTQ+ legislation introduced in 2021–2022 were collected from all 50 US states, categorized, and analyzed. Individual-level data for 2021–2022 were obtained from the HMS, and a multilevel analysis was conducted to assess the association between proposed anti-LGBTQ+ legislation and depressive symptoms while considering individual factors. Results: A significant positive association between proposed anti-LGBTQ+ legislation and increased depressive symptoms among LGBTQ+ college students was found. This association remained significant after controlling for individual-level stressors and identities, including a sense of belonging, campus environment perceptions, first-generation student status, and transgender or gender non-conforming identity (TGNC). Conclusions: The findings underscore the need for mental health support and inclusive policies for LGBTQ+ college students, particularly in regions where anti-LGBTQ+ legislation is proposed or enacted, to mitigate the potential negative impact of multiple factors on their mental well-being.

Fredrick, E. G., Mann, A. K., Brooks, B. D., & Hirsch, J. K. (2022). Anticipated to Enacted: Structural Stigma Against Sexual and Gender Minorities Following the 2016 Presidential Election. Sexuality Research and Social Policy, 19(1), 345–354. https://doi.org/10.1007/s13178-021-00547-0

Introduction Structural stigma, or stigma at a society or policy level, has a negative impact on the mental and physical health of sexual and gender minorities (SGMs). In particular, political leaders and the policies they enact can limit the resources and safety of SGM. Following the 2016 presidential election, there was fear of an increase in structural stigma in the USA. However, research on the specifics of anticipated structural stigma is lacking. Methods Using data from 187 participants who completed an online study conducted from 2016 to 2017, we used inductive thematic coding to examine anticipated structural stigma. Results We found four themes: (1) anticipated negative consequences of specific anti-SGM political figures, (2) concerns about the loss of existing SGM rights, (3) fear of new anti-SGM policies, and (4) fears of vulnerability related to limited existing protections. Conclusion We discuss how these themes tie into each other, map them onto existing structural stigma work, and use laws and policies that have been passed or proposed in the past 4 years to describe how these anticipated stigmas have become enacted. Keywords Sexual minority · Gender minority · Structural stigma · Anticipated stigma

Goldberg, A. E., & Abreu, R. (2024). LGBTQ parent concerns and parent–child communication about the Parental Rights in Education Bill ('Don’t Say Gay’) in Florida. Family Relations: An Interdisciplinary Journal of Applied Family Studies, 73(1), 318–339. https://doi.org/10.1111/fare.12894

Objective: The current study sought to understand LGBTQ parents' concerns about how Florida's Parental Rights in Education Act (commonly referred to as the 'Don't Say Gay' bill) would impact their children and family unit and whether and how they communicated with children about it. Background: Florida's Parental Rights in Education bill, which was signed into law in 2022, has implications for educators, youth, and families, including LGBTQ parent families. Indeed, children in LGBTQ parent families already face marginalization and erasure in school settings, where curricula and policies often primarily center and reflect heterosexual parent families. Method: We surveyed LGBTQ parents (N = 90) in Florida in 2022. The sample was primarily cisgender women (62%) and cisgender men (26%), with most participants identifying as lesbian (52%) or gay (23%). Almost two thirds of participants (63%) were White, and almost one third (32%) were Latinx. Findings: More than three quarters of participants were worried about the bill. Primary concerns centered on how it would restrict their children's ability to speak freely about their families in the classroom and impact their sense of self by cultivating a climate where their families were marginalized. Parents also highlighted broader concerns about how the legislation would fuel further anti‐LGBTQ sentiment. Parents with few concerns typically had very young or high‐school–age children or had children in private school. Parents who talked about the bill with their children tended to be parents of older children, with parents of younger children often emphasizing family diversity to foster a sense of pride. Conclusion: The Parental Rights in Education Act and other anti‐LGBTQ legislation have the potential to impact a range of vulnerable children and families, including LGBTQ parent families. Implications Youth and family advocates and practitioners should work to educate others about the effects of this legislation and support LGBTQ parent families in collective action and resiliency efforts.

