October is LGBTQIA+ History Month—a designated month-long tribute to recognize, acknowledge, and share the history of the ongoing battle for equality for lesbian, gay, bisexual, transgender, queer, intersexual, and asexual people. In the first and second blogs of this series, we explored the exhausting effects of workplace inequities, the extremely limited federal data collection efforts, and the profound economic disparities within the LGBTQIA+ community. For the third and final blog, we’re examining the higher rates of poor mental health, mental and/or physical disabilities, and food insufficiency in the LGBTQIA+ community compared to the straight, cisgender population.  

Gay and gender-diverse individuals have consistently faced an uphill battle for their existence to be seen as valid and equitable to those of their straight, cisgender counterparts. From the fight for marriage equality to the recent reversal of diversity, equity, and inclusion (DEI) programs in the workplace, these battles are reinforced by cisgender, heterosexual structures that attempt to “other” the LGBTQIA+ community into oblivion.  

Although multiple genders have existed throughout history, Western science failed to acknowledge homosexuality and gender variances until the mid-20th century. The American Psychiatric Association chose to classify homosexuality and gender variance as pathological disorders before fully understanding them as natural human identities. The Diagnostic and Statistical Manual (DSM) labeled homosexuality as a disorder until 1987, and it wasn’t until 2013 that the DSM removed gender nonconformity as a disorder. 

Research shows that negative mental health symptoms such as gender dysphoria and suicidal ideation significantly reduce, if not fully disappear, when gender-diverse people are in a supportive, gender-affirming environment. Alternatively, LGBTQIA+ stigmatization targets the individual’s mental health and well-being by promoting restrictions on necessary health care, social mobility, and professional opportunities.  

IWPR analysis of American Community Survey (ACS) and Household Pulse Survey (HPS) data illustrates the extremely high rates of poor mental health reported by the LGBTQ community, with the most marginalized members facing the highest rates of anxiety, worry, or depression for several days within the past month: 

• At 83.6 percent, transgender/nonbinary individuals were the most likely to report poor mental health status, compared to 52.6 percent of the straight, cisgender population. 

• 79.5 percent of LGBQ, cisgender women reported poor mental health status, compared to 56.2 percent of straight, cisgender women. 

• LGBQ, White, cisgender men were 30.1 percent more likely to report poor mental health status compared to White, straight, cisgender men. 

In 2020, the National Suicide Hotline Designation Act established specialized LGBTQIA+ services within the 988 Suicide and Crisis Lifeline, providing critical counseling for LGBTQIA+ youth, who are at an increased risk of suicidality. However, in July 2025, the LGBTQIA+ hotline was dismantled by the Trump administration, removing potentially lifesaving access to mental health resources for LGBTQIA+ youth. Although the 988 hotline is still an existing resource for those who are struggling with mental illness, LGBTQIA+ people must now turn to other nongovernmental organizations, such as The Trevor Project Suicide Hotline, for specialized services. 

In addition to the disproportionately high rates of poor mental health, individuals in the LGBTQIA+ community also report much higher rates of mental and/or physical disability. As revealed through IWPR’s analysis, the LGBTQIA+ community reported much higher rates of disability compared to the straight population:  

• 31.2 percent of transgender/nonbinary individuals reported disability status, compared to 11.4 percent of the straight, cisgender population. 

• LGBQ, cisgender women and men were the second and third most likely to report disability status (20.8 percent and 14.1 percent, respectively). 

For individuals with physical disabilities, it is extremely difficult, and sometimes just not possible, to work in physically demanding jobs, meaning that labor-intensive fields such as trade, health care, and the service industry might not be an option. Finding employment that truly accommodates disability can be difficult in and of itself, but additional barriers—such as income limits for individuals receiving government benefits and marriage penalties, which can cause people with disabilities to lose some or all of their lifesaving benefits if they were to marry their partners—prevent the LGBTQIA+ community from progressing economically.  

