Understanding the LGBTQ+ Divide: A review on the impact of geographic location and political climate on LGBTQ+ patient care in the United States.

Background: In the United States, laws and policies are proposed and passed daily that either protect or restrict transgender patients’ access to care. The objective of this study is to review the existing body of literature on the effect of state-level policy on transgender patients’ overall health. Methods: Primary literature was identified through PubMed and the National Institutes of Health. Search terms included keywords related to the following concepts: LGBTQ terms, differentiating terms, regional terms, and health outcome terms. Inclusion criteria: Quantifiable studies conducted on the American LGBTQ and Transgender population from January 2015 to April 2023. Exclusion criteria: Studies not conducted in English, on the American population, and not relevant to the research question. Results were individually discussed and then synthesized using a narrative approach. Results: A total of 6 studies were identified for review. The difference in rates of suicidality, suicide attempt, depression, and anxiety between Democratic and Republican states was statistically significant (p Conclusion: Republican-run states, on average, had policies in place restricting access and treatment for transgender patients which is correlated with worse health outcomes. Advocacy is greatly needed to help protect this at-risk population and further research is needed to better understand how state-level barriers impact transgender patients across the US.