Goldberg, A. E., Abreu, R. L., & Flores, A. R. (2024). Perceived impact of the parental rights in education act ('don’t say gay’) on LGBTQ+ parents in Florida. The Counseling Psychologist, 52(2), 224–266. https://doi.org/10.1177/00110000231219767

Prior studies indicate that anti-LGBTQ+ legislation has negative consequences for the well-being of LGBTQ+ people, their families, and their communities. In July of 2022, Florida’s Parental Rights in Education Act, also called the 'Don’t Say Gay' bill, was signed into law. The law aimed to limit K–3 instruction and discussion related to sexuality and gender, encompassing LGBTQ+ identities. The present study surveyed 113 LGBTQ+ parents in Florida about their experiences and perceptions related to the Parental Rights in Education Act. Qualitative content analysis revealed five major themes and 14 subthemes, including: (a) living in Florida: pros and cons; (b) initial reactions to the law; (c) feelings over time; (d) coping with worries; and (e) beyond 'coping': considering the future and possibility of relocation. Recommendations center on the need for counseling psychologists to use their privilege and training to advocate on behalf of LGBTQ+ parents, families and others impacted by this legislation.

Goldberg, A. E., Moyer, A. M., Weber, E. R., & Shapiro, J. (2013). What changed when the gay adoption ban was lifted?: Perspectives of lesbian and gay parents in Florida. Sexuality Research & Social Policy: A Journal of the NSRC, 10(2), 110–124. https://doi.org/10.1007/s13178-013-0120-y

This exploratory, qualitative study examined the perspectives of 22 lesbian and gay parents (15 female and seven male) who were residents of Florida while the state’s gay adoption ban was in

effect and who had adopted or were in the process of adopting a child. Participants were interviewed about their experiences before and after the lifting of the gay adoption ban, which occurred in 2010. Participants described numerous negative consequences of the ban, including the inability to adopt foster children and the legal invisibility of one partner’s parental status (e.g., among lesbian couples who had become parents via donor insemination). Parents described various positive changes that occurred in their families once the ban was lifted, such as a profound sense of relief for parents and their children, as well as legal recognition of both partners as parents. Our findings highlight the negative consequences of discriminatory legislation on lesbian/gay-parent families, as well as some subsequent positive effects once such legislation is removed.

Gonzalez, K. A., Abreu, R. L., Arora, S., Lockett, G. M., & Sostre, J. (2021). “Previous resilience has taught me that I can survive anything:” LGBTQ resilience during the COVID-19 pandemic. Psychology of Sexual Orientation and Gender Diversity, 8(2), 133–144. https://doi.org/10.1037/sgd0000501

Coronavirus disease 2019 (COVID-19) has disproportionately negatively affected the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community, a group who faces identity-based marginalization in society. LGBTQ resilience narratives are important in buffering against the negative impact of minority stress, but little is known about how LGBTQ people have been resilient during the COVID-19 pandemic. The current research addresses this gap in the literature. Participants included 129 LGBTQ individuals who shared how they have been resilient during the COVID-19 pandemic. Qualitative thematic analysis revealed three COVID- 19-specific resilience themes, including: (1) Previous preparation fostered resilience, (2) Radical acceptance as resilience, and (3) Resilience through providing support and building community. Discussion explores how psychologists can work with LGBTQ people to identify and cultivate resilience narratives focused on self-love, self-acceptance, radical acceptance, and community resilience.

Grzanka, P. R., Spengler, E. S., Miles, J. R., Frantell, K. A., & DeVore, E. N. (2020). “Sincerely Held Principles” or Prejudice? The Tennessee Counseling Discrimination Law. The Counseling Psychologist, 48(2), 223–
248. https://doi.org/10.1177/0011000019886972

In 2016, Tennessee became the first state to allow counselors and therapists in private practice to deny services to any client based on the therapist’s sincerely held principles. The law’s proponents framed mental health care ethics as infringing on counselors’ religious liberties; its critics denounced the bill because it apparently targeted LGBT+ individuals. This exploratory study is the first statewide assessment of LGBT+ Tennesseans’ (N = 346) perceptions of the law and how it may affect their help-seeking attitudes and behaviors. Evidence suggests widespread awareness of the law among our respondents and deep skepticism toward mental health care. Further, most respondents view the law as cover for discrimination. We stress the need for broader research on conscience clauses and call for advocacy against these laws, which have the potential to engender widespread harm to multiple minority groups.

