Anti-LGBTQ+ bills tied to negative mental health and increased substance use for LGBTQ+ communities
The American Civil Liberties Union has tracked the increasing number of anti-LGBTQ+ bills year to year, starting in 2018. With each year, anti-LGBTQ+ rhetoric is increasingly being used as the vehicle for people to garner political power. Kentucky is increasingly among the states with the highest rate of these kinds of bills.
Currently at 515 bills, there is a nationwide influx of anti-LGBTQ+ legislation. The bills in Kentucky’s 2024 legislative session mirror bills from the last few legislative sessions in states such as Tennessee, Georgia, and Alabama. These bills were banning drag, attacking DEI, regulating curriculum and bathrooms in schools, and criminalizing homelessness.
With context behind some of the moving parts behind anti-LGBTQ+ legislation, let’s look at the context right in front of the moving parts: the communities impacted by the bills designed to garner political power.
According to UCLA’s William Institute, LGBTQ+ people experience four times more interpersonal violence than non-LGBTQ+ people. In an interview with NPR, Elena Redfield of the Institute shares,
“Anti-LGBT sentiment is so pervasive in our society, and we know that while there are these horrible incidents of extreme violence, there are also everyday types of violence that LGBT people do experience… And it also includes the kind of policy conversations we’re hearing from lawmakers, including the anti-transgender bills that have been happening in state legislatures and bills like the Don’t Say Gay law in Florida.”
The language in the Don’t Say Gay law in Florida closely mimicked aspects of Kentucky’s Don’t Say Gay law, SB 150. In addition to the higher rates of violence experienced by the LGBTQ+ community, there is an increasing culture created by anti-LGBTQ+ bills. Narratives from these controversial bills spread like wildfire, serving the special interest groups writing the bills and the politicians sponsoring them. Meanwhile, the comfort, safety, and livelihood of the LGBTQ+ community is compromised through discrimination and becomes fostered as more socially acceptable. Hate is emboldened by this kind of legislation.
A recent Washington Post analysis of FBI data shows that states with restrictive laws have seen the number of hate crimes on K-12 campuses more than quadruple since the onset of bills centering the rights of LGBTQ+ youth. Further, calls to LGBTQ+ youth crisis hotlines have heavily increased, “with some advocates drawing a connection between the political climate and the spike in bullying and hate crimes.”
The Trevor Project’s 2023 National Survey on LGBTQ Youth Mental Health reports that:
- LGBTQ youth (13-24) are more than four times as likely to attempt suicide than their peers.
- 41% of LGBTQ youth seriously considered attempting suicide in the past year (including half of transgender and nonbinary young people).
- 14% of LGBTQ youth attempted suicide in the past year, including nearly 1 in 5 transgender and nonbinary young people.
- Nearly 1 in 3 LGBTQ young people said their mental health was poor most of the time or always due to anti-LGBTQ policies and legislation. Nearly two in three LGBTQ young people said that hearing about potential state or local laws banning people from discussing LGBTQ people at school made their mental health a lot worse.
This data illustrates how LGBTQ+ youth are immensely struggling with their mental health. Such trends are consistent in adult LGBTQ+ communities as well, with another recent William’s Institute study illustrating that 81% of transgender adults in the U.S. have thought about suicide and 42% of adults have attempted it.
Oliver Hall (they/ them) directs Kentucky Health Justice Network’s Trans Health Advocacy program, ensuring trans Kentuckians can access supportive, competent healthcare. SB 150, which was infused with parts of Rep. Decker’s HB 470, complicated gender-affirming healthcare access for trans people in Kentucky– namely banning the standard of care for youth. Proposed in Kentucky’s 2024 legislative session, HB 49 also sought to regulate access to gender affirming healthcare.
In an interview with Queer Kentucky, Hall shares their experience working with people who cannot access gender-affirming healthcare, “People feel hopeless. They aren’t able to make plans for other parts of their lives.” Gender dysphoria is a pervasive experience, and it severely undermines autonomy over one’s own body.
They continue, “It feels like you don’t have your own life, and for some people, this can make it hard to find a life worth living.” Hall highlights that the increased visibility of LGBTQ+ communities is dangerous, and that this impact is especially true for the most marginalized trans folks, namely Black trans women.
Hall notices the positive impacts of being able to access gender-affirming care, saying “The change, even when someone realizes they can access gender-affirming care, is extreme. Their entire disposition changes, and often, they describe having hope for the first time.” Once people are able to access the care, “Suddenly, they can see a future for themselves… This is reflected in my experience as well and is a part of what motivates me to ensure every Kentuckian has access to gender-affirming care.”
As being able to access gender-affirming healthcare contributes to better quality of life outcomes for trans Kentuckians, not being able to access that same care can lead to negative outcomes. According to Hall, the anti-LGBTQ+ legislation has a “profound impact” on the mental health of young people. For youth they have worked with who have supportive parents, those youth have been able to access care out-of-state.
Even with supportive parents, there is a “significant impact from the logistical burden of traveling long distances for care regularly… and from knowing that people in power have dedicated so much time to make your life harder,” Hall shares.
For youth without supportive parents, the dysphoria they experience is “compounded with a feeling of isolation and distrust of the people who are supposed to help them,” Hall continues.
