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CNN
3 days ago
- Health
- CNN
What is gender-affirming care? Your questions answered
The right of transgender minors to access gender-affirming care has sparked debate across the United States. With a US Supreme Court ruling upholding Tennessee's ban on the practice, experts say, activists will probably be emboldened to enact even more restrictions. Currently, about 40% of trans youth live in a state that restricts access to gender-affirming care, according to KFF, a health policy and research organization. Major medical associations support access to such care at all ages, saying it can be lifesaving. Tennessee is among the 27 states that have passed bans on gender-affirming health care for transgender children and teenagers, according to a CNN analysis of data from the Movement Advancement Project, a nonprofit think tank that advocates for LGBTQ rights. Until this year, the federal government described early gender-affirming care as 'crucial to overall health and well-being' for trans and nonbinary children and adolescents. But the Trump administration has been cracking down on access. Soon after President Trump took office, he issued an executive order called 'Protecting Children from Chemical and Surgical Mutilation.' It characterized gender-affirming care as 'immoral, unjust, and disproven' and ordered the US Department of Health and Human Services to complete a review of evidence used to support its practice. That report – which was created by authors whom HHS refused to name – was issued May 1. That month, HHS Secretary Robert Kennedy Jr. sent a letter to health care establishments telling them to ignore long-held science-based professional guidelines and instead rely on the his agency's review even though the document says that 'it is not a clinical practice guideline.' The HHS review was highly critical of the science used to inform the practice of gender-affirming care. When it was released, the American Academy of Pediatrics said it was 'deeply alarmed,' and organization President Dr. Susan Kressly said it 'misrepresents the current medical consensus and fails to reflect the realities of pediatric care.' Additionally, at the start of LGBTQ+ Pride month, the FBI tweeted the number for a tip line to report providers that offer certain gender-affirming care services for minors. Gender-affirming care is a multidisciplinary approach that includes medically necessary and scientific evidence-based practices to help a person safely transition from their assigned gender – the one a clinician assigned them at birth, based mostly on anatomic characteristics – to their affirmed gender – the gender by which the person wants to be known. Although the term gender-affirming care came into the public's lexicon fairly recently, Dr. Madeline Deutsch, director of the UCSF Gender Affirming Health Program, said the practice has been around for some time and is based on decades of scientific research. Major mainstream medical associations – including the American Medical Association, the American Psychiatric Association, the Endocrine Society, the American Psychological Association, the American Academy of Pediatrics and the American Academy of Child & Adolescent Psychiatry – have affirmed the practice of gender-affirming care and agree that it's the gold standard of clinically appropriate care that can provide lifesaving treatment for children and adults. 'While we are always assessing the strength of the evidence for this kind of care, every major US medical association has found that the medical evidence is strong and in support of centers that provides this kind of care and have been doing so for decades,' said Dr. Kellan Baker, executive director of the Whitman-Walker Institute, a health care organization that works on LGBTQ+ issues. Last year, an extensive but controversial research review in the UK called the use of puberty-delaying medications into question, saying that the rationale for early puberty suppression was 'unclear' and that any benefit for mental health was supported by 'weak evidence.' Although the review — known as the Cass Review for Dr. Hilary Cass, the pediatrician who conducted it — has come under sharp criticism from several scholars and practitioners, it prompted the UK to ban puberty blockers for use in trans patients. Other children who enter early puberty still have access to the medication. The process typically starts with a conversation between a clinician and the individual. If the patient is a child, the conversation will also include the caregivers when possible. 'It's to really get a better sense of what's bringing them into the clinic,' said licensed clinical psychologist Dr. Melina Wald, who co-founded the Gender Identity Program at Columbia University Medical Center. 'We are also looking to understand the child's understanding of their own gender, gender expression and a history related to that.' After experts determine what the person needs, a multidisciplinary group of clinicians will design a plan just for them. Depending on the person's age, care can include mental health care and support groups, legal help and sometimes medical help like hormones or surgery when a person is past puberty. 'This is individualized care, not some one-size-fits-all-plan,' Baker said. A transition plan can be as simple as offering support to someone when they start using different pronouns, change their hairstyle or clothing, or use a different name. 'When we support and allow people to do these things, their lives get better,' Deutsch said. Mental health care: Often, gender-affirming care will include counseling. A 2018 study found that the prevalence of mental health problems among transgender youth was seven times higher than among their cisgender peers. Mental health problems don't necessarily stem from a person's identity; a growing number of studies show that they often occur because of social discrimination and what's known as minority stress. Stigma, marginalization, discrimination, bullying, harassment and violence can lead to feelings of isolation and rejection. People who identify as transgender may also need mental health help just to determine what their identity is, to come to terms with it and to find self-acceptance. Mental health care can also help people come out to their family and friends and develop coping mechanisms so they can be who they are in a world that isn't always friendly or accepting. Gender-affirming care, studies show, lowers a person's odds of depression and suicidality and is associated with improved well-being. Medication and surgery: Some people may also receive age-appropriate medical care like hormone treatments, puberty blockers, voice and communication therapy, gynecologic and urologic care and reproductive treatments. Typically, surgeries are offered only to adults. The World Professional Association for Transgender Health's guidelines, which are considered the gold standard for gender-affirming care around the world, say this kind of care should provide a person 'safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment.' When children get to a certain stage of puberty – diagnosed by a medical provider – and still have a persistent, well-documented sense that their gender does not align with the sex assigned at birth, doctors and family may decide to move forward with reversible pubertal suppression, commonly called puberty blockers. Although not all patients choose this treatment, some research shows that gender-incongruent youth may feel increased distress when they start to develop secondary sex characteristics. These gonadotrophin-releasing hormone drugs were first used to delay puberty for people with what's known as precocious puberty, when a child's body changes into that of an adult too soon. Puberty blockers can keep secondary sex traits from developing for a few years, to give the child time to access support, explore their gender identity and develop coping skills, according to the American Academy of Pediatrics. If a patient decides to stop treatment, puberty resumes. 