Horne, S. G. (2020). The challenges and promises of transnational LGBTQ psychology: Somewhere over and under the rainbow. American Psychologist, 75(9), 1358–1371. https://doi.org/10.1037/amp0000791

This article explores the influence of psychology developed in WEIRD (Western, educated, industrialized, rich, and democratic) contexts and its relationship to transnational lesbian, gay, bisexual, transgender, and queer (LGBTQ) concerns. It covers several points associated with an LGBTQ movement forward fallacy, including the limitations of identitarian methods of analysis; presumption of visibility as a necessary aspect of LGBTQ emancipation; the centering of oppression narratives in LGBTQ international scholarship; the assumption of the relevance and desirability of WEIRD concepts; and the difficulties in applying human rights discourses to achieve LGBTQ emancipation. A transnational LGBTQ psychology that honors the authentic lives of LGBTQ people and decolonizes and dismantles context-specific homophobia/transphobia-related stigma is discussed. Finally, the promising directions of transnational LGBTQ psychology through research directions, networking, and advocacy are described.

Horne, S. G., Johnson, T., Yel, N., Maroney, M. R., & McGinley, M. (2022). Unequal Rights Between LGBTQ Parents Living in the U.S.: The Association of Minority Stress to Relationship Satisfaction and Parental Stress. Couple and Family Psychology Research and Practice, 11(2), https://doi.org/10.1037/cfp0000192

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals who become parents in the United States may not be granted legal recognition as parents upon beginning their families, which can result in inequality in parenting rights between partners. In an online survey with 420 LGBTQ parents who were living with a partner with whom they had cocreated a family and had at least one child under age 18, we explored whether parents in couples with unequal rights (N = 113) report minority stress, and whether minority stress was related to relationship dissatisfaction and parental stress. Explored through a mediated path model, parents in couples with unequal rights reported less disclosure about LGBTQ identity and more worry about family discrimination in comparison with parents in couples with full rights. Furthermore, these minority stressors were related to relationship dissatisfaction and associated with parental stress. Unequal rights, accompanied by worry about discrimination and lower reported outness, may put a strain on the couple relationship, which, in turn, may be associated with parental stress. Advocacy efforts should be employed to reduce obstacles to full parentage rights for LGBTQ families. Clinical implications for working with LGBTQ parents with discrepant rights are discussed.

Horne, S. G., McGinley, M., Yel, N., & Maroney, M. R. (2022). The stench of bathroom bills and anti-transgender legislation: Anxiety and depression among transgender, nonbinary, and cisgender LGBQ people during a state referendum. Journal of Counseling Psychology, 69(1), 1–13. https://doi.org/10.1037/cou0000558

Informed by structural stigma theory, this article presents the results of two studies that explored mental health experiences of transgender, nonbinary, and gender-diverse (TNG) individuals and cisgender lesbian, gay, bisexual, and queer (LGBQ) individuals (N = 523) prior to and following a state referendum to remove gender-based protections. In the Preelection Study, a path model explored relationships among individual factors (i.e., TNG identity, history of gender-based victimization), interpersonal variables (i.e., Referendum familiarity, exposure to Referendum- related messages, sexual orientation, and gender identity-specific social support), and mental health factors (i.e., Referendum-related anxiety and depressive symptomatology). Referendum- related anxiety mediated the relationships between TNG identity, gender-based victimization, sexual orientation and gender identity social support, and depressive symptomatology, explaining 40% of the variance in depressive symptomatology. Postelection, a subsample of participants (N = 117) was used to test a model of differences from pre- to postelection. Neither TNG identity nor victimization predicted Postelection mental health, however, Referendum- related anxiety and depressive symptomatology were significantly lower following the ballot vote that retained gender-based rights. Clinical implications suggest sexual and gender minorities may report increased anxiety in the face of anti-lesbian, gay, bisexual, transgender, and queer (LGBTQ) legislation, which may be associated with heightened symptoms of depression. TNG people and LGBTQ people with histories of genderbased victimization may be more at risk for mental health concerns related to anti-TNG legislation.

Jones, T. (2024). Trans bans expand: anti‑LGBTIQ+lawfare and neo‑fascism. Sexuality Research and Social Policy. Advance online publication. https://doi.org/10.1007/s13178-024-00948-x (Open access)

