QUEER KENTUCKY · 2025 SURVEY FINDINGS
In spring 2025, Queer Kentucky partnered with The Moore Lab, led by Drs. Justin X. Moore and Sydney P. Howard, alongside collaborating researchers Drs. Keith J. Watts and Rachel H. Farr, to survey 559 LGBTQ+ Kentuckians across every region of the state. This is the most comprehensive dataset on queer life in Kentucky ever collected.
This data is for journalists, policymakers, healthcare providers, community organizations, and researchers working on LGBTQ+ health and well-being in Kentucky. For underlying data, methodology questions, or interview requests, contact [email protected].
How to read this data: This is a convenience sample of LGBTQ+ adults, not a population estimate. Percentages reflect the experiences of survey respondents. Groups with fewer than 30 respondents are noted with raw counts. This survey documents what respondents reported; it cannot establish causation.
IRB Protocol #94156 · Data collected April 8 to July 17, 2025 · n=559 Kentucky respondents · Citing this data?
IRB Protocol #94156 · Data collected April 8 to July 17, 2025 · n=559 Kentucky respondents · Citing this data?
Policy Climate & Mental Health
The Political Environment Is Breaking People Down
Key Findings +
- 34.5% of respondents say policy debates very negatively impacted their mental health. 69.9% reported any negative impact, meaning roughly 7 in 10 LGBTQ+ Kentuckians say the policy environment is hurting their mental health in some way. Stories built only on the “very negative” figure miss the majority experiencing harm.
- Northern Kentucky reports the highest “very negative” rate of any metro area: 43.2%, 8.7 points above the statewide average. People living with HIV report 19.4% (7/36) very negative impact. Black respondents: 16.7% (13/78). Cisgender women: 45.3% (63/139), with 84.2% (117/139) reporting any negative impact, the highest of any gender group.
- 47.4% of transgender men and 46.2% of transgender women say policy debates have impacted their ability to access health information. Legislation targeting medical providers is showing up in information access, not only in physical access.
- Physical assault attributed to the anti-LGBTQ+ climate: 15.2% statewide. Western Kentucky: 29.2%. The Southeastern Border region (n=21): 45.0%. These are also the regions with the thinnest access to healthcare and harm reduction services.
- 54.5% of Western Kentucky respondents report feeling physically unsafe at home. 52.2% feel unsafe in public. These figures measure ongoing perceived threat, not just discrete incidents. Urban areas are not exempt: 42.0% of Louisville and 40.8% of Lexington respondents feel unsafe in public.
- 8.1% have made a concrete decision to move out of Kentucky because of the political climate, roughly one in twelve people in this dataset. The survey asked about resolved intention, not wishful thinking. This figure is a floor, not a ceiling.
- Western Kentucky’s departure rate is 18.5%, more than double the state average: the same region with the highest physical assault rate, worst healthcare access, largest HIV testing gap, and highest hard drug use. Nonbinary respondents (10.8%) and pansexual respondents (11.4%) are leaving at above-average rates.
HIV & Sexual Health
Rural LGBTQ+ Kentuckians Face a System That Often Refuses to See Them
Key Findings +
- 48.2% of all respondents have never been tested for HIV. In Western Kentucky, that figure is 67.2%, 19 points above the statewide rate. Testing is the entry point to the entire sexual health system. Where access is lowest, every downstream intervention fails with it.
- HIV testing has historically centered gay and bisexual men. This dataset shows who gets missed: 53.6% of cisgender women have never been tested. Transgender women: 57.7%. Nonbinary respondents: 50.6%. Standard outreach is not reaching them.
- Among rural members of the HIV prevention priority population (n=29), 39.3% said a provider refused LGBTQ+ care, versus 12.1% in urban and suburban areas. PrEP uptake follows the same fault line: Northern Kentucky’s PrEP rate (16.3%) is 14.3 points below the statewide average. Eastern Kentucky (n=10): 10.0%. The Hazard area (n=12): 8.3%. The PrEP gap and the provider access gap are the same gap expressed differently.
- Only 30.6% of all respondents are currently on PrEP. Urban and suburban respondents have the highest PrEP utilization of any group, because PrEP requires a prescribing provider, a pharmacy, and follow-up care, all more available in cities.
