In Harm's Way: How the 2024 U.S. Election Might Affect Sexual- and Gender-Minority Health.

Immediately after taking office in 2025, the current U.S. presidential administration established an unprecedented number of policies hostile to sexual- and gender-minority (SGM) populations: restricting the rights and social legitimacy of transgender individuals, curtailing youth access to gender-affirming medical care, terminating federal research and data collection on sexual and gender diversity, and restricting open discussion of sexual and gender diversity in educational settings. These events pose a greater threat to SGM health than previous state-level hostile policies, because of their scope, speed, and scale, and because they serve to institutionalize animus toward gender-minority populations into U.S. law and policy. We use extant research on structural stigma to predict the most likely mental and physical health consequences of these events, and we also forecast health consequences for the family members of SGM individuals and individuals whose paid employment involves SGM populations. We review evidence for the mechanisms through which these effects may unfold (institutional changes, increased minority stress, decreased social safety, and behavioral changes) and identify subpopulations at disproportionate risk (gender-minority populations, youth, those facing intersectional stigma, and those with existing health vulnerabilities). We conclude with a call for targeted efforts to ameliorate these negative health consequences, and we review research indicating that increasing social support and safety is the most effective and feasible strategy for doing so. We call for urgent, community-based efforts to increase the number and quality of nurturant social connections among all individuals who have been placed in harm's way by the changed U.S. political climate.