Introduction: Anti-fascist theories suggest different meanings for anti-LGBTIQ+ rights laws. This paper explores how 2023 increases in US anti-LGBTIQ+ bill attempts can be explained. Methods: A Critical Discourse Analysis of 1054 US anti-LGBTIQ+ state-level bill submissions from 1 Jan 2018 to 31 December 2023, compared 2023 trends to previous data. Results: The co-ordinated neofascist mobilisation behind US hyper-productivity and erratic contradictory justifications of anti-LGBTIQ+ bills expanded exponentially, emphasising less resisted campaigns. Initially smaller bills targeted political weak spots: transgender youth in primary schools, bathrooms and politically enabling Republican-governed states. Increasingly bills expanded in number, frequency, size, and punitive reach against LGBTIQ+ and other citizens’ rights, in wider contexts (higher education, public and Democrat-governed spaces). By 2023, bill strategies used hypocritical and hypothetical anti-LGBTIQ+ logics; replicated federally to thwart democratic and economic structures. Conclusions: Anti-fascist, Queer and critical socialist theories explained the 2023 bills’ increase as building upon past partisan mobilisation on wedge transgender state election issues; towards neofascist diminishment of increasingly wider-ranging and higher-level US democratic structures, rights protections, and economic functioning. Policy attacks on vulnerable social groups’ rights — particularly trans youth — can signal ‘early stages’ within neo-fascist strong-man state-identity creation supporting democratic structure diminishments. Policy Implications: Multi-level multi-cultural pluralist democratic institutions and support structures with inter-reinforced rights recognition expansions should be required by and should protect the rights of all citizens.

Jones, T. (2024). United States of hate: mapping backlash Bills against LGBTIQ+ youth. Sex Education, 24(6), 816-835. Article 2241136. https://doi.org/10.1080/14681811.2023.2241136 (open access)

Following the recent proliferation of anti-discrimination protections supporting LGBTIQ+ youth internationally, backlash periods have ensued. Whilst liberal-progressive rights models theorise ‘backlash’ as an expected consequence of rights recognitions progress, some post-colonial and Queer scholars frame backlash within enduring authoritarian anti-rights tendencies, and question assumptions of progress. To understand backlash more adequately, this paper explores state-level anti-LGBTIQ+ Bills potentially impacting youth proposed in the USA between 2018 and 2022. Critical discourse analysis is used to map the different types, locations, conceptual arrangements and outcomes of 543 anti-LGBTIQ+ rights US state-level proposed Bills. Bill attempts were mainly concentrated in Republican-governed states including Tennessee (48), Missouri (40), Iowa (39), Oklahoma (32) and Texas (32). Overly extended claims concerning girls/women’s religious and parental rights were advanced in opposition to LGBTIQ+ youth rights, and as part of wider rights attacks. Bills used anti-rights and pro-rights discourses to mask as ‘backlash’ the rights claims advanced by elite-led anti-rights mobilisations.

King, E., Hebl, M., Corrington, A., Dhanani, L., Holmes, O., Lindsey, A. P., Madera, J., Maneethai, D., Martinez, L., Ng, E. S., Nittrouer, C. L., Sabat, I., Sawyer, K., & Thoroughgood, C. (2024). Understanding and addressing the health implications of anti-LGBTQ+ legislation. Occupational Health Science, 8(1), 1–41. https://doi.org/10.1007/s41542-024-00174-2

In the published version, one of the authors was inadvertently omitted. The author's information is present in the erratum.] Intensifying social discourse and political movements have stalled a trajectory of increasing support for lesbian, gay, bisexual, transgender, queer, plus (LGBTQ+) people. Emerging anti-LGBTQ+ restrictions and legislation have critical implications for organizations and workers. This anthology highlights anticipated challenges including effects on stigmatization at the individual and societal level, and negative physical and mental health- related consequences that vary across subgroups in the U.S. and beyond. In addition, this synthesis describes individual, ally, and organizational strategies for protecting and improving the health of LGBTQ+ workers. In so doing, this work provides timely, evidence-based predictions as well as recommendations to support LGBTQ+ workers.

Kuroki, M. (2021). The rise in extreme mental distress among LGBT people during Trump’s rise and presidency. Economics & Human Biology, 43, 101034. https://doi.org/10.1016/j.ehb.2021.101034

Lesbian, gay, bisexual, and transgender (LGBT) advocates argue that President Donald Trump’s 2016 election victory and his administration's agenda raised concerns about changes to legal rights and discrimination based on sexual orientation and gender identity. Using data on more than one million randomly sampled people during 2014–2020, this study estimates event study and difference-indifferences models to examine whether the prevalence of extreme mental distress (the percentage who reported major mental and emotional problems in all 30 of the last 30 days) increased among LGBT people relative to non-LGBT people after Trump became the Republican presidential frontrunner in early 2016. The difference-in-differences estimate indicates that the extreme mental distress gap between LGBT people and non-LGBT people increased from 1.8 percentage points during 2014–2015 to 3.8 percentage points after Trump’s presidency became a real possibility in early 2016.