'That just basically puts everything on pause, and children can be on that for a couple of years without any ill effects, and it's totally reversible,' Deutsch said. 'If it's stopped, then everything just continues where you left off.' Studies show that puberty blockers can reduce the distress that may happen when a child develops secondary sex characteristics such as breasts, an Adam's apple or voice changes. Studies show that transgender adolescents who used puberty blockers were less likely to have suicidal thoughts than those who wanted the treatment but did not get it. Puberty blockers can also make a transition later in life easier, since the person did not develop these secondary sex characteristics. At this stage in the gender-affirming care process, after a thorough evaluation by a medical professional, a patient may also receive hormone therapy that can lead to gender-affirming physical change. Puberty blockers can carry some risks, and more long-term studies are needed, according to the Pediatric Endocrine Society. Long-term studies on fertility and bone health are limited and provide 'varied results,' according to the American Academy of Pediatrics. The World Professional Association for Transgender Health guidelines say that before giving puberty blockers, the provider must make sure the person has demonstrated a sustained and persistent pattern of gender dysphoria or gender incongruence; they must have the emotional and cognitive maturity to provide informed consent; any coexisting mental health problems that could interfere with treatment or consent need to be addressed; the person needs to be told that there could be reproductive effects, and fertility preservation options should be discussed; and the child must have reached Tanner Stage 2 of puberty, which is when a girl starts to develop breast buds and a boy's scrotum and testicles begin to increase in size. A pediatric endocrinologist must agree with this decision. Professional medical guidelines, with some rare exceptions, do not recommend puberty blockers, hormone therapies or surgery for children who have not gone through puberty. If such treatment is indicated, the clinician would first do a thorough evaluation in collaboration with the patient and their caregiver to understand the child's unique needs. 'I think one of the big myths out there is that there's a sense that kids are rushed into decisions related to medical care, like hormone therapy or surgery. That's just not the case,' Wald said. Dr. Leana Wen, an emergency physician and the former Baltimore Health Commissioner, told CNN's Pamela Brown that the 988 suicide prevention hotline service should be a " bipartisan, nonpartisan initiative to get services to as many people as need them, including LGBTQ individuals." The administration is considering eliminating the service as a way to cut back on funding for next year's discretionary budget for mental health, according to an internal document reviewed by CNN. Deutsch agreed: 'Kids don't make stuff up about this, wanting to become trans because it's trendy or something,' she said. 'Trans youth and trans people in general do not have access to a hormone vending machine.' Some critics point out that youth who take puberty blockers may change their minds about their gender identity later in life. Several studies have shown most people who opt for gender-affirming care don't later regret their choices — including an October 2022 study in the Netherlands that found 98% of transgender youth who had started gender-affirming medical treatment in adolescence continued to use those hormones around five or six years later in adulthood. Among 3,306 UK Gender Identity Development Service patients included the Cass Review analysis, fewer than 10 patients detransitioned to their birth-registered gender. Questions about the benefits of puberty-blocking medications gained fresh attention in October when the author of a federally funded study was quoted as saying she had delayed publication of some of her results because of fears that they would be 'weaponized' in a heated political climate. Johanna Olson-Kennedy, medical director at the Center for Transyouth Health and Development at Children's Hospital of Los Angeles, said that in the study, which she helped lead, puberty blockers did not appear to improve the mental health of 95 children ages 8 to 16 who were followed for two years to understand their mental and physical functioning as doctors used the medications to delay the physical changes associated with puberty. Some advocates for gender-affirming care for youth said this is a typical level of caution taken by researchers to carefully present and interpret scientific data. However, researchers said it remains critical to publish data; puberty blockers may have prevented a decline in mental health, even if they didn't lead to improvement in mental functioning, but it's impossible to know if the data isn't released. If a child identifies as transgender or gender-diverse, research suggests that they know their gender as clearly and consistently as their peers who identify as cisgender or the gender they were assigned at birth, even if it conflicts with other people's expectations about what a typical 'boy' or 'girl' is. Some critics of the process suggest that children should wait until adulthood to transition, but the American Academy of Pediatrics says in its guidelines that this approach is 'outdated,' in part because it assumes that gender identity becomes fixed at a certain age, and the approach is based on 'binary notions of gender in which gender diversity and fluidity is pathologized.' The group also argues that the approach was based on early studies with methodological flaws, limited follow-up and validity concerns. More recent research shows that 'rather than focusing on who a child will become, valuing them for who they are, even at a young age, fosters secure attachment and resilience, not only for the child but also for the whole family.' Wald says that waiting to transition can create additional psychological distress for a child and can raise their risk of depression, suicidality, self-harm or substance misuse. 'Withholding intervention means that the child is going to go through a puberty that is discordant with their gender identity and would ultimately mean that later, at the age of 18, there would be changes to their body that they would make it even more difficult,' she said. 'These children and teens can be incredibly resilient,' Wald added. 'With support and access to care, they will thrive and can be just as successful as any kid.' A 2022 analysis of data from the US Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System and its Youth Risk Behavior Survey found that a tiny fraction of people in the United States – about 0.6% of those 13 and older, or about 1.6 million people – identify as transgender, according to the Williams Institute, a think tank at UCLA Law that provides scientific research on gender identity and sexual orientation. While the percentage of adults who identify as transgender in the US has remained basically the same, the number of young people who identify as such doubled – to 300,000 – from the last time the Williams Institute did the research in 2016 and 2017. A 2022 Pew Research Center survey determined that 5.1% of adults younger than 30 are trans or nonbinary. It may not be a direct comparison, however, as the Williams Institute's previous survey did not have survey data for younger teens and had to use statistical modeling to extrapolate based on adult data. The report cannot explain why more young people may be identifying as transgender, but it notes that more data has become available about this population. CNN's Brenda Goodman, Meg Tirrell and Kristen Rogers contributed to this report.
