Youth's Lives Every Day

Background
Politics and legislative actions can profoundly impact the mental health and well-being of LGBTQ+ young people, who have fewer mental health challenges and lower suicide risk in environments that are welcoming to LGBTQ+ people.1-4 However, in recent years, an unprecedentedly high number of LGBTQ+-related policies have been proposed in state legislatures, leading to the enactment of many anti-LGBTQ+ laws throughout the United States and the creation of drastically different policy landscapes from state to state.5 Despite a growing body of research linking LGBTQ+-related policies to the health outcomes of LGBTQ+ people, little is known about how LGBTQ+ young people respond to their policy environments, such as by relocating or crossing state lines to access health care. By gaining more knowledge of how LGBTQ+ young people respond to their policy environment, advocates and policymakers can create or modify policy to better support LGBTQ+ young people and their families. This brief uses data from the 2024 U.S. National Survey on the Mental Health of LGBTQ+ Young People, as well as data from the Movement Advancement Project on LGBTQ+-related laws and policies,6 to explore the relationship between state-level LGBTQ+ policy, well-being, and decisions to leave a state.
The Movement Advancement Project tracks over 50 different LGBTQ+-related laws and policies that shape LGBTQ+ people’s lives, experiences, and equality. The laws are scored and summarized to determine an overall policy tally score for each state, the District of Columbia, and the five populated U.S. territories. The major categories of laws covered by the policy tally are Relationship & Parental Recognition, Nondiscrimination, Religious Exemptions, LGBTQ+ Youth, Health Care, Criminal Justice, and Identity Documents. Though these scores are an excellent measure of the current LGBTQ+ policy landscape across a wide range of issues, they do not necessarily reflect the entire political or social landscape for LGBTQ+ people.
Results
Nine out of ten (90%) LGBTQ+ young people reported that recent politics negatively impacted their well-being, with 37% experiencing this impact sometimes and 53% experiencing it a lot. Only 10% reported no negative impact. Transgender and nonbinary (TGNB) young people reported a greater degree of negative impacts (94%; 33% sometimes, 61% a lot), relative to cisgender young people (83%; 46% sometimes, 37% a lot). Just over two in five (41%) reported any positive impacts from recent politics to their well-being either sometimes (38%) or a lot (3%), with the majority (59%) reporting never experiencing a positive impact from recent politics. Positive impacts from recent politics did not differ by gender identity.

Because of LGBTQ+-related politics or laws, LGBTQ+ young people and their families often had to make decisions to leave their state. Nearly two in five (39%) reported considering moving to a different state, and 4% actually moved due to LGBTQ+-related politics or laws. In addition, 9% of LGBTQ+ young people reported having to cross into another state in order to obtain medical care due to these policies. Compared to their cisgender peers, TGNB young people reported more frequently considering moving to a different state (45% vs. 26%), moving to a different state (4% vs. 3%), and crossing into another state to access medical care (12% vs. 4%).
The LGBTQ+ policy index6 was scored so that higher values indicate a greater number of LGBTQ+-friendly policies, ranging from -12.50 to 43.00 (M = 18.46, SD = 18.43). Notably, 27% of LGBTQ+ young people in the sample lived in a state with a negative policy index, indicating an especially harmful policy environment. After splitting the remaining LGBTQ+ young people in states with a positive policy index into four categories, we found that 20% lived in a state with a low overall LGBTQ+ policy index, 7% in fair, 8% in medium, and 38% in states with a high LGBTQ+ policy index. LGBTQ+ young people’s consideration and decision to leave a state varied by the policy environment they lived in. Those living in states with higher LGBTQ+ policy indices reported less frequently considering leaving a state and crossing state lines to access health care, and were more likely to have previously moved states. This effect was particularly pronounced among TGNB young people living in a state with a negative policy index, as evidenced by nearly seven in ten (68%) having considered moving to another state, and nearly one in five (18%) having left their state to access health care.