Substance use also fits into this conversation, as Hall shares, “when people feel overwhelmed by their dysphoria, they’re going to want to find a way to disconnect from that, and disconnecting from your body through substance use is an easy way to do that.” Access to care serves as a way to combat the public health issue of substance use in queer communities.
Regarding travel to access care, Hall shared that, regardless of age, trans folks in rural areas “generally have to travel much further to access gender-affirming care, compounded with the fact that they might not have as many trans people around them to field questions and give recommendations.” KHJN serves to fill some of that need by being a resource for folks in rural areas, but letting people in all corners of the state know what resources they provide remains a challenge.
Dr. Eli Pendleton (he/him) at Baptist Health Medical Group has had a niche created for him in specializing in the care of trans patients. He sees hundreds of trans patients a year, and he has been providing care for trans Kentuckians since 2015. In an interview with Dr. Pendleton, he shares, “The drumbeat in Frankfort impacts the wellbeing of my trans patients. My patients feel targeted – as though everyone is against them. These bills make it easy to feel like a burden.”
Despite community discussion around mental health, Dr. Pendleton shares that access to mental healthcare comes with gatekeeping around accessibility. This creates “another layer of despair for folks,” and Dr. Pendleton has seen many trans patients leave the state because of the political sentiment. He says his patients do not feel welcome here.
Dr. Pendleton vulnerably shared how gut-wrenching it is to see the vilifying of the trans population. There is a struggle for youth to access care, and even for adults who are able to access care, “They are constantly looking over their shoulders.”
Dr. Pendleton sees providing care for trans patients as being compliant with the medical oath to provide the standard of care for anyone. He recognizes that the trans population is a particularly vulnerable population, and he considers himself fortunate to provide care and resources given his community and network. Yet, people from all over the state drive to see him. While he finds this flattering, he also finds it depressing because trans patients should be able to access quality healthcare in any corner of the state.
While Dr. Pendleton did not intend on specializing in supporting trans patients, people were often referred to him because he was willing to learn how to care for this population. Around the time of beginning to see trans patients in 2015, Dr. Pendleton’s sibling actually came out as trans.
Given that existing resources are more focused in cities, in Dr. Pendleton’s experience, there are often rural folks who are in despair and losing hope from being so removed from those resources. While he is grateful to provide care and support his trans patients in embracing their full selves, he recognizes that there is still such a large accessibility gap for gender-affirming healthcare. Further, he recognizes that the rhetoric of anti-LGBTQ+ bills contribute to feelings of isolation and hopelessness.
Dr. Pendleton shares that, “If my brother was stuck in rural Kentucky, I’d hope there’d be someone there to help him. Everyone deserves care, and I cannot imagine the effects of my brother not getting the care he needs.”
Regarding the failed HB 49 and the successful SB 150, Dr. Pendleton does not understand how anyone could call themselves a doctor while supporting laws that would allow for one to refuse care if they disagree with the patient. This is not consistent with his understanding of practicing medicine by the standards of care.
“People should not have to feel like they have to move out of their homes to access the care they need. I wish there was less hate in Frankfort telling people that,” says Dr. Eli Pendleton.
Dr. Carolyn Lauckner (she/her) is an Assistant Professor at the University of Kentucky’s Center for Health Equity Transformation. She is presenting results from her research at the Annual Conference of the Research Society on Alcohol this month.
The focus groups for the research were “conducted as part of formative research for a 5-year NIH study in which we are developing an alcohol reduction program for sexual minority men and transgender/ nonbinary young adults,” according to Dr. Lauckner. Over a third of those in the focus group were from Kentucky, and all were of diverse gender identities and sexual orientations.
In an interview with Queer Kentucky, Dr. Lauckner mentions how stigmas experienced by the LGBTQ+ community can lead to riskier substance use. Dr. Lauckner shares that this is likely due to discrimination and three types of stigma – structural and political, social, and internal. Plus, “Substance use and mental health go hand in hand,” Dr. Lauckner continues.
In the focus groups, Dr Lauckner found what people said to be “heartbreaking.” Several participants said political anti-LGBTQ+ bills and the surrounding rhetoric drove them to drink more– likely due to the stigmas that the bills spread. The substance use issue within the LGBTQ+ community is then compounded due to standard treatment options often not being affirming to those of diverse gender identities and sexual orientations.
Dr. Lauckner notes how localized the issue is due to the local and statewide politics, but also how present anti-LGBTQ+ narratives are in the media, despite social progress. These factors may contribute to increased substance use and poorer mental health among the LGBTQ+ community in Kentucky.
However, Dr. Lauckner mentions that participants also shared the story of how these legislative attacks actually brought the LGBTQ+ community together through the means of fighting back.
In coordination with the University of Kentucky, Queer Kentucky is working to track the lived experiences of LGBTQ+ communities, including the impact of anti-LGBTQ+ legislation and rhetoric. To take the survey, use THIS LINK.
This story is part of a series from Queer Kentucky focused on following the 2024 Kentucky General Assembly from a queer lens. Follow Queer Kentucky on your favorite social media platform to stay up-to-date with our GA24 coverage.