CNN
3 days ago
- Health
- CNN
What is gender-affirming care? Your questions answered
The right of transgender minors to access gender-affirming care has sparked debate across the United States. With a US Supreme Court ruling upholding Tennessee's ban on the practice, experts say, activists will probably be emboldened to enact even more restrictions. Currently, about 40% of trans youth live in a state that restricts access to gender-affirming care, according to KFF, a health policy and research organization. Major medical associations support access to such care at all ages, saying it can be lifesaving. Tennessee is among the 27 states that have passed bans on gender-affirming health care for transgender children and teenagers, according to a CNN analysis of data from the Movement Advancement Project, a nonprofit think tank that advocates for LGBTQ rights. Until this year, the federal government described early gender-affirming care as 'crucial to overall health and well-being' for trans and nonbinary children and adolescents. But the Trump administration has been cracking down on access. Soon after President Trump took office, he issued an executive order called 'Protecting Children from Chemical and Surgical Mutilation.' It characterized gender-affirming care as 'immoral, unjust, and disproven' and ordered the US Department of Health and Human Services to complete a review of evidence used to support its practice. That report – which was created by authors whom HHS refused to name – was issued May 1. That month, HHS Secretary Robert Kennedy Jr. sent a letter to health care establishments telling them to ignore long-held science-based professional guidelines and instead rely on the his agency's review even though the document says that 'it is not a clinical practice guideline.' The HHS review was highly critical of the science used to inform the practice of gender-affirming care. When it was released, the American Academy of Pediatrics said it was 'deeply alarmed,' and organization President Dr. Susan Kressly said it 'misrepresents the current medical consensus and fails to reflect the realities of pediatric care.' Additionally, at the start of LGBTQ+ Pride month, the FBI tweeted the number for a tip line to report providers that offer certain gender-affirming care services for minors. Gender-affirming care is a multidisciplinary approach that includes medically necessary and scientific evidence-based practices to help a person safely transition from their assigned gender – the one a clinician assigned them at birth, based mostly on anatomic characteristics – to their affirmed gender – the gender by which the person wants to be known. Although the term gender-affirming care came into the public's lexicon fairly recently, Dr. Madeline Deutsch, director of the UCSF Gender Affirming Health Program, said the practice has been around for some time and is based on decades of scientific research. Major mainstream medical associations – including the American Medical Association, the American Psychiatric Association, the Endocrine Society, the American Psychological Association, the American Academy of Pediatrics and the American Academy of Child & Adolescent Psychiatry – have affirmed the practice of gender-affirming care and agree that it's the gold standard of clinically appropriate care that can provide lifesaving treatment for children and adults. 'While we are always assessing the strength of the evidence for this kind of care, every major US medical association has found that the medical evidence is strong and in support of centers that provides this kind of care and have been doing so for decades,' said Dr. Kellan Baker, executive director of the Whitman-Walker Institute, a health care organization that works on LGBTQ+ issues. Last year, an extensive but controversial research review in the UK called the use of puberty-delaying medications into question, saying that the rationale for early puberty suppression was 'unclear' and that any benefit for mental health was supported by 'weak evidence.' Although the review — known as the Cass Review for Dr. Hilary Cass, the pediatrician who conducted it — has come under sharp criticism from several scholars and practitioners, it prompted the UK to ban puberty blockers for use in trans patients. Other children who enter early puberty still have access to the medication. The process typically starts with a conversation between a clinician and the individual. If the patient is a child, the conversation will also include the caregivers when possible. 'It's to really get a better sense of what's bringing them into the clinic,' said licensed clinical psychologist Dr. Melina Wald, who co-founded the Gender Identity Program at Columbia University Medical Center. 'We are also looking to understand the child's understanding of their own gender, gender expression and a history related to that.' After experts determine what the person needs, a multidisciplinary group of clinicians will design a plan just for them. Depending on the person's age, care can include mental health care and support groups, legal help and sometimes medical help like hormones or surgery when a person is past puberty. 'This is individualized care, not some one-size-fits-all-plan,' Baker said. A transition plan can be as simple as offering support to someone when they start using different pronouns, change their hairstyle or clothing, or use a different name. 'When we support and allow people to do these things, their lives get better,' Deutsch said. Mental health care: Often, gender-affirming care will include counseling. A 2018 study found that the prevalence of mental health problems among transgender youth was seven times higher than among their cisgender peers. Mental health problems don't necessarily stem from a person's identity; a growing number of studies show that they often occur because of social discrimination and what's known as minority stress. Stigma, marginalization, discrimination, bullying, harassment and violence can lead to feelings of isolation and rejection. People who identify as transgender may also need mental health help just to determine what their identity is, to come to terms with it and to find self-acceptance. Mental health care can also help people come out to their family and friends and develop coping mechanisms so they can be who they are in a world that isn't always friendly or accepting. Gender-affirming care, studies show, lowers a person's odds of depression and suicidality and is associated with improved well-being. Medication and surgery: Some people may also receive age-appropriate medical care like hormone treatments, puberty blockers, voice and communication therapy, gynecologic and urologic care and reproductive treatments. Typically, surgeries are offered only to adults. The World Professional Association for Transgender Health's guidelines, which are considered the gold standard for gender-affirming care around the world, say this kind of care should provide a person 'safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment.' When children get to a certain stage of puberty – diagnosed by a medical provider – and still have a persistent, well-documented sense that their gender does not align with the sex assigned at birth, doctors and family may decide to move forward with reversible pubertal suppression, commonly called puberty blockers. Although not all patients choose this treatment, some research shows that gender-incongruent youth may feel increased distress when they start to develop secondary sex characteristics. These gonadotrophin-releasing hormone drugs were first used to delay puberty for people with what's known as precocious puberty, when a child's body changes into that of an adult too soon. Puberty blockers can keep secondary sex traits from developing for a few years, to give the child time to access support, explore their gender identity and develop coping skills, according to the American Academy of Pediatrics. If a patient decides to stop treatment, puberty resumes. 