Lee, W. Y., Hobbs, J. N., Hobaica, S., DeChants, J., Price, M. N. & Nath, R. State-level anti-transgender laws increase past-year suicide attempts among transgender and non-binary young people in the USA. Nature human behaviour. https://doi.org/10.1038/s41562-024-01979-5

From 2018 to 2022, 48 anti-transgender laws (that is, laws that restrict the rights of transgender and non-binary people) were enacted in the USA across 19 different state governments. In this study, we estimated the causal impact of state-level anti-transgender laws on suicide risk among transgender and non-binary (TGNB) young people aged 13–17 (n = 35,196) and aged 13–24 (n = 61,240) using a difference-in-differences research design. We found minimal evidence of an anticipatory effect in the time periods leading up to the enactment of the laws. However, starting in the first year after anti-transgender laws were enacted, there were statistically significant increases in rates of past-year suicide attempts among TGNB young people ages 13–17 in states that enacted anti-transgender laws, relative to states that did not, and for all TGNB young people beginning in the second year. Enacting state-level anti-transgender laws increased incidents of past-year suicide attempts among TGNB young people by 7–72%. Our findings highlight the need to consider the mental health impact of recent anti-transgender laws and to advance protective policies.

Levitt, H. M., Ovrebo, E., Anderson-Cleveland, M. B., Leone, C., Jeong, J. Y., Arm, J. R., Bonin, B. P., Cicala, J., Coleman, R., Laurie, A., Vardaman, J. M., & Horne, S. G. (2009). Balancing dangers: GLBT experience in a time of anti-GLBT legislation. Journal of Counseling Psychology, 56(1), 67–81. https://doi.org/10.1037/a0012988

In the past few years, 26 states have changed their constitutions to restrict marriage to one man and one woman. There has been little research on the psychological effects of this political process on gay, lesbian, bisexual, and transgender (GLBT) people. In this qualitative project, 13 GLBT people were interviewed about their experience during the process of a constitutional amendment. A grounded theory analysis of these semistructured interviews was conducted. The

core category, or central finding, was 'GLBT people need to balance the dual dangers of engagement with GLBT advocacy and self-protection through withdrawal.' Other findings focused on the experience of living in a context of painful reminders that one is seen as less than human by the government and public, and in which one's life is frequently and publicly misrepresented to advance hostile political campaigns. Social support and a process of self- acceptance helped participants to face their fears of isolation, discrimination, and aggression and to fight for social justice.

Levitt, H. M., Schuyler, S. W., Chickerella, R., Elber, A., White, L., Troeger, R. L., Karter, J. M., Preston, J. M., & Collins, K. M. (2020). How discrimination in adoptive, foster, and medical systems harms LGBTQ+ families: Research on the experiences of prospective parents. Journal of Gay & Lesbian Social Services: The Quarterly Journal of Community & Clinical Practice, 32(3), 261–282. https://doi.org/10.1080/10538720.2020.1728461

LGBTQ + people face multiple challenges to parenthood because of barriers such as discriminatory legislation and policies influencing foster parenting, adoption, and reproductive health services. This study documents these obstacles and examines their impact through a grounded theory analysis of interviews of LGBTQ + prospective parents. Stressors included social isolation, unnecessary medicalization, prohibitive financial costs related to accessing social and medical services (sometimes across state lines), and being denied services, parental leave, and insurance coverage. Findings indicate that heteronormative attitudes and discrimination can lead to debilitating and enduring harm upon the economic, emotional, and relational well-being of growing LGBTQ + families.

Price, S. F., Puckett, J., & Mocarski, R. (2021). The Impact of the 2016 US Presidential Elections on Transgender and Gender Diverse People. Sexuality Research and Social Policy, 18(4), 1094–1103. https://doi.org/10.1007/s13178-020-00513-2

Introduction With Trump’s presidency came a rise in the oppression of transgender and gender diverse (TGD) people, as the nation witnessed a removal of protections for TGD people. Methods We examined the daily experiences of 181 TGD individuals (ages 16–40, M age=25.6) through their reflections about daily stressors over the course of 8 weeks (data collected fall 2015–summer 2017), some of which reflected shifts during the election period. Results During the 2016 presidential election, participants reported a rise in marginalization stress and the subsequent impact on safety, mental health, and well-being. There were three emergent themes: External Rejection and Stigma from Dominant Culture; Supporting the TGD Community; and Fear for the Self and Development of Proximal Stressors. Conclusions In line with marginalization stress theory, participants vocalized the progression from exterior stigmatization to proximal stressors and their heightened sense of vigilance and fear of the dominant culture. Policy Implications Based on the results of this study, policy makers and TGD advocates must work to ensure that political rhetoric and action do not serve to further marginalize and erase TGD communities.

