The LGBT Health & Development Program

Research Blog—Queer in the South: Risk, Resilience, and Movement for Change

Posted on December 17th, 2015 by Liz McConnell in Featured, Research Blog. No Comments

Outline of the state of South Carolina filled in with a rainbow flag.

Image credit: Fry1989, “LGBT flag map of South Carolina,” January 12, 2012.

More than one in three LGBTQ adults live in the South, more than any other region of the country [1,2]. At the same time, the South has the lowest regional climate score for acceptance of LGB people, and transgender Southerners also report a hostile climate [1,3]. LGBTQ Southerners are also more likely than LGBTQ people in other regions to be people of color, low-income, and raising children [1,4]. Although this is the reality of many LGBTQ Southerners, the LGBTQ South is just beginning to gain attention nationwide.

Health Inequities. LGBTQ Southerners face a number of health inequities, including [1,4-6]:

  • The lowest percentage of LGBTQ people with health insurance
  • The highest number of new cases of HIV among men who have sex with men (MSM)
  • The highest number of youth calls to The Trevor Project suicide prevention hotline
  • Difficulty obtaining health services due to lack of providers and discrimination, particularly for transgender people
  • High rates of family rejection and youth homelessness

Social Determinants of Health. Like most health inequities, these are driven by social determinants of health: the conditions in which people live, shaped by public policy and inequalities in resource distribution [7]. For LGBTQ Southerners, these include [1,4]:

All of these environmental factors work together to negatively impact the health of LGBTQ people living in the South. For example, LGBTQ people in all Southern states can legally be fired for their sexual orientation or gender identity, which makes them vulnerable to poverty and loss of health care. At the same time, high rates of victimization mean LGBTQ people in the South are at risk for mental health difficulties and health risk behaviors like substance use. Many LGBTQ Southerners also deal with racial discrimination.

Need for LGBTQ Funding. Despite the high number of LGBTQ people who live in the South, the region received less than 3% of US LGBTQ funding in 2012, or about $1.71 per LGBTQ adult compared to the national average of $5.78 [2,5]. This money was also spent differently. Nationally, more LGBTQ funding goes to civil rights and advocacy work. In the South, more funding goes to health issues and direct services [2]. This may be because LGBTQ organizations are trying make up for the lack of LGBTQ competent health care [4,5,6]. However, civil rights and advocacy work is also needed, since system-level social determinants of health create these inequities.

Movements for Change. Although LGBTQ people in the South face some obstacles, they also show resilience and vibrant advocacy for social change [5,8]. Organizations like Southerners on New Ground continue the South’s strong history of intersectional organizing [4,5] by prioritizing issues like immigration. For these Southerners, change is just a matter of time.

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[1] Hasenbush, A., Flores, A.R., Kastanis, A., Sears, B., & Gates, G. J. (2014). The LGBT divide: A data portrait of LGBT people in the Midwestern, Mountain, & Southern states.  Retrieved from:

[2] Kan, L. M. (2014). Out in the South, part one: Foundation funding for LGBTQ issues in the U.S. South. Retrieved from:

[3] Southerners on New Ground. (2010). “In your face and in the trenches”: Southern trans people speak out. Retrieved from:

[4] King, D. L., & Fisher-Borne, C. (2015). Out in the South, part three: Opportunities for funding LGBT communities in the U.S. South. Retrieved from:

[5] Southerners on New Ground. (2015). Out South: A convening of LGBTQ leadership. Retrieved from:

[6] The Trevor Project. (2015). Programs. Annual Report FY2013. Retrieved from:

[7] World Health Organization. (2015). Social determinants of health. Retrieved from:

[8] Griffin, C. (Ed.) (2015). Crooked letter i: Coming out in the South. Montgomery, AL: NewSouth Books.

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