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Symposia

LGBTQ+

LGBTQ+ Structural Stigma and Health: Advancing the State of the Science Through New Meta-Analytic, Methodological, and Mechanistic Insights

2 - (SYM 16) The Walls Are Narrowing In: The Mental Health Effects of U.S. State Policies Targeting LGBTQIA+ People

Friday, November 21, 2025
5:27 PM - 5:48 PM CST
Location: Imperial 12, Level 4
Keywords: LGBTQ+, Stigma, Mental Health Disparities
Recommended Readings: Lattanner, M. R., et al. (2024). State of the science of structural stigma and LGBTQ+ health: Meta-analytic evidence, research gaps, and future directions. Annual Review of Public Health. https://doi.org/10.1146/annurev-publhealth-071723-013336,   Hatzenbuehler, M. L., et al. (2024). Structural stigma and LGBTQ+ health: A narrative review of quantitative studies. The Lancet Public Health, 9(2), e109–e127. https://doi.org/10.1016/s2468-2667(23)00312-2,   Ford, J. V., et al. (2024). (Re)conceptualizing structural stigma: Insights from a qualitative study of sexual minority men in a longitudinal, population-based cohort. Stigma and Health. https://doi.org/10.1037/sah0000571,   Hollinsaid, N. L., et al. (2023). Incorporating macro-social contexts into emotion research: Longitudinal associations between structural stigma and emotion processes among gay and bisexual men. Emotion, 23(6), 1796–1801. https://doi.org/10.1037/emo0001198,   Burger, J., & Pachankis, J. E. (2024). State of the science: LGBTQ-affirmative psychotherapy. Behavior Therapy,55(6), 1318–1334. https://doi.org/10.1016/j.beth.2024.02.011
Abstract Body
There has been a sudden rise in state policies restricting the civil rights and healthcare access of LGBTQIA+ people across the United States. Although these policies have limited the rights of LGBTQIA+ people more broadly, they have largely targeted transgender and gender non-conforming (TGNC) young people. These policies include restricting access to gender-affirming care, banning TGNC people from bathrooms and school sports, banning discussions of sexual orientation and gender identity and expression in schools, and enabling the denial of services to LGBTQIA+ people on the basis of religion.

Although several large-scale, quantitative studies have identified associations between these policies and the mental health of LGBTQIA+ people, to our knowledge, there has been less research that centers the lived experiences of LGBTQIA+ people themselves. The purpose of the present study was to use qualitative methods to examine the perspectives of LGBTQIA+ people exposed to these LGBTQIA+-targeted policies.

Drawing from The PRIDE Study— the largest community-engaged prospective cohort study of LGBTQIA+ adults across all 50 U.S. states and its territories—we purposefully sampled participants living in states that had proposed or enacted policies targeting LGBTQIA+ people. From July to October 2024, we conducted individual, semi-structured interviews with 61 LGBTQIA+ adults and analyzed transcripts using thematic analysis.

Interviews revealed that these policies are negatively impacting the mental health and well-being of LGBTQIA+ people. Specifically, we organized participants’ interview responses concerning the negative mental health effects of these policies into three mental health themes and one cross-cutting theme: (1) chronic worry and hypervigilance, (2) social isolation, (3) hopelessness and powerlessness, and (4) the mental health impacts of these policies are disproportionately affecting those most targeted by these policies (e.g., youth, TGNC people) and those without the social and economic resources to protect themselves from these policies’ negative and cascading psychological effects.

The rise of state policies targeting LGBTQIA+ people is having wide-ranging negative mental health impacts on LGBTQIA+ people, particularly TGNC people who have been disproportionately targeted by these policies. Multi-level interventions are needed to support the mental health and well-being of LGBQIA+ people across the country.