Regression analyses revealed that LGBTQ+ young people living in states with a higher LGBTQ+ policy index reported higher odds of recent politics positively impacting their well-being (aOR = 1.003, 95% CI = 1.001 – 1.004, p = .008) and lower odds of recent politics negatively impacting their well-being (aOR = 0.996, 95% CI = 0.993 – 1.000, p = .033), compared to those living in states with a lower LGBTQ+ policy index. LGBTQ+ young people living in states with a higher LGBTQ+ policy index also had lower odds of crossing into another state to access medical care (aOR = 0.969, 95% CI = 0.965 – 0.972, p < .001) and considering moving to a different state (aOR = 0.952, 95% CI = 0.950 – 0.954, p < .001). A higher current LGBTQ+ policy index was also associated with higher odds of having previously moved to another state (aOR = 1.009, 95% CI = 1.004 – 1.013, p < .001).
Looking Ahead
These findings underscore the relationship between LGBTQ+-related policies, decisions to leave a state, and the well-being of LGBTQ+ young people. LGBTQ+ young people living in states with a higher LGBTQ+ policy index reported that recent politics were less likely to negatively impact their well-being. They were also less likely to report crossing state lines for health care or consider moving to another state. These relationships highlight the critical role of state-level policy in shaping the lived experiences of LGBTQ+ young people. However, they also illustrate that despite the nationalization of politics and media, states with policies that recognize the rights and liberties of LGBTQ+ people do in fact positively influence the lives of LGBTQ+ young people living there.
The disparities faced by TGNB young people compared to their cisgender peers, especially in accessing health care, signal an urgent need for policies that specifically address the needs of TGNB young people. Policies that welcome LGBTQ+ identities not only reduce logistical and emotional burdens (e.g., not needing to travel long distances for necessary health care), but are related with improved mental health outcomes.7 This improvement is likely due to the creation of more stable and supportive environments for LGBTQ+ young people to thrive. While some LGBTQ+ young people and their families may have the resources to relocate to a state more supportive of LGBTQ+ individuals, many cannot, even if they are considering or desiring to move. Notably, the same factors that might preclude the ability of LGBTQ+ young people and their families from moving, such as poverty, housing discrimination, and employment access, are the same ones that disproportionately affect LGBTQ+ people of color and increase their risk of mental health and suicide.8,9
Our results point to LGBTQ+ young people in states with a higher LGBTQ+ policy index as being more likely to have previously moved to another state. Though our data precludes establishing a causal relationship, this finding is consistent with LGBTQ+ young people and their families having moved from a state with a lower LGBTQ+ policy index to a state with a higher one. Finally, although only 4% of LGBTQ+ young people in our sample reported leaving a state because of LGBTQ+-related policies, based on estimations that 9.5% of 13 to 17 year olds and 15.2% of 18 to 24 year olds in the U.S. are LGBT,10,11 this would correspond to roughly 266,000 LGBTQ+ young people and their families uprooting their lives to leave a state because of LGBTQ+-related politics or laws.
Looking forward, this research calls for continued advocacy for policies that support LGBTQ+ young people at the local, state, and federal levels. Future studies should explore the long-term effects of policy on LGBTQ+ youth, with attention to intersectional factors such as race, socioeconomic status, and geographic location. Additionally, investigating how community organizations, schools, and healthcare providers can complement existing policies to further support LGBTQ+ youth is crucial. By prioritizing inclusive policies and practices, we can address the systemic challenges that disproportionately affect LGBTQ+ youth and work toward creating a society where all young people, regardless of their gender identity or sexual orientation, can flourish.
The Trevor Project is committed to supporting LGBTQ+ young people through crisis intervention, research, and advocacy initiatives. TrevorSpace, our dedicated social media platform, offers LGBTQ+ young people a safe and supportive community where they can connect with supportive peers. Our 24/7 crisis services—available by phone, chat, and text—ensure that LGBTQ+ young people have access to counselors whenever they need help. Our education team empowers adults with the tools and knowledge to effectively support LGBTQ+ young people across all identities, while our advocacy team works to promote access to welcoming environments, both at the federal and state level. Additionally, we are committed to continuing to publish research focused on the relationship between policy and LGBTQ+ mental health.
You can read more research from The Trevor Project on the relationship between policy and LGBTQ+ young people’s mental health here: Anti-LGBTQ+ School Policies and LGBTQ+ Young People and State-level Anti-transgender Laws Increase Past-year Suicide Attempts among Transgender and Non-binary Young People. Additionally, here is a resource for LGBTQ+ young people on how to take care of their mental health and well-being following the recent election: Finding Support & Building Community After the 2024 Elections.
The Movement Advancement Project (MAP) provides rigorous research, insight, and communications that help speed equality and opportunity for all. MAP works to ensure that all people have a fair chance to pursue health and happiness, earn a living, take care of the ones they love, be safe in their communities, and participate in civic life. MAP’s LGBTQ+ policy work includes original research reports, innovative analysis, and Equality Maps, tracking 50+ laws and policies across all 50 states, Washington D.C., and the five territories. The Movement Advancement Project’s maps are updated and maintained in real time, always reflecting the current landscape across the country. For more information, visit MAP.
Methods
References
Recommended Citation
The Trevor Project & Movement Advancement Project. (2025). How State Policy Affects the Well-Being and Relocation of LGBTQ+ Young People.
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