'That just basically puts everything on pause, and children can be on that for a couple of years without any ill effects, and it's totally reversible,' Deutsch said. 'If it's stopped, then everything just continues where you left off.' Studies show that puberty blockers can reduce the distress that may happen when a child develops secondary sex characteristics such as breasts, an Adam's apple or voice changes. Studies show that transgender adolescents who used puberty blockers were less likely to have suicidal thoughts than those who wanted the treatment but did not get it. Puberty blockers can also make a transition later in life easier, since the person did not develop these secondary sex characteristics. At this stage in the gender-affirming care process, after a thorough evaluation by a medical professional, a patient may also receive hormone therapy that can lead to gender-affirming physical change. Puberty blockers can carry some risks, and more long-term studies are needed, according to the Pediatric Endocrine Society. Long-term studies on fertility and bone health are limited and provide 'varied results,' according to the American Academy of Pediatrics. The World Professional Association for Transgender Health guidelines say that before giving puberty blockers, the provider must make sure the person has demonstrated a sustained and persistent pattern of gender dysphoria or gender incongruence; they must have the emotional and cognitive maturity to provide informed consent; any coexisting mental health problems that could interfere with treatment or consent need to be addressed; the person needs to be told that there could be reproductive effects, and fertility preservation options should be discussed; and the child must have reached Tanner Stage 2 of puberty, which is when a girl starts to develop breast buds and a boy's scrotum and testicles begin to increase in size. A pediatric endocrinologist must agree with this decision. Professional medical guidelines, with some rare exceptions, do not recommend puberty blockers, hormone therapies or surgery for children who have not gone through puberty. If such treatment is indicated, the clinician would first do a thorough evaluation in collaboration with the patient and their caregiver to understand the child's unique needs. 'I think one of the big myths out there is that there's a sense that kids are rushed into decisions related to medical care, like hormone therapy or surgery. That's just not the case,' Wald said. Dr. Leana Wen, an emergency physician and the former Baltimore Health Commissioner, told CNN's Pamela Brown that the 988 suicide prevention hotline service should be a " bipartisan, nonpartisan initiative to get services to as many people as need them, including LGBTQ individuals." The administration is considering eliminating the service as a way to cut back on funding for next year's discretionary budget for mental health, according to an internal document reviewed by CNN. Deutsch agreed: 'Kids don't make stuff up about this, wanting to become trans because it's trendy or something,' she said. 'Trans youth and trans people in general do not have access to a hormone vending machine.' Some critics point out that youth who take puberty blockers may change their minds about their gender identity later in life. Several studies have shown most people who opt for gender-affirming care don't later regret their choices — including an October 2022 study in the Netherlands that found 98% of transgender youth who had started gender-affirming medical treatment in adolescence continued to use those hormones around five or six years later in adulthood. Among 3,306 UK Gender Identity Development Service patients included the Cass Review analysis, fewer than 10 patients detransitioned to their birth-registered gender. Questions about the benefits of puberty-blocking medications gained fresh attention in October when the author of a federally funded study was quoted as saying she had delayed publication of some of her results because of fears that they would be 'weaponized' in a heated political climate. Johanna Olson-Kennedy, medical director at the Center for Transyouth Health and Development at Children's Hospital of Los Angeles, said that in the study, which she helped lead, puberty blockers did not appear to improve the mental health of 95 children ages 8 to 16 who were followed for two years to understand their mental and physical functioning as doctors used the medications to delay the physical changes associated with puberty. Some advocates for gender-affirming care for youth said this is a typical level of caution taken by researchers to carefully present and interpret scientific data. However, researchers said it remains critical to publish data; puberty blockers may have prevented a decline in mental health, even if they didn't lead to improvement in mental functioning, but it's impossible to know if the data isn't released. If a child identifies as transgender or gender-diverse, research suggests that they know their gender as clearly and consistently as their peers who identify as cisgender or the gender they were assigned at birth, even if it conflicts with other people's expectations about what a typical 'boy' or 'girl' is. Some critics of the process suggest that children should wait until adulthood to transition, but the American Academy of Pediatrics says in its guidelines that this approach is 'outdated,' in part because it assumes that gender identity becomes fixed at a certain age, and the approach is based on 'binary notions of gender in which gender diversity and fluidity is pathologized.' The group also argues that the approach was based on early studies with methodological flaws, limited follow-up and validity concerns. More recent research shows that 'rather than focusing on who a child will become, valuing them for who they are, even at a young age, fosters secure attachment and resilience, not only for the child but also for the whole family.' Wald says that waiting to transition can create additional psychological distress for a child and can raise their risk of depression, suicidality, self-harm or substance misuse. 