The prevalence of physical disabilities and mental health difficulties among the LGBTQIA+ community indicates that they may be more likely to need time off to receive medical care or rest due to strains on their physical or mental health. For example, transgender individuals who choose to medically transition may have to take time off work to undergo surgery and recovery. Because there is currently no nationwide requirement for employers to provide paid sick leave for their employees, LGBTQIA+ people may be at greater risk of having to take unpaid time off to receive care, causing them to fall further behind economically. IWPR’s Federal Policy Solutions to Advance Gender Equity Paid Leave brief calls for national policies that guarantee workers across all industries and sectors the right to earn paid leave. Crucially, legislation that would advance these policies, such as the Family and Medical Insurance Leave Act and the Caring for All Families Act, includes LGBTQIA+ partnerships and families. 

Overall, the impacts of employment barriers, from the emotional labor that results in poor mental health to the lack of jobs that accommodate physical disabilities, compound with one another and lead to further economic obstacles that affect well-being, such as housing insecurity and food insufficiency. IWPR analysis revealed that: 

• 59.5 percent of transgender/nonbinary individuals reported food insufficiency compared to 40.6 percent of the straight, cisgender population. 

• LGBQ men were 31.4 percent more likely to report receiving food benefits compared to straight, cisgender men. Furthermore, LGBQ, Black, cisgender men were 57.8 percent more likely to report receiving food benefits compared to straight, Black, cisgender men. 

• At 45.8 percent, transgender/nonbinary individuals were the least likely to report home ownership, compared to 69.0 percent of the straight, cisgender population. 

• LGBQ women and straight, cisgender women reported very similar rates of having children under the age of 18 in the household (33.3 percent and 35.0 percent, respectively); however, LGBQ women were 12.4 percent more likely to report food insufficiency than straight, cisgender women. From difficulty concentrating and higher rates of illness, to decreased academic performance and more behavioral issues, the effects of food insecurity on school-aged children are severe. 

For LGBTQIA+ people of color, additional layers of discrimination can deter them from being “out,” which results in scarce data representation for these marginalized communities. Over half of the HPS and ACS surveys included data collected from White respondents. In comparison to their White counterparts, Asian and Black transgender/nonbinary individuals were represented in single-digit percentages, indicating hesitancy to report openly. Studies show worse mental, physical, and social outcomes from compounding homophobia, transphobia, and racism within such LGBTQIA+ communities.  

Along with prejudices in their intersecting social communities, LGBTQIA+ people of color are more likely to be discriminated against by their health care providers than their White counterparts. Because they sit at this intersection of discrimination, researchers conclude that individuals who are both LGBTQIA+ and a person of color come out later in life, and may overall be less public with their sexual identities as a form of compromise and protection. 

As IWPR’s State Policy Action Lab (State PAL) shows, gender-affirming care is eligible for Medicaid coverage in 28 states, and 25 states prohibit private insurance from refusing to cover transgender health care, with 12 bills introduced in state legislatures this year to further advance similar health care coverage. Yet, 51 bills were also introduced to ban access to gender-affirming care, of which 4 were signed into law, resulting in 27 states with current laws or policies that limit or prohibit young people from accessing gender-affirming care.  

Studies show that access to gender-affirming care significantly improves mental health outcomes by lowering rates of anxiety, depression, and suicidality in transgender people. Because depression can make it more difficult to work, bans that prevent trans people from accessing the positive mental health benefits provided by gender-affirming care could make it more difficult for transgender people to work and build economic stability. 

As we wrap up October with the final part of this blog series, we recognize the timely overlap of LGBTQIA+ History Month and National Disability Employment Awareness Month. The systems that established being cisgender and heterosexual as the “norm” are consequently disadvantageous for any individual who exists outside of these rigid standards. This is especially true for LGBTQIA+ people with disabilities, which can severely impact their economic well-being. All members of the LGBTQIA+ community deserve equal protection, opportunity, and tools to achieve lasting economic equity.  

This is the third and final blog of a three-part series highlighting the inequities and injustices that the LGBTQIA+ community faces every day in the United States. Through exploring numerous discriminatory labor practices that LGBTQIA+ people experience in the workplace, this series seeks to increase understanding and bring awareness to the systemic barriers that have impacted this community.   

This blog was prepared by Miranda Peterson, Victoria Gianopoulos, and Brigid Rawdon, with data analysis from Dr. Mrinmoyee Chatterjee.