LGBTQ+ Patient Rights: How to Get Affirming Care and File Discrimination Complaints

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Updated: June 12, 2026

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LGBT adults are twice as likely as non-LGBT adults to report unfair or disrespectful treatment from a provider, and half skipped or postponed needed care in the past year because of cost. Federal protections have narrowed since 2024, so state law now determines most coverage and complaint outcomes.

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IF YOU’RE EXPERIENCING HEALTH CARE DISCRIMINATION RIGHT NOW

Call Lambda Legal’s Help Desk at 1-866-542-8336 for free legal guidance.

Right now: Write down names, dates and exact statements. Request your full medical record from the provider in writing.

This week: File a Section 1557 complaint with the HHS Office for Civil Rights within 180 days and appeal any coverage denial in writing. If the insurer denies the appeal, escalate to your state insurance commissioner.

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LGBTQ+ HEALTH CARE AT A GLANCE
  • More than half of LGBT adults (51%) skipped or postponed needed care in the past year because of cost, compared with 34% of non-LGBT adults.
  • Paying for health care is a problem for 43% of LGBT adults, and 39% had trouble affording prescription drugs.
  • One in three LGBT adults (33%) say a provider treated them unfairly or with disrespect in the past three years, roughly twice the 15% rate non-LGBT adults reported.
  • For 25% of LGBT adults, health got worse after skipping or postponing care due to cost, compared with 18% of non-LGBT adults.
  • Medicaid is the primary coverage source for 13% of LGBT adults, compared with 7% of non-LGBT adults. Check Medicaid eligibility by state.
  • Health care costs are a worry for 76% of LGBT adults. Your deductible and out-of-pocket maximum affect what you pay; our health insurance buying guide covers how to compare plans.

*KFF and Williams Institute define their study populations as “LGBT adults.” MoneyGeek uses “LGBTQ+” only in editorial framing, not when citing a specific statistic.

An illustrative image of someone finding a health care provider.

How to Recognize Health Care Discrimination

Discrimination in clinical settings follows patterns. KFF’s 2023 Racism, Discrimination and Health Survey documented four provider behaviors that LGBT adults report at roughly twice the rate of non-LGBT adults.

Unfair or Disrespectful Treatment

Thirty-three percent of LGBT adults say a provider treated them unfairly or with disrespect in the past three years, compared with 15% of non-LGBT adults. In practice, this includes a clinician dismissing concerns, talking down to a patient or refusing to use a patient's name or pronouns after being corrected.

First action: Document the incident the same day and ask the facility's patient advocate for a written response. Most hospitals list a patient relations contact through the Joint Commission’s accreditation lookup.

Assumptions Without Asking

Forty percent of LGBT adults report a provider assumed something about them without asking, compared with 17% of non-LGBT adults. Common examples include providers presuming a patient's partners, gender identity or family structure based on appearance.

Next step: Correct the record in writing through the patient portal so future visits start from accurate information.

Being Blamed for a Health Problem

Thirty-two percent of LGBT adults say a provider suggested they were personally to blame for a health problem, compared with 15% of non-LGBT adults. This pattern most often surfaces in mental health, sexual health and weight-related visits.

First action: Request a second opinion in writing and ask that the second clinician's notes be added to your record.

Having Questions or Requests Ignored

Thirty-two percent of LGBT adults report a provider ignored a direct request or question, compared with 14% of non-LGBT adults. About 60% of LGBT adults prepare for negative experiences before a medical visit, including bringing a support person or rehearsing how to describe symptoms.

First action: Submit your question through the patient portal so the provider's response, or lack of one, becomes part of the record.

Cost and Coverage Barriers

Cost is the largest single barrier to care for LGBT adults, separate from the four provider behaviors above. KFF found 51% skipped or postponed needed care in the past year because of cost, and 25% report their health got worse as a result. Coverage denials, narrow networks and exclusions for gender-affirming care increase the pressure, especially for the 13% of LGBT adults whose primary coverage is Medicaid. If you're shopping the ACA marketplace, our marketplace health insurance guide covers how to compare plans on network and exclusions, not just premium.