'Withholding intervention means that the child is going to go through a puberty that is discordant with their gender identity and would ultimately mean that later, at the age of 18, there would be changes to their body that they would make it even more difficult,' she said. 'These children and teens can be incredibly resilient,' Wald added. 'With support and access to care, they will thrive and can be just as successful as any kid.' A 2022 analysis of data from the US Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System and its Youth Risk Behavior Survey found that a tiny fraction of people in the United States – about 0.6% of those 13 and older, or about 1.6 million people – identify as transgender, according to the Williams Institute, a think tank at UCLA Law that provides scientific research on gender identity and sexual orientation. While the percentage of adults who identify as transgender in the US has remained basically the same, the number of young people who identify as such doubled – to 300,000 – from the last time the Williams Institute did the research in 2016 and 2017. A 2022 Pew Research Center survey determined that 5.1% of adults younger than 30 are trans or nonbinary. It may not be a direct comparison, however, as the Williams Institute's previous survey did not have survey data for younger teens and had to use statistical modeling to extrapolate based on adult data. The report cannot explain why more young people may be identifying as transgender, but it notes that more data has become available about this population. CNN's Brenda Goodman, Meg Tirrell and Kristen Rogers contributed to this report.
Time of India
02-06-2025
- Business
- Time of India
Pride Month 2025: Under Trump 2.0, least safe US states for LGBTQ+ people revealed. Check details
As Pride Month kicks off, a new report reveals deepening disparities in safety, rights, and inclusion for LGBTQ+ Americans depending on where they live. From health care access and legal protections to the tone set by state leadership, conditions for LGBTQ+ individuals vary dramatically across the United States. Out Leadership's 2025 State LGBTQ+ Business Climate Index, now in its seventh year, evaluates all 50 states on how welcoming they are to LGBTQ+ residents. This year's findings come amid intensifying legislative pressure, with hundreds of anti-LGBTQ+ bills introduced across the country and heated debates over flag bans and transgender rights dominating public discourse. Compiled with input from the Williams Institute and the Movement Advancement Project, the annual index is a resource for corporate leaders and policymakers. It comes at a time when Pride events face a rising tide of political opposition. In 2025, Utah became the first state to explicitly ban LGBTQ+ flags on government property, with Idaho and Montana following with similar restrictions. In total, at least 31 flag-related bills have been introduced in 17 states, targeting LGBTQ+ symbols in public spaces. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Trade Bitcoin & Ethereum – No Wallet Needed! IC Markets Start Now Undo ALSO READ: Jonathan Joss, who died in Texas shooting, lost him home and two dogs in January in tragic incident According to the Movement Advancement Project, over 700 anti-LGBTQ+ bills have been proposed so far this year. Organizers report that this legislative onslaught—paired with federal rollbacks of diversity, equity, and inclusion (DEI) initiatives under the Trump administration—has prompted major corporations like Mastercard, PepsiCo, and Nissan to scale back or withdraw support from major Pride events, reports NewsWeek. Live Events Despite financial strain and heightened security risks, Pride organizers across political divides are pressing forward. They emphasize the enduring importance of Pride as a space for visibility, identity, and solidarity. The report also cautions business leaders about the potential reputational and operational risks of operating in states where LGBTQ+ people face legal and social hostility. Top-Ranked States for LGBTQ+ Safety in 2025 The 2025 Index reveals a clear geographic pattern: states in the Northeast and on the West Coast lead in LGBTQ+ inclusivity and safety. Top 10 States: Massachusetts – 93.67 New York – 93.67 Connecticut – 92.27 New Jersey – 90.00 Vermont – 89.50 Rhode Island – 89.43 California – 88.57 Washington – 86.53 Maryland – 84.83 Oregon – 83.97 Massachusetts and New York tied for the top spot, each scoring 93.67 out of 100. These states, along with others in the top ten, have adopted robust nondiscrimination laws, bans on conversion therapy, inclusive health care policies, and benefit from strong pro-LGBTQ+ leadership. Massachusetts Governor Maura Healey—the first openly lesbian governor in the U.S.—has prioritized equality across her administration. ALSO READ: Under Trump's 'big beautiful bill', 15 million Americans to lose their health care coverage? Check details Lowest-Ranked States for LGBTQ+ Safety in 2025 At the other end of the spectrum, states in the South and Plains regions continue to score lowest on the index. Bottom 10 States: Arkansas – 29.50 South Carolina – 32.15 Louisiana – 33.00 South Dakota – 34.80 Mississippi – 36.60 West Virginia – 37.43 Oklahoma – 37.62 Montana – 38.10 Missouri – 39.03 Alabama – 39.40 Arkansas remains the lowest-ranked state for the third year in a row. Many of the lowest-ranking states have expanded religious exemptions and enacted restrictions on updating gender markers on legal documents. Oklahoma, for example, has seen an uptick in LGBTQ+ residents seeking to move elsewhere due to safety concerns, with organizations like Rainbow Railroad and TRACTION reporting increased calls for help. ALSO READ: Jonathan Joss, 'King of the Hill' actor who voiced John Redcorn, shot dead several times in Texas Out Leadership underscores that state leadership plays a critical role in shaping outcomes. States with inclusive policies often have proactive, supportive governance. Michigan, for example, rose in the rankings after Governor Gretchen Whitmer signed legislation expanding hate crime protections. As Pride 2025 unfolds, the index serves as both a reflection of current conditions and a call to action—for businesses, leaders, and citizens alike—to ensure that LGBTQ+ individuals can live openly and safely, no matter where they reside. ALSO READ: US to observe federal holiday on June 19. Are stock markets closed that day? The authors of the index highlight a growing divide between states with high and low rankings, leading to increasing geographic polarization that affects not only legislation but also the everyday lives of LGBTQ+ individuals. 'Top-ranked states for LGBTQ+ equality continue to perform well, but the scores of the lowest-ranked states have dropped sharply,' said Brian Sims, Managing Director of Public Policy and Government Affairs at Out Leadership. 'This trend reflects a deepening polarization in both political and cultural attitudes toward the LGBTQ+ community across the country.'