Raifman, J., Moscoe, E., Austin, S. B., Hatzenbuehler, M. L., & Galea, S. (2018). Association of state laws permitting denial of services to same-sex couples with mental distress in sexual minority adults: A difference-in-difference-in-differences analysis. JAMA Psychiatry, 75(7), 671–677. https://doi.org/10.1001/jamapsychiatry.2018.0757

Importance: Recent evidence suggests that state policies affecting sexual minorities are associated with health disparities. Twelve states have laws permitting the denial of services to same-sex couples, and the US Supreme Court is considering whether states can prohibit the denial of services to same-sex couples. Objective: We investigated whether state laws permitting individuals to refuse services to sexual minorities were associated with changes in the proportion of sexual minority adults reporting mental distress. Design, Setting, and Participants: This difference-in-difference-in-differences linear regression analysis with state fixed effects used Behavioral Risk Factor Surveillance System (BRFSS) data from 2014 through 2016 from adults aged 18 to 64 years in 3 states that implemented laws permitting the denial of services to same-sex couples (Utah, Michigan, and North Carolina) and 6 nearby control states (Idaho and Nevada, Ohio and Indiana, and Virginia and Delaware, respectively). Sexual minority adults were defined as those who identified as gay, lesbian, bisexual, or not sure of their sexual orientation under a module on sexual orientation that BRFSS implemented in 2014 and each state could opt to include. Analysis controlled for year and individual-level sex, race, ethnicity, age group, educational attainment, income, employment, and marital status. A permutation test was conducted to precisely estimate statistical significance. Exposures: An interaction term indicating whether individuals identified as a sexual minority and lived in a state with a law permitting denial of services to same-sex couples in 2015. Main Outcomes and Measures: Mental distress, defined as poor mental health on 14 or more of the past 30 days. RESULTS: Of 109 089 participants, 4656 (4.8%; all percentages incorporate survey weights) identified as sexual minorities, 86141 (72.1%) were non-Hispanic white, and ages were uniformly distributed between 18 and 64 years. In 2014, 2038 of 16637 heterosexual adults (12.6%) and 156 of 815 sexual minority adults (21.9%) in the 3 same-sex denial states reported mental distress. The proportion of sexual minority adults reporting mental distress increased by 10.1 percentage points (95% CI, 1.8 to 18.5 percentage points, permutation-adjusted P value = .046) between 2014 and 2016 in states that passed laws permitting denial of services to same-sex couples compared with control states, a 46% relative increase in sexual minority adults experiencing mental distress. Laws permitting denial of services to same-sex couples were not associated with significant changes in heterosexual adults experiencing mental distress (−0.36 percentage points, 95% CI, −1.73 to 1.01 percentage points). Conclusions and Relevance: Laws permitting denial of services to same-sex couples, which exist in 12 states and are under consideration by the US Supreme Court, are associated with a 46% increase in sexual minority adults experiencing mental distress. 

Riggle, E. D. B., Drabble, L. A., Matthews, A. K., Veldhuis, C. B., Nisi, R. A., & Hughes, T. L. (2021). First Comes Marriage, Then Comes the Election: Macro-level Event Impacts on African American, Latina/x, and White Sexual Minority Women. Sexuality Research and Social Policy, 18(1), 112–126. https://doi.org/10.1007/s13178- 020-00435-z

Introduction Sexual minority women (SMW) may have different experiences of macro-level events, such as changes in marriage laws or election outcomes, related to their multiple identities. African American, Latina/x, and White identities intersect with gender/sex and sexual identity to influence experiences at the intrapersonal, interpersonal, social, and political levels of the socio-ecological environment. Methods Participants include 100 African American, 35 Latina/x, and 164 White SMW (N=299) in wave 4 (2017–2019) of a longitudinal study of SMW’s health conducted in the USA (Chicago Health and Life Experiences of Women Study). Responses to nine open-ended survey questions about marriage equality and the 2016 Presidential election were examined. Results Thematic analysis noted similarities across groups and focused on group differences in four areas: (1) personal well-being (including fear and anxiety about discrimination; risk associated with masculine presentation; and religion as stress and support); (2) interpersonal relationships (including relationships with partners, family, and in a community); (3) societal discrimination and prejudice (including harassment in public spaces and concerns about travel); and (4) civil rights, government harassment, and police-state violence. Conclusions Emerging differences emphasized the impact of race/ethnicity and the intersection of race/ethnicity and gender on experiences of marriage equality and the 2016 election. Policy Implications Findings suggest that a more nuanced understanding of the experiences of individuals with different racial/ racialized identities and the intersection of race/ethnicity with sexual identities is essential to creating culturally competent and effective supports for SMW.

