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When Policy Gets Under the Skin (In a Good Way): The Case of LGBT Health


By Caroline Fitz, MPhil (Graduate Student Intern, APA Public Interest Government Relations Office)

In what percentage of states do you think it’s legal to discriminate against lesbian, gay, bisexual, and transgender (LGBT) individuals in the workforce: 20%, 40%, 60%?

If you guessed 60%, you’re right. In 29 and 33 states, respectively, employers can fire you for who you love or your gender identity. And indeed, many LGBT individuals experience adverse job outcomes as a result of this. Research showing that discrimination hurts – mentally, socially, and physically – makes this even more alarming. From overhearing homophobic slurs to social exclusion (or, worse still, experiencing physical violence), these events cause distress and undermine mental health, far too often culminating in suicide or attempted suicide.

Your gut response to this might be: End discrimination; put policies into place to stop discrimination in its tracks! If this sounds about right to you, you’re not alone. Most Americans (70% of voters nationwide, including 56% of Republicans) support the Employment Non-Discrimination Act (ENDA), which seeks to halt LGBT workplace discrimination. If passed, ENDA would have a profound impact on the protection of LGBT individuals in employment settings. Nondiscrimination legislation is powerful in its ability to change hearts and minds, which in turn, trickles down to affect the way people interact with LGBT individuals.

Additionally, recent psychological research out of Columbia University suggests that– independent of changing attitudes and norms – nondiscrimination policy directly affects LGBT people’s lives. It turns out, it just “feels good” to live in an environment where your rights are protected. This research compared rates of LGB mental illness and mortality between states where LGB-protective laws do vs. do not exist. They also compared these and other health-related outcomes before and after the implementation of protective or restrictive state legislation. Throughout their analyses, these researchers controlled for a constellation of factors known to impact health outcomes, including interpersonal experiences of discrimination. That way, they could be confident that any differences in health outcomes were the result of LGB-protective laws and nothing else.

Results across studies consistently showed that LGB individuals fare much better under protective policies. LGB people living in places that protect their rights not only report lower rates of mental illness, but also are projected to live an astounding 12 years longer than their counterparts living in places that lack such protections (or restrict their rights). Critically, these researchers controlled for interpersonal instances of unfair treatment, which suggests that policy affects health in its own right.

Laws matter. Protective policies make life better for LGBT individuals, even if there aren’t instantaneous changes in popular opinion about the LGBT community. By no means do these findings imply that the biases people harbor towards LGBT individuals aren’t important (and don’t need to change), or that policy doesn’t impact these attitudes. Instead, they simply suggest that laws affect LGBT health in more ways than one. In addition to indirectly affecting LGBT well-being by changing social norms and reducing prejudicial behavior, policy directly gets under the skin to affect – improve – this population’s health.

What you can do

This LGBT Health Awareness Week, support protective LGBT policies, including ENDA! Make a difference in the public discourse; promote positive attitude change toward LGBTs; and work to achieve protections that have an immediate, positive impact on LGBT people nationwide!

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