Newsweek
02-06-2025
- Politics
- Newsweek
Least Safe US States for LGBTQ+ People Revealed
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. As Pride Month begins, a new report highlights widening disparities in how LGBTQ+ Americans experience safety and equality across the country. From access to health care and legal protections to the tone set by state leadership, conditions vary drastically. Out Leadership's 2025 State LGBTQ+ Business Climate Index, now in its seventh year, ranks all 50 states on how welcoming they are to LGBTQ+ residents. The findings come at a time of mounting legislative pressure, with hundreds of anti-LGBTQ+ bills introduced in statehouses nationwide and public debates over flag bans and trans rights intensifying. The annual index, compiled with input from the Williams Institute and the Movement Advancement Project, serves as a reference for corporate leaders and policymakers. The Context Pride 2025 arrives amid a heightened political and legislative backlash against LGBTQ+ rights. Utah became the first state to explicitly ban LGBTQ+ flags from government buildings and schools, Idaho and Montana following suit with restrictions. People take part in The New Queens Pride Parade in the neighborhood of Jackson Heights in the New York City borough of Queens, NY, June 1, 2025. June is traditionally considered Pride Month. People take part in The New Queens Pride Parade in the neighborhood of Jackson Heights in the New York City borough of Queens, NY, June 1, 2025. June is traditionally considered Pride Month. Sipa via AP Images/Photo by Anthony Behar/Sipa USA The flag bans are part of a wider trend—at least 31 flag-related bills have been introduced across 17 states, many of which explicitly or implicitly prohibit LGBTQ+ symbols on public property. More than 700 anti-LGBTQ+ bills have been introduced in 2025 alone, according to the Movement Advancement Project. Pride organizers say the wave of legislation—coupled with the Trump administration's federal rollback of diversity, equity, and inclusion (DEI) initiatives—has led major corporate sponsors such as Mastercard, PepsiCo, and Nissan to withdraw support from some of the nation's largest Pride events. Despite financial losses and heightened security concerns, organizers in red and blue states insist that Pride celebrations will continue, emphasizing their importance as public expressions of identity and solidarity. The report aims to help business leaders "understand and respond to these risks and opportunities," noting that "multinational companies face operational and reputational risks when they do business in places where the legal and/or social atmosphere makes it difficult for LGBTQ+ people to live openly." Which States are Ranked the Safest for LGBTQ+ Americans? The 2025 State LGBTQ+ Business Climate Index underscores a clear geographic trend: states on the West Coast and in the Northeast dominate the top of the rankings, while many Southern and Plains states lag behind. These states were ranked highest in the State LGBTQ+ Business Climate Index: Massachusetts—93.67 New York—93.67 Connecticut—92.27 New Jersey—90.00 Vermont—89.50 Rhode Island—89.43 California—88.57 Washington—86.53 Maryland—84.83 Oregon—83.97 According to the index, Massachusetts and New York tied for first place in 2025, each earning a score of 93.67 out of 100. Connecticut (92.27), New Jersey (90.00), and Vermont (89.50) round out the top five safest states for LGBTQ+ residents. Alexandria Ocasio-Cortez, United States Representative, takes part in The New Queens Pride Parade in the neighborhood of Jackson Heights in the New York City borough of Queens, NY, June 1, 2025. June is traditionally considered... Alexandria Ocasio-Cortez, United States Representative, takes part in The New Queens Pride Parade in the neighborhood of Jackson Heights in the New York City borough of Queens, NY, June 1, 2025. June is traditionally considered Pride Month. More Photo by Anthony Behar/Sipa USA/AP Images Many of these states have enacted expansive nondiscrimination protections, bans on conversion therapy, inclusive health care policies, and active support from state leadership. Massachusetts is led by Governor Maura Healey, the country's first openly lesbian governor, whose administration has prioritized LGBTQ+ equality in policy and practice. Maryland and Washington, D.C.-adjacent states, also performed well. Maryland's score rose to 84.83, thanks to robust family support and workplace protections. Which States are Ranked the Least Safe for LGBTQ+ Americans? These states were ranked the lowest in the State LGBTQ+ Business Climate Index: Arkansas—29.50 South Carolina—32.15 Louisiana—33.00 South Dakota—34.80 Mississippi—36.60 West Virginia—37.43 Oklahoma—37.62 Montana—38.10 Missouri—39.03 Alabama—39.40 Arkansas ranks as the least safe state for LGBTQ+ people for the third consecutive year, followed by South Carolina, Louisiana and South Dakota at the bottom of the rankings. Alabama's score was slightly higher at 39.40, yet still placed it in the bottom ten. Many of these states also saw drops due to expanded religious exemptions and bans on updating gender markers on official documents including birth certificates and driver's licenses. (USA Today) Oklahoma, which scored just 37.62, has seen a notable increase in residents seeking to relocate, including LGBTQ+ families leaving due to threats or fear of discrimination. Nonprofit organizations such as TRACTION in Washington state and Rainbow Railroad in Canada have seen surging requests for support from LGBTQ+ people in red states. (USA Today) Out Leadership emphasizes that political leadership is a strong predictor of state scores. In contrast to bottom-tier states, those with inclusive policies often benefit from proactive governance. For instance, Michigan's rise in the rankings was linked to legislation signed by Governor Gretchen Whitmer expanding hate crime protections. The index's authors note that the gap between high- and low-ranking states is widening, creating geographic polarization not just in law, but also in lived experiences. "While the top ranked states for LGBTQ+ equality broadly are staying strong, the bottom ranked states decreased in score significantly. This continues to signal increasing polarization across the country in political and cultural attitudes toward the LGBTQ+ community," said Brian Sims, Managing Director, Public Policy and Government Affairs for Out Leadership.