First action: Request any coverage denial or plan exclusion in writing, then start an internal appeal within your insurer's deadline, often 180 days. HealthCare.gov’s appeals page outlines the federal process.

What to Do if You’re Discriminated Against

  1. 1
    Document Everything

    Write down what happened the same day. Capture date, time, location and names and titles of everyone involved. Use quotation marks for direct statements. Save voicemails, portal messages, denial letters and Explanation of Benefits statements. Request your full medical record in writing; providers must respond under HIPAA within 30 days.

  2. 2
    Use the Facility’s Internal Process First

    Most hospitals and large practices have a patient advocate or grievance line. Ask for the facility’s nondiscrimination policy in writing, file your complaint with patient relations or compliance, and request a written response with a timeline.

  3. 3
    File a Federal Section 1557 Complaint

    Most hospitals, Medicaid and Medicare providers and ACA marketplace insurers receive federal funding. If yours does, file with the HHS Office for Civil Rights under Section 1557 of the Affordable Care Act. File online within 180 days. You don't need a lawyer.

    Federal protections for sexual orientation and gender identity have been narrowed by 2025 rulemaking and ongoing litigation, so outcomes vary. File anyway; the complaint record matters even when enforcement is uncertain.

  4. 4
    File State-Level Complaints

    State protections often reach further than federal ones, especially in states with explicit sexual orientation and gender identity nondiscrimination laws.

    • State medical board: for clinician conduct, including refusal of care. The Federation of State Medical Boards directory lists every board.
    • State insurance commissioner: for coverage denials and network adequacy. Find yours through the NAIC commissioner directory.
    • State attorney general or human rights commission: for civil rights violations.
    • State Medicaid office: if the issue involves Medicaid coverage of gender-affirming or other care.
  5. 5
    Get Free Legal Help
  6. 6
    Appeal a Coverage Denial

    For insurance denials covering gender-affirming care, PrEP, fertility care or mental health, use the formal appeals process. Our step-by-step insurance appeals guide covers what each letter should include.

    1. Request the denial in writing with the plan language cited.
    2. File an internal appeal within the insurer’s deadline, often 180 days.
    3. Cite Section 1557 and any applicable state nondiscrimination law.
    4. If denied again, request an external review through your state insurance department.
    5. For Medicaid denials, request a fair hearing within the deadline, often 90 days, though deadlines vary by state.
  7. 7
    Protect Your Mental Health Through the Process

    While your complaint works through the system, some resources provide immediate support. Call 988 and press 3 for LGBTQ+ counselors, Trans Lifeline at 1-877-565-8860 or the Trevor Project for callers under 25 at 1-866-488-7386 while you continue seeking care. Find a new affirming provider through the directories below before you stop seeing a discriminating one.

What LGBTQ+ Patient Protections Exist Under Federal and State Law in 2026?

Federal protections are narrower than they were two years ago, and state law now drives most access to nondiscriminatory and gender-affirming care.

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    Federal: Contested, Not Settled

    Section 1557 of the Affordable Care Act still prohibits sex-based discrimination in federally funded health programs, but protections for sexual orientation and gender identity have been narrowed by 2025 rulemaking and ongoing litigation. A November 2025 JAMA Health Forum analysis documented federal policy changes affecting LGBTQ+ populations, including Medicaid eligibility changes, restrictions on gender-affirming care and revised nondiscrimination rules.

    The July 4, 2025 reconciliation bill is expected to leave millions of low- and moderate-income people uninsured as Medicaid access tightens. Because LGBT adults have lower incomes and higher Medicaid reliance than non-LGBT adults, the changes affect this community more. If you're losing coverage, you can compare options through the ACA marketplace or our individual health insurance guide.

