Progressive states must become safe havens for LGBTQ adolescents

It should come as no surprise that the new speaker of the U.S. House of Representatives is anti-LGBTQ+, given the escalation of such sentiments across the nation. During the 2023 legislative session, more than 550 anti-LGBTQ+ bills were introduced across 43 state houses; more than 200 of these targeted transgender and non-binary people, particularly youth. As of August 2023, more than 80 bills had passed, making it the worst year on record for LGBTQ+ rights. 

What happens when these discriminatory policies force LGBTQ+ people to move to more supportive enclaves, which also have some of the most expensive housing in the country and highest per capita rates of homelessness? This question is particularly salient for LGBTQ+ adolescents and young adults who often lack social, familial, and financial support.

Discriminatory bills include those that limit gender-affirming care, require schools to notify parents about children’s preferred pronouns, and Florida’s infamous ‘Don’t Say Gay’ bill. In 2023, nearly 100,000 transgender adolescents ages 13-17 live in states that have banned access to healthcare, sports, or school bathrooms; one-third of transgender youth live in states where gender-affirming care is banned or severely limited. 

States like California, WashingtonNew York, and Massachusetts rank high on LGBTQ+ equality, and continue passing bills to strengthen LGBTQ+ rights (e.g., all-gender restrooms, transgender adolescents’ privacy, foster care). These states also have expensive housing markets and high levels of homelessness. While supportive policies are imperative to counteract the discriminatory legislation enacted nationwide, progressive states must also develop policies and programs to support LGBTQ+ adolescents who are being forced to move there to access healthcare and maintain their physical and mental wellbeing. This can include set-aside funding for LGBTQ+ youth-specific housing subsidies and services and the further integration of housing agencies, government services, and community organizations that serve LGBTQ+ adolescents. We must ensure that LGBTQ+ youth who flee to more inclusive states can build a healthy and full life without fear of housing insecurity.

A 2023 Human Rights Campaign Survey among 14,000 LGBTQ+ adults nationwide asked if people would move, have already moved away or have taken steps to move from a state that passed a gender-affirming care ban: Thirty-four percent of LGBTQ+ adults and 53% of transgender and non-binary adults said they would move. While some LGBTQ+ adolescents have parents with the financial means, and desire, to leave discriminatory states, not all are so lucky: some young adults must move on their own even without social and financial support. Currently, 30% of the homelessness population, and 50% of those experiencing unsheltered homelessness, are in California; it also has the second highest average home price and third most expensive rental prices in the country. 

LGBTQ+ young people are disproportionately represented among homeless youth. While 10% of adolescents nationwide are LGBTQ+, they constitute 30-40% of all homeless adolescents; nearly 40% of transgender young adults report a history of homelessness and housing instability.  

I have worked with LGBTQ+ adolescents for nearly 20 years and have seen the detrimental impact that discriminatory policies have on all aspects of their health. While people may argue that these young people should remain in their home state, LGBTQ+ adolescents in discriminatory environments are more likely to experience bullyingpoor mental health, housing and employment discrimination, and physical violence. These outcomes cause poor health and are also known risk factors for homelessness and housing instability. This suggests that the recent and continued uptick in discriminatory policies will continue to force LGBTQ+ adolescents and young adults to flee discriminatory states, while simultaneously putting them at risk for housing instability.

For more than 50 years, states like California, New York, and Washington have been a refuge for LGBTQ+ individuals who felt unsafe in their homes, cities, and states. I am proud to live in a state like California that has historically welcomed LGBTQ+ individuals. As voters, we must demand policies and programs that extend this welcome to LGBTQ+ young people who are currently under attack. To maximize their health, and give them the future they deserve, we must ensure that housing and related services are available and affordable to LGBTQ+ adolescents and young adults fleeing discriminatory states.

Morgan Philbin is an associate professor in the UCSF Department of Medicine, and a Public Voices Fellow on homelessness with the OpEd Project in partnership with the UCSF Benioff Homelessness and Housing Initiative.