Yahoo
28-05-2025
- General
- Yahoo
As anti-trans laws get more extreme, here's where state laws stand in 2025
Since 2020, every new year has brought a new record of state bills attempting to roll back transgender rights. Most of that legislation has not become law. Even as the sheer volume of bills continues to grow, LGBTQ+ advocates continue to defeat the majority of them. But each year, Republicans introduce more and more bills. And each year, those bills become broader and more extreme, as politicians look for new ways to enforce a binary definition of gender — and that escalation is turning up in the bills that do pass. The American Civil Liberties Union (ACLU) is tracking 575 anti-LGBTQ+ state bills so far this year, most of which target transgender people. One hundred and five of those bills have failed and 54 have passed into law. Those newly passed laws include restrictions on trans students' ability to use school restrooms or play school sports, Pride flag bans on government property, gender-affirming care restrictions, and bans on updating personal identity documents like driver's licenses and birth certificates. Many of these laws define sex in ways that exclude trans and intersex people. Men and boys are defined as people who can produce sperm. Women and girls are defined as people who can produce eggs. Sex is defined in terms of reproductive capacity, with some exceptions for developmental or genetic anomalies that prevent having children. Throughout these different policies, regulating gender is a central goal. As summer draws near and more state legislative sessions come to an end, The 19th is tracking the emerging trends, firsts and surprises this year as statehouse Republicans brought a record-breaking number of anti-LGBTQ+ bills. Republicans have become more explicit in trying to create legal distinctions between men and women based on their characteristics at birth — in the name of protecting women's-only spaces or defining what a woman is. Now, 15 states strictly define sex based on reproductive anatomy, chromosomes or hormones. None of these laws were in place prior to 2023, and five of them went into effect this year. These laws exclude trans and nonbinary people from state nondiscrimination protections. They also have the potential to embolden public scrutiny and discrimination of women who don't fit into traditional gender roles. Nineteen states now ban transgender people from using bathrooms that match their gender identity in various government-owned buildings, including K-12 schools, according to the Movement Advancement Project, which tracks LGBTQ+ policy. Several of the most far-reaching bans, which restrict access to bathrooms in public places like libraries, museums and colleges, were passed this year in states including Montana, South Dakota and Wyoming. Meanwhile, Republicans in other states want to expand pre-existing policies. This year, Idaho and Arkansas widened the scope of their K-12 bathroom bans to apply to colleges, jails and all government buildings. And while Arkansas had already stopped issuing driver's licenses with an 'X' gender marker in 2024, the state passed a law this year to require that gender be displayed on all licenses. In March, Texas Attorney General Ken Paxton argued in a nonbinding opinion that driver's licenses and birth certificates previously updated for transgender Texans via court orders should be reverted back to reflect sex assigned at birth. Over time, the anti-trans bills that do make it into law are becoming more severe, said Logan Casey, director of policy research at the Movement Advancement Project. 'Especially now with the Trump administration signalling very strongly, throughout the campaign and since inauguration, that attacking transgender people is one of their top priorities, it's no surprise to me that state electeds continue prioritizing this in their own efforts,' Casey said. This year, Iowa became the first state in the country to completely rescind nondiscrimination protections for trans people. The Iowa Civil Rights Act previously protected trans people against discrimination in employment, housing, credit and lending, public accommodations and education. The law was a lifeline for many people, according to ACLU of Iowa Executive Director Mark Stringer. Now, those protections have been stripped from the state code. They had been in place since 2007 and were endorsed at that time by many Republican lawmakers. Iowa's new law also bans updates to gender markers on birth certificates and bans schools from teaching students about LGBTQ+ identities from kindergarten through sixth grade. It goes into effect on July 1. This moment was years in the making, according to Keenan Crow, director of policy and advocacy at One Iowa, a statewide LGBTQ+ advocacy organization. The political environment for trans people in the state has been bad and getting worse, as many Republican moderates have been replaced with extremists who want to embrace culture war issues, Crow said. 'It's escalated from things like the 'don't say gay, don't say trans' stuff and the book bans all the way up to removing an entire class of people from the Civil Rights Act,' they said. 'When I started this job almost 12 years ago, I was really proud of our state. We were one of the first states to add gender identity as a protected class. We were the third state for marriage equality.' For years, Iowa had been a good place for transgender people to live freely without facing much discrimination or political scrutiny, Crow said. It's no longer that way. 