Rostosky, S. S., Riggle, E. D. B., Horne, S. G., Denton, F. N., & Huellemeier, J. D. (2010). Lesbian, gay, and bisexual individuals’ psychological reactions to amendments denying access to civil marriage. American Journal of Orthopsychiatry, 80(3), 302– 310. https://doi.org/10.1111/j.1939-0025.2010.01033.x

Political campaigns to deny same-sex couples the right to civil marriage have been demonstrated to increase minority stress and psychological distress in lesbian, gay, and bisexual (LGB) individuals (S. S. Rostosky, E. D. B. Riggle, S. G. Horne, & A. D. Miller, 2009). To further explicate the psychological reactions of LGB individuals to marriage amendment campaigns, a content analysis was conducted of open-ended responses from 300 participants in a national online survey that was conducted immediately following the November 2006 election. LGB individuals indicated that they felt indignant about discrimination; distressed by the negative

rhetoric surrounding the campaigns; fearful and anxious about protecting their relationships and families; blaming of institutionalized religion, ignorance, conservative politicians, and the ineffective political strategies used by LGBT organizers; hopeless and resigned; and, finally, hopeful, optimistic, and determined to keep fighting for justice and equal rights. These 7 themes are illustrated and discussed in light of their implications for conceptualizing and intervening to address discrimination and its negative psychological effects.

Rostosky, S. S., Riggle, E. D. B., Horne, S. G., & Miller, A. D. (2009). Marriage amendments and psychological distress in lesbian, gay, and bisexual (LGB) adults. Journal of Counseling Psychology, 56(1), 56–66. https://doi.org/10.1037/a0013609

An online survey of lesbian, gay, and bisexual (LGB) adults (N 1,552) examined minority stress (I. H. Meyer, 2003) and psychological distress following the 2006 general election in which constitutional amendments to limit marriage to 1 man and 1 woman were on the ballot in 9 states. Following the November election, participants living in states that passed a marriage amendment reported significantly more minority stress (i.e., exposure to negative media messages and negative conversations, negative amendment-related affect, and LGB activism) and higher levels of psychological distress (negative affect, stress, and depressive symptoms) than participants living in the other states. Multiple hierarchical regression analyses revealed significant positive main effects of minority stress factors and state ballot status on psychological distress. In addition, the association between amendment-related affect and psychological distress was significantly higher in states that had passed a marriage amendment compared with other states. Discussion of these findings emphasizes that marriage amendments create an environment associated with negative psychological outcomes for LGB individuals.

Russell, G. M. (2000). Voted Out: The Psychological Consequences of Anti-Gay Politics. Qualitative Studies in Psychology, New York University Press.

When, in 1992, the citizens of Colorado ratified Amendment 2, effectively stripping lesbians, gay men, and bisexuals of protection from discrimination under the state's constitution, the vote divided the state and left the gay population disspirited and angry. Their psychological predicament offered an opportunity to examine the precise intersection at which the individual meets social oppression. Voted Out is the first to document the psychological impact of anti-gay legislation on the gay community, illustrating the range of reactions, from depression, anger, and anxiety to a sense of empowerment and a desire to mobilize, which such legislation can engender. It also offers a detailed account of an innovative team approach to the qualitative coding and analysis process. Blending traditional quantitative methods with more innovative qualitative analyses, it provides a valuable opportunity to compare quantitative and qualitative data focused on the same issue within one volume. https://opensquare.nyupress.org/books/9780814769232/read/

Russell, G. M., Bohan, J. S., McCarroll, M. C., Smith, N. G. (2011). Trauma, Recovery, and Community: Perspectives on the Long-Term Impact of Anti-LGBT Politics. Taumatology, 19(2), 14-23. https://doi.org/10.1177/1534765610362799

Research conducted since the early 1990s has suggested that elections designed to delimit the rights of lesbian, gay, and bisexual (LGB) individuals carry the potential for significant negative psychological consequences. Research has also suggested that some LGB people use these elections as opportunities for positive individual and social change. Virtually all of the research on the psychological impact of anti-LGB elections has focused on the immediate aftermath of these political events. This article reports results from a qualitative study designed to explore community members’ perceptions of the longer term impact of the full cycle of Colorado’s Amendment 2, including the campaign, election, and judicial reversal. The results from interviews with a purposive sample of LGB and heterosexual informants offer commentaries on the enduring impact of Amendment 2 at the levels of individuals, the LGBT community, and the broader community.

