Sexual Orientation and Gender Identity-Related State-Level Policies and Perceived Health Among Lesbian, Gay, Bisexual, and Transgender (LGBT) Older Adults in the United States

We examined the associations between state-level policies and the health of lesbian, gay, bisexual, and transgender (LGBT) older adults. Methods: Using data from the 2018–2020 Behavioral Risk Factor Surveillance System surveys, we assessed physical and mental health by the tally of points for enacted LGBT-related policies (Low= <0–49.9% of possible points, High= 50–100% of possible points) in 10,032 sexual minority (i.e., lesbian, gay, and bisexual) and 1,072 transgender (non-sexual minority) adults aged 50 and older from 41 states. Results: Sexual minority adults in low tally states had greater odds of reporting fair or poor general health and 14 or more days of poor physical health in the past 30 days. Transgender participants in low tally states also had greater odds of reporting fair or poor general health. Discussion: Lesbian, gay, bisexual, and transgender adults have significantly greater risk of poor health if they live in a state with fewer LGBT anti-discriminatory policies enacted.