'I wouldn't anymore recommend that trans folks move here because their rights are being eroded, literally, as we speak,' they said. In Texas, where the legislative session ends on June 2, Republicans introduced a bill that would charge transgender people with a felony if they inform their employer or the government about their gender identity. This bill, which has not advanced through the state legislature, would subject trans people to up to two years in prison and a $10,000 fine for the crime of 'gender identity fraud,' according to the Houston news site Chron. This legislation marks a dramatic escalation of Republican lawmakers' attempts to criminalize being transgender in America. Medical providers in six states face felony charges for providing gender-affirming care to minors, and in two states — Utah and Florida — it is a criminal offense for trans people to use bathrooms that match their gender identity in certain circumstances. Notably, 2025 has also marked a return of states attempting to overturn marriage equality. As of late April, half a dozen states had introduced bills asking the Supreme Court to overturn Obergefell v. Hodges, according to the New York Times. Marriage equality, or same-sex marriage, has been viewed as morally acceptable by most Americans for years, per Gallup. In response to a bill that would ban state spending on gender-affirming care for trans prisoners, Georgia Democrats organized a mass walkout in April. The frustration that fueled their walkout wasn't just about that bill, according to the Associated Press: This year, Republican lawmakers pushed and prioritized anti-trans bills like never before. Those efforts included restricting Medicaid coverage of gender-affirming care and rescinding care for state workers. That bill did not become law, as Georgia's legislative session ended early. One of the most public signs of Democratic resistance to anti-trans policies played out in Maine, as Gov. Janet Mills challenged President Donald Trump over his executive order threatening federal funding for schools that allow trans girls on girls' teams. When Trump personally threatened to cut state funding if Maine didn't comply with the order, Mills dug in. 'We'll see you in court,' she told Trump during a White House meeting with governors in February. In response, the Trump administration brought the hammer down: The Department of Education, the Department of Health and Human Services and the Department of Agriculture all opened investigations into Maine's university system and state education department, ProPublica reports. The USDA and the National Oceanic and Atmospheric Administration halted funding, while the Social Security Administration briefly canceled contracts. The Justice Department threatened to sue. All of that political pressure was exerted over two transgender girls competing in school sports, per ProPublica. In early May, the state reached an agreement with the Trump administration to restore some funding for Maine's students to have access to school meals. There have also been signs of Republican opposition to anti-trans policies this year. In March, as state legislators in Montana considered a bill to allow private citizens to sue drag performers, 13 Republicans flipped their votes following impassioned speeches from Democrats, including trans state Rep. Zooey Zephyr. Without those Republican votes, the bill failed. Another Montana bill, which would allow the state to remove trans kids from their parents' custody if they transition, was defeated after nonbinary state Rep. SJ Howell gave a floor speech in opposition to the bill. Twenty-nine Republicans flipped their votes. In Wyoming, the Republican governor allowed the state's sex definition bill to become law without his signature — which, he explained in a statement, was due in part to his opposition to how the legislation was drafted. In his letter to Wyoming's secretary of state, Gov. Mark Gordon said that the law 'oversteps legislative authority and encroaches upon the role of the courts.' Unlike previous bills he signed into law that banned trans people from using bathrooms and locker rooms that match their gender identity, this new law 'has a different agenda,' he wrote — one that he could not put his signature behind. This law 'does not provide clear direction on how it would improve current policies or enforcement, nor does it outline any specific issues it seeks to resolve,' he said. In May, five Pennsylvania Democrats voted in support of a bill to ban trans girls and women from girls' sports in kindergarten through college. Their breakaway votes reflect a small but growing chorus of Democratic lawmakers ceding ground on trans rights — particularly when it comes to sports — following Trump's re-election. Some lawmakers, like Democratic state Sen. Paul Sarlo in New Jersey, have plainly said that they believe trans women should be banned from women's sports. Others have spoken more generally — California Gov. Gavin Newsom is one of the most high-profile Democrats to argue that trans women competing in women's sports is 'deeply unfair.' These comments were all made as part of discussions of how Democrats can better appeal to voters. Joelle Bayaa-Uzuri Espeut of the Normal Anomaly Initiative, one of the nation's leading Black LGBTQ+ nonprofits headquartered in Texas, said that anxiety, uncertainty and confusion are rampant in response to the extreme political attacks seen this year. But trans people are also feeling emboldened to fight back, she said. 'With these extreme bills that are being proposed, trans people and our allies are standing up and stepping up and saying, we won't be erased. We will still be visible, regardless of these proposed bills,' she said. To Espeut, visibility is an antidote to fear. 'We're being threatened just by making our identity a felony. Visibility is key. Visibility is an act of revolution. It's an act of resistance,' she said. 'It is showing that they are not going to win.' The post As anti-trans laws get more extreme, here's where state laws stand in 2025 appeared first on The 19th. News that represents you, in your inbox every weekday. Subscribe to our free, daily newsletter.
