The rate of individuals receiving gender-affirming care - care received by a person whose assigned sex at birth doesn't match their gender identity - has risen more than 300% from 2016 to 2021, according to new analysis by the Center for Improving Value in Health Care.

Dr. Liz Kvach - medical director of LGBTQ+ Health Services with Denver Health - said steps that anyone can take to support a person's gender identity, including using their preferred pronouns "she," "him" or "they," can make a big difference, especially for young people.

"There's a lot of data that actually helps improve resiliency and improve mental-health outcomes," said Kvach, "including reduction of depression and anxiety and suicidality, if youth are supported. Especially by parents and schools and other social support networks that they have around them."

A 2011 study found that 41% of transgender adults had attempted suicide, but Kvach said when people have access to gender-affirming care, suicide attempts drop significantly.

Last year Colorado became the first state to require comprehensive gender-affirming care as part of minimum, or "benchmark," health-care plans sold on the individual and small-group markets, which accounts for about a quarter of the state's insured population.

Commercial plans are not required to comply until 2023.

The number of gender-affirming care services for teens and young adults covered by Medicaid has increased nearly 11 fold since 2016, but it's estimated that just 20% of transgender, gender diverse and non-binary youths access care through health insurance.

Kvach said the lack of gender-affirming training at medical schools for health-care providers, and training for support staff, continues to be a major barrier to accessing care.

"Up to a quarter or more people have experienced discrimination or negative treatment in a health-care setting," said Kvach. "And that number is probably actually much higher, and will often cause people to not want to seek out care."

Having a positive experience also makes it more likely people will come back for their preventive health-care needs.

Kvach has treated hundreds of people at Denver Health's LGBTQ+ Health Services. She said it's hard to count the number of patients who have told her that gender-affirming care has been life-saving for them.

A new study suggests laws in New Mexico and 22 other states to protect school-aged LGBTQ youth are having a positive impact.

According to research by the Trevor Project, suicide attempts in states with specific protections for LGBTQ youth were 18% lower, and physical violence reported by those youth was 3% lower.

Katalina Hadfield, a member of Equality New Mexico's board of directors, said she believes the state's progressive protections are due to a community-centered culture.

"Where folks are really willing to help each other out, and look out for one another," said Hadfield. "And I think that is part of what helps students in a lot New Mexico schools feel more included."

In recent decades, New Mexico has seen prominent advances in gay and lesbian rights, where same-sex sexual activity has been legal since 1975.

Last year, a bill passed in the New Mexico Legislature to remove loopholes - and explicitly include local entities and counties to prevent discrimination and human rights violations.

The Human Rights Campaign says in 2023, more than 550 - a record number - of anti-LGBTQ bills were introduced across 43 states, and more than 80 were passed into law.

Both Florida and Texas are among the top ten for introducing and passing hostile laws.

Hadfield, who grew up in New Mexico, knows several people who have left those states because they feel unwelcome and scared.

"And when you travel there," said Hadfield, "even if you run into some nice people - if you get for some reason wrapped up in the criminal justice system there, or even something as simple as a speeding ticket, you get sucked into this government system that has legislated and made a policy choice to not respect trans people."

Results from the Trevor Project were published in the online journal LGBT Health. The findings are based on responses from more than 27,000 students ages 13 to 24, in 44 states.

After 30 years of championing the rights of LGBTQ+ people, Equality New Mexico has its finger on the pulse of supportive legislation and has made its earliest endorsements ever for the 2024 election.

Marshall Martinez, executive director of the group, said the advocacy organization has come out early for candidates he calls equality "rock stars," those who have demonstrated proactive leadership in the fight for LGBTQ+ issues. He believes New Mexico and a handful of other states serve as models in supportive legislation.

"Queer and trans people deserve to be happy and healthy in the community they live in," Martinez pointed out. "But until we can make that happen at the national level, we want to make sure that those in New Mexico can have that life, and that others folks could consider coming to New Mexico for that life."

Last year the New Mexico Legislature passed the Reproductive and Gender Affirming Health Care bill, protecting individuals who seek such care from discrimination by public bodies.