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    State: Where Most Protection Is Now

    State-level law determines three things federal law no longer settles cleanly: whether insurers can deny coverage based on sexual orientation or gender identity, what Medicaid covers for gender-affirming care and how far religious refusals can reach. The table below shows where each protection stands; for live updates, the Movement Advancement Project’s interactive map is the most current source.

State-by-State LGBTQ+ Health Care Protections (2026)

The table summarizes Movement Advancement Project tallies as of May 2026. State laws change frequently; verify with MAP before relying on this for major decisions.

Table last verified: May 26, 2026. By: Nathan Paulus.

Alabama
No
No
Yes
No
Alaska
No
No
No
No
Arizona
No
No
Partial
No
Arkansas
No
No
Yes
No
California
Yes
Yes
No
Yes
Colorado
Yes
Yes
No
Yes
Connecticut
Yes
Yes
No
Yes
Delaware
Yes
Yes
No
Yes
Washington, D.C.
Yes
Yes
No
Yes
Florida
No
No
Yes
No
Georgia
No
No
Yes
No
Hawaii
Yes
Yes
No
Yes
Idaho
No
No
Yes
No
Illinois
Yes
Yes
No
Yes
Indiana
No
No
Yes
No
Iowa
No
No
Yes
No
Kansas
No
No
Yes
No
Kentucky
No
No
Yes
No
Louisiana
No
No
Yes
No
Maine
Yes
Yes
No
Yes
Maryland
Yes
Yes
No
Yes
Massachusetts
Yes
Yes
No
Yes
Michigan
Yes
Yes
No
Yes
Minnesota
Yes
Yes
No
Yes
Mississippi
No
No
Yes
No
Missouri
No
No
Yes
No
Montana
No
No
Yes
No
Nebraska
No
No
Partial
No
Nevada
Yes
Yes
No
Yes
New Hampshire
Yes
No
No
Yes
New Jersey
Yes
Yes
No
Yes
New Mexico
Yes
Yes
No
Yes
New York
Yes
Yes
No
Yes
North Carolina
No
No
Yes
No
North Dakota
No
No
Yes
No
Ohio
No
No
Yes
No
Oklahoma
No
No
Yes
No
Oregon
Yes
Yes
No
Yes
Pennsylvania
Partial
Yes
No
No
Rhode Island
Yes
Yes
No
Yes
South Carolina
No
No
Yes
No
South Dakota
No
No
Yes
No
Tennessee
No
No
Yes
No
Texas
No
No
Yes
No
Utah
No
No
Yes
No
Vermont
Yes
Yes
No
Yes
Virginia
Yes
Yes
No
Yes
Washington
Yes
Yes
No
Yes
West Virginia
No
No
Yes
No
Wisconsin
No
No
No
No
Wyoming
No
No
No
No
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HOW TO READ THIS TABLE

A "Yes" in any column means that law is in effect in that state.

  • Column 1: State law prohibits insurers from denying coverage based on sexual orientation or gender identity.
  • Column 2: State Medicaid covers medically necessary gender-affirming care.
  • Column 3: The state restricts or bans gender-affirming care for minors. Some states extend these restrictions to adults on public coverage.
  • Column 4: Licensed mental health providers are prohibited from practicing conversion therapy on minors.
An illustrative image of a patient getting treatments.

How to Find an Affirming Provider

National directories vet and filter for LGBTQ+ competency. Start with the list below and narrow by state and specialty.

National directories:

Coverage and legal help:

Urgent mental health support:

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About Christopher Murray

Christopher Murray, Personal Finance Writer

Christopher Murray is a personal finance and sustainability writer covering diverse topics, from budgeting to unique investment options like socially responsible investing (SRI) and cryptocurrency. His works focus on sustainability as the best savings tool. He contributes finance articles to MoneyGeek.

Murray earned both his English literature and gender studies degrees from Smith College.

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