Anti-LGBTQ Policy Proposals Can Harm Youth Mental Health

Research BriefYouth & Young AdultsJul 7 2021

Discrimination against lesbian, gay, bisexual, queer, and/or questioning (LGBTQ)* youth remains a contributing factor to the disproportionately high rates of socio-emotional distress and mental illness among LGBTQ youth, when compared to straight and cisgender youth.

This exploratory analysis compares proposed anti-LGBTQ legislation to the volume of Crisis Text Line (CTL) conversations from LGBTQ texters under age 18 and suggests that proposed anti-LGBTQ legislation may contribute to LGBTQ youth’s experiences of emotional distress. Our policy analysis shows that state legislatures proposed over 200 pieces of anti-LGBTQ legislation from 2015 to 2019. At the time of this publication, 2021 has already seen more than 200 pieces of legislation of this type in 35 states. This stark increase highlights an urgent need to understand how such legislation—whether enacted or not—impacts LGBTQ youth well-being.

Key Findings

  • In 42 states, state legislators subjected LGBTQ youth to at least one piece—and sometimes as many as 12 pieces—of proposed anti-LGBTQ legislation in a single year from 2015 to 2019. In total during this time, state legislatures introduced 215 pieces of anti-LGBTQ legislation, for an average of 43 proposed laws each year.
  • Laws creating restrictions on single-sex facilities were among the most frequent types of anti-LGBTQ legislation proposed.
  • The number of texts to Crisis Text Line in a state where anti-LGBTQ legislation was proposed increased in the four weeks after such legislation was proposed; this difference was small but statistically significant.


Researchers use the concept of minority stress—a culmination of social discrimination, stigma, and anticipated rejection from friends, family, and community—to explain increased rates of mental illness among lesbian, gay, and bisexual (LGB) youth. State policy has played a critical role in the ever-evolving landscape of civil rights and discriminatory practice in the United States, and state legislative proposals to limit access to services for LGBTQ people represent one source of minority stress. Policies such as banning transgender athletes from sports, prohibiting health care for transgender youth, or allowing religious exemptions in foster care create conditions for increased discrimination and reduced access to services for individuals with marginalized identities. Research suggests that the stress associated with policies that restrict rights or remove protections for LGBTQ people has a negative impact on their mental health. Organizations that run LGBTQ-focused suicide prevention hotlines have long pointed to sharp increases in calls during times in which pieces of anti-LGBTQ state legislation are introduced. This suggests that LGBTQ-related legislation may have immediate implications for the health and welfare of young people, separate and apart from the specific provisions of the policy itself.

We sought to test whether there is any relationship between proposed anti-LGBTQ legislation and instances of LGBTQ youth in crisis. Although this analysis is exploratory, it provides important new findings that indicate an association between the introduction of anti-LGBTQ state legislation and the volume of LGBTQ youth seeking crisis support. The legislative data set that we generated is available for other researchers and stakeholders to access. This data set allows users to explore the types, frequency, and regional distribution of anti-LGBTQ legislation from 2015 to 2019.


In 42 states, state legislators subjected LGBTQ youth to at least one piece—and sometimes as many as 12 pieces—of proposed anti-LGBTQ legislation in a single year from 2015 to 2019, for a total of 215 pieces of legislation within the categories we analyzed. The largest number of state bills were introduced in 2016 (with 59), and the fewest in 2018 (with 28). Texas and Oklahoma proposed the most anti-LGBTQ legislation during the time period, with 23 and 16 bills respectively. Among the most common types of proposed legislation were prohibitions on health care for transgender youth and the provision of religious exemptions from marriage ceremonies.


Select topics to include:

Select all
Unselect all

Excluding trans youth from athletics
Prohibiting health care for trans youth
Religious exemptions from marriage ceremonies
Religious exemptions in foster care and adoption
Religious exemptions in health care
Religious Freedom Restoration Act (RFRAs) or First Amendment Defense Acts (FADAs)
Single-sex facility restrictions

States in the Northeast introduced fewer pieces of anti-LGBTQ legislation, while states in the South (especially Oklahoma, Texas, and Missouri) introduced the most. Additionally, over time, there has been a decrease in the number of proposed pieces of legislation, although the decrease is not linear (42 in 2015, 59 in 2016, 45 in 2017, 28 in 2018, and 41 in 2019). Although outside the scope of this study, the significant increase in proposed anti-LGBTQ legislation in 2021 thus far underscores the urgent need to understand how such legislation contributes to the minority stress of LGBTQ youth.

Proposed anti-LGBTQ legislation is associated with a small but statistically significant increase in texts to Crisis Text Line from LGBTQ youth. Using a multi-level model to compare the number of daily conversations with LGBTQ youth on days with and without anti-LGBTQ legislation, we found that the daily text volume was higher on days for which an anti-LGBTQ bill had been proposed in the past four weeks (fixed-effect of .036, p<.0206). This effect is small, corresponding to approximately 1.1 additional conversations per state per month, but is statistically significant. For more details about the approach, see our Technical Appendix.

This suggests a possible association between the proposal of anti-LGBTQ legislation and an increase in youth mental health help-seeking behavior. Future research should further investigate this relationship and explore alternative data sources.


The results of this exploratory analysis suggest that proposing anti-LGBTQ legislation may increase the number of LGBTQ youth who experience a mental health crisis. These preliminary findings suggest that the negative impacts of anti-LGBTQ legislation on LGBTQ youth may be broader-reaching than previously understood and may go beyond the specific provisions of such laws once enacted. As policymakers consider introducing legislation that limits access to or participation in services and opportunities for LGBTQ people, they must also consider the potential detrimental impacts of such policy debates on the well-being of LGBTQ youth.

Future Research

Our preliminary findings suggest that—with a larger sample of mental health crisis call or text conversation frequency data from LGBTQ youth—a future study might reveal a stronger correlation between proposed anti-LGBTQ legislation and help-seeking behavior by LGBTQ adolescents. A future study to quantitatively examine the link between proposed legislation using more sophisticated quasi-experimental methods (such as difference in difference, interrupted time series, or an event study model) would provide more conclusive evidence of the impact of legislation on LGBTQ youth’s mental health. Such a model might require additional years of data to gain sufficient statistical power. Future research should also explore whether there is a correlation between proposed supportive LGBTQ legislation and LGBTQ youth mental health.

Our Approach

Technical Appendix

* This brief uses the acronym LGBTQ, which stands for lesbian, gay, bisexual, transgender, queer, and/or questioning. At times we employ variations of this acronym (such as LGB, or LGBQ), which are used intentionally to reflect the populations represented in specific data collections.