LGBTQ+ Health, Policy, and Politics: Advances, Challenges, and Potential Opportunities

The landscape of politics and policies that impact the health and well-being of lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) people in the United States has evolved substantially in the last 50 years. Tracing its roots back to the 1960s, the LGBTQ+ rights movement has often relied on health as an organizing principle to advance progress through advocacy, research, and public policy. In this article, the authors present the evolution of LGBTQ+ data collection and health policy research-with particular attention to nationwide marriage equality, the Affordable Care Act, and access to transgender-inclusive health insurance coverage-and then discuss the possible future trajectories of LGBTQ+ inclusion and equity. The authors also reflect on the pendulous trajectory of LGBTQ+ rights and progress, which have oscillated between incremental advancements and reactionary periods of regression. Ultimately, through decades of grassroots organizing, advocacy, legal battles, and shifts in public opinion, the LGBTQ+ community's visibility and acceptance have grown. Concurrently, the body of LGBTQ+-specific health research has proliferated and has informed policies that have meaningfully improved the health and well-being of LGBTQ+ people. Although the country is currently in an era of substantial policy retraction, the authors remain hopeful about the next 50 years.