Russell, G. M., & Richards, J. A. (2003). Stressor and Resilience Factors for Lesbians, Gay Men and Bisexuals Confronting Antigay Politics. American Journal of Community Psychology, 31(3–4), 313–328. https://doi.org/10.1023/A:1023919022811
When lesbian, gay, and bisexual (LGB) people encounter antigay campaigns and elections, they face explicit and implicit homophobic attacks. In order to understand the points of stress and the bases for resilience in the face of these attacks, we developed a 130-item quantitative survey on the basis of results of an earlier qualitative study. Three hundred, sixteen Colorado LGB people endorsed items representing sources of stress and sources of resilience associated with the campaign for and passage of an antigay referendum. Factor analyses of the results suggested 5 sources of stressors and 5 sources of resilience for LGB persons and their communities.

Seelman, K. L., & Walker, M. B. (2018). Do anti-bullying laws reduce in-school victimization, fear-based absenteeism, and suicidality for lesbian, gay, bisexual, and questioning youth? Journal of Youth and Adolescence, 47(11), 2301–2319. https://doi.org/10.1007/s10964-018-0904-8

Lesbian, gay, and bisexual youth are at heightened risk for bullying and other forms of in-school victimization. Anti-bullying laws are a potential policy mechanism for addressing this issue, yet there has been little investigation of the impact of such policies for this population using generalizable samples or quasi-experimental designs. The current study explores whether the presence of state anti-bullying laws predicts lower likelihood of bullying victimization, fear-based absenteeism, in-school threats or injury with a weapon, and suicidality for lesbian, gay, bisexual, and questioning high school students in the United States. Based on Youth Risk Behavior Survey data across 22 states from 2005–2015, coupled with data about the presence of general and enumerated anti-bullying laws that include sexual orientation as a protected class, this study analyzes this topic using a quasi-experimental design (linear difference-in-difference models). The results indicate that lesbian, gay, bisexual, and questioning youth (particularly boys aged 15 or younger) experienced less bullying victimization in states with general or enumerated anti-bullying laws. There was modest evidence of a reduction in fear-based absenteeism among boys in states with such laws. However, there was little evidence of a relationship between such policies and in-school threats or injuries or suicidality. Further, lesbian, bisexual, and questioning girls’ likelihood of victimization, absenteeism, or suicidality was generally not related to the presence of anti-bullying laws. The results suggest that general and enumerated anti-bullying laws may help reduce bullying victimization for gay, bisexual, and questioning boys.

Tran, J. T., Loecher, N., Kosyluk, K. A., & Bauermeister, J. A. (2023). Anti‐lgbtq+ sex education laws: The effects on students and implications for schools and school practitioners. Psychology in the Schools. https://doi.org/10.1002/pits.23013

Anti‐Lesbian, Gay, Bisexual, Trans, and/or Queer (LGBTQ+) education laws are defined as laws that prohibit or limit schools from discussing same‐sex relationships, broader sexuality, and gender issues in their sexual education curriculum. This study presents a historical context of anti‐LGBTQ+ sex education laws, examines the extant literature on the possible impact of these laws, and suggests recommendations for schools and school practitioners. Anti‐LGBTQ+ sex education laws may impact school climate and have been associated with poorer well‐being for LGBTQ+ students and cisgender heterosexual allies that encompass a range of sexual orientations and gender identities. With an Executive Order from the US president outlining the need to support LGBTQ+ youth in schools and the US Surgeon General's Advisory to highlight the urgent need to address the nation's youths' mental health, it is imperative to support LGBTQ+ students. We offer strategies that may be used to address anti‐LGBTQ+ sex education laws by school administrators and practitioners in a call for advocacy to make changes in sex education policy to improve the well‐being of students, particularly LGBTQ+ youth.

Last updated 03.10.2025