- Black Kentuckians are adopting doxy-PEP at 28.2%, nearly triple the rate of white respondents at 10.5%. That is proactive health-seeking behavior outpacing the systems meant to support them.
- 59 respondents reported frequent condomless sex with no recent HIV testing and no PrEP. Of those, 29 are nonbinary and 15 are cisgender women. Standard prevention messaging is not reaching them.
Transgender Women
The Policy Burden on Trans Women Is Not Theoretical. It Shows in the Numbers.
Key Findings +
- 48.0% of transgender female respondents report increased suicidal thoughts attributed to policy debates, the highest of any gender group and 19.5 points above the statewide average. Nearly half. This figure warrants primary reporting and community engagement, not just data journalism.
- Transgender women report a “very negative” mental health impact rate of 23.1%, below the statewide average of 34.5%. Yet their suicidal ideation rate is the highest of any group. These two measures point in opposite directions. The suicidality data is the more meaningful measure of what transgender women in Kentucky are experiencing right now.
- 44.0% report chemsex in the past year, the highest of any gender group and more than twice the statewide average of 17.8%. The co-occurrence with the highest suicidality and below-average mental health ratings suggests chemsex is occurring in a context of significant psychological burden.
- 57.7% have never been tested for HIV, 9.5 points above the statewide average, despite transgender women facing some of the highest HIV risk of any population group nationally. The gap between HIV risk and HIV testing is most stark here.
- Trans women’s healthcare needs are specific and layered: HIV prevention, hormone therapy, surgical care where accessed, and routine primary care all require knowledgeable, affirming providers. Provider refusal at any point drives avoidance across all of it. 46.2% say policy debates have impacted their ability to access health information.
- Kentucky’s legislative agenda has specifically targeted transgender women through bans on gender-affirming care, bathroom restrictions, and deadnaming requirements. The survey cannot isolate which policies respondents were thinking of, but the data reflects the documented burden of targeted legislative action.
Community Belonging
Belonging Is the Thread Running Through Every Finding
Key Findings +
- Respondents with strong LGBTQ+ community belonging used hard drugs at a 23.0% lifetime rate. Those with moderate belonging: 73.6%. Low belonging: 68.8%. A 50-percentage-point difference between strong and moderate belonging is not a marginal effect. It is the single largest gap between any two comparable groups in this entire dataset, and it holds across age, income, and region.
- 65.5% of respondents report strong LGBTQ+ community belonging (score 4.5 or above on a 6-point scale, using the validated 18-item LGBTQ+ Belongingness Attainment Scale). The statewide average is 4.86. Most respondents have strong belonging. The 11.4% with low belonging drive the risk patterns.
- Respondents living with HIV reported the lowest belonging scores of any group measured: an average of 3.98, nearly a full point below the statewide average. Research from this dataset (Watts et al., 2026) found belonging is the key protective factor against policy-attributed suicidality. The group with the highest suicidal ideation also has the least community connection.
- The low-belonging group’s outcomes are worse across nearly every measure in this dataset: substance use, mental health, healthcare access, and housing stability all show compounding disadvantage for those who are least connected to LGBTQ+ community.
- LGBTQ+ community belonging is the single strongest correlation in this dataset. It appears across mental health, substance use, sexual health, and housing, as both a protective factor and a gap. Belonging is not just social. It is structural.
Louisville Metro
The State’s Urban Core Has the Infrastructure. It Is Being Outpaced.
Key Findings +
- 24.5% of Louisville respondents reported chemsex in the past year, the highest of any region and 6.7 points above the statewide average of 17.8%. Louisville is also the region with the most harm reduction infrastructure, at 35.4% access, the highest of any region. The services exist. The need is outpacing them.
- 46.3% of Louisville respondents have ever used cocaine, crack, heroin, or methamphetamine, 6.4 points above the statewide rate of 39.9%. 28.6% drink alcohol weekly or more, the highest of any region. Louisville’s concentration of nightlife, service venues, and LGBTQ+ social spaces likely shapes both figures.
- 32.4% of Louisville respondents report increased suicidal thoughts attributed to policy debates, 3.9 points above the statewide average of 28.5%. Attempted suicide is at 25.8% versus 22.5% statewide. Louisville’s “very negative” mental health rating (33.2%) is slightly below the statewide average: suicidality and general mental health burden do not always move together.
- 32.8% of Louisville respondents currently smoke cigarettes, well above the statewide average and concentrated enough to be a distinct public health issue for this community.
- Louisville has lower “no regular provider” rates than most of the state, and provider refusals occur at lower rates than in Western Kentucky (29.2%) or South Central KY (20.8%). The relative advantage in access tracks with Louisville’s concentration of LGBTQ+-affirming clinics, but it is a relative advantage, not an absence of barriers.
- Louisville’s 24.5% chemsex figure means 1 in 4 of these 190 survey respondents reported chemsex, not 1 in 4 of all LGBTQ+ Louisvillians. The geography of chemsex within Louisville is not captured here. What is captured: Louisville has the highest regional rate, and only about 3 in 10 chemsex participants statewide connect that behavior to hookup apps.
Urban vs. Rural Divide
Where You Live Shapes What Care You Can Access
Key Findings +
- Urban and suburban respondents make up 75% of the sample (n=418). Statewide averages are substantially shaped by this group. The regional pages in the data explorer tell the fuller story within and beyond that urban core.
- 39.3% of the rural HIV priority population reported a provider refused LGBTQ+ care, versus 12.1% in urban and suburban areas. That is not a difference in need. It is a difference in access. Western Kentucky’s HIV-never-tested rate is 67.2%, nearly 20 points above the statewide rate of 48.2%.
- Urban and suburban respondents have the highest PrEP utilization of any density group because PrEP requires a prescribing provider, a pharmacy, and follow-up care, all more available in cities. The PrEP gap between urban and rural Kentucky is the provider access gap expressed in medication form.
- Urban and suburban respondents report above-average mental health burden from policy debates. Higher engagement with advocacy and closer following of legislation attacking their community may amplify reported impact. 42.0% of Louisville and 40.8% of Lexington respondents feel physically unsafe in public.
- Rural LGBTQ+ respondents report lower LGBTQ+ community belonging than urban or suburban respondents. Rural isolation is not just geographic. It is the absence of the peer community and infrastructure that belonging requires, and belonging is the single strongest protective factor in this dataset.
- Urban LGBTQ+ people face higher chemsex and hard drug use rates alongside better harm reduction access. Rural LGBTQ+ people face lower drug use rates but higher provider refusal, higher assault rates, and lower access to every service. Both are crisis conditions. The nature of the crisis differs by ZIP code.
Explore the Full Dataset
The interactive data explorer gives you access to every finding in the survey. Filter by region, identity group, and topic to build your own analysis.
Built for journalists, policymakers, researchers, and healthcare providers working on LGBTQ+ health and well-being in Kentucky.
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Data note: This survey is a community sample and cannot be generalized to all LGBTQ+ Kentuckians. Cells with fewer than 10 respondents are suppressed; cells with 10 to 29 respondents show raw counts. All findings reflect self-reported data collected in 2024 and 2025 by The Moore Lab, led by Drs. Justin X. Moore and Sydney P. Howard, alongside collaborating researchers Drs. Keith J. Watts and Rachel H. Farr, in partnership with Queer Kentucky.
How to Cite This Data
For articles and reports:
Queer Kentucky 2025 Community Health Survey. Queer Kentucky, in partnership with The Moore Lab (Drs. Justin X. Moore and Sydney P. Howard) and collaborating researchers Drs. Keith J. Watts and Rachel H. Farr. Data collected 2024 to 2025. IRB Protocol #94156. n=559 Kentucky respondents.
In-text (AP style):
“…according to the 2025 Queer Kentucky Community Health Survey (queerkentucky.com/queer-kentucky-survey-2025)…”
Peer-reviewed publications from this dataset:
Watts et al., Healthcare (2026); Watts et al., Sexes (2025).
For interview requests, underlying data, or methodology questions, contact [email protected]. Underlying figures are available to working journalists on request, subject to respondent privacy protections.