In addition to LGBTQ+ issues, Martinez said Equality New Mexico also makes endorsements based on legislators' positions on economic policies such as paid family and medical leave. Another issue is abortion access, which he noted has become especially important since the U.S. Supreme Court overturned abortion as a constitutional right in the 2022 Dobbs v. Jackson Women's Health Organization decision.

"First and foremost, we can't rely on the federal government to uphold our protections," Martinez contended. "We will continuously point to the Dobbs decision as an indication that the federal judiciary is no longer the backstop that we used to think it was."

Martinez added the LGBTQ+ rights organization has endorsed 15 candidates for New Mexico's House and Senate seats and expects a second round of endorsements before November.

By Sara Youngblood Gregory for Yes! Magazine.
Broadcast version by Kathryn Carley for Commonwealth News Service reporting for the YES! Media-Public News Service Collaboration

In December 2023, Pope Francis announced that Catholic priests may bless same-sex unions-as long as they do not resemble marriage.

Despite headlines heralding a radical shift, the declaration notes Church doctrine "remains firm" on its definition of holy matrimony as the exclusive province of heterosexuals. One month prior, the Vatican also announced that transgender people can be baptized.

Though inclusive steps forward at first glance, both announcements sidestepped any tangible commitment to LGBTQ people. The documents were stereotypically vague: Both blessings and baptisms are permitted only if they carry no risk of public "scandal" or "disorientation" among the faithful, terms that are not defined in the documents.

In short, the Vatican's "progressive" moves perpetuate a long-standing trend within Christianity, where LGBTQ Christians are expected to be grateful for the table scraps of a well-fed faith-or at least feel sated with the rancid "hate the sin, love the sinner" ethos popular across Christian denominations.

"It's no question that religion globally has been used as a weapon, especially against LGBTQIA persons," says teaching pastor and theologian Roberto Che Espinoza, Ph.D. "But religion actually is rooted in the practice of re-connection or binding together. The Latin root for the English word religion is religio," a noun referring to an obligation, bond, or reverence.

And there is no shortage of LGBTQ people of faith. A 2020 study by the Williams Institute at the University of California, Los Angeles, found that nearly half the country's LGBTQ population-5.3 million people-self-identified as a person of faith.

So can queer people still hungry for spiritual connection-especially those who revere Christian traditions-find religious communities that recognize queerness as a blessing, rather than a sin? An emerging group of queer and trans faith leaders, activists, on-the-ground organizers, and people who simply refuse to give up their faith are already answering that call, carving out affirming faith traditions, building tools to remediate religious harm, and proving that it's possible to build a queer church.

Sanctified Discrimination

For many LGBTQ people, disconnection is a defining element of their faith, with a third of religious LGBTQ adults reporting conflicts between their faith and identity in a 2013 Pew Research Center study. Many experience rejection for the first time via their faith communities, or at least learn that their identities are inherently dirty or impure. As of 2018, an estimated 700,000 people have undergone conversion therapy in the United States, a practice involving forcibly "changing" someone's gender or sexual identity. Though widely discredited-and illegal to subject minors to in 22 states-conversion therapy is still used in some religious settings. According to research from the Williams Institute, 81% of people who underwent conversion therapy did so at the hands of a religious leader.

Even for those who escaped the direct impacts of religious trauma, current U.S. politics are deeply intertwined with weaponized Christianity, making it nearly impossible to emerge unharmed as an LGBTQ person-personally, politically, or spiritually. The Republican party, which has long-standing ties to the Religious Right, is increasingly overt in its embrace of Christian nationalism-the belief that the U.S. should be a strictly Christian country. According to a 2023 survey by the Public Religion Research Institute and the Brookings Institution, more than half of self-identified Republicans currently sympathize with or explicitly adhere to Christian nationalism.

Christian nationalism goes beyond the desire to create a Christian theocracy. It's about creating a country where certain people are privileged and others-LGBTQ people, people of color, and those seeking reproductive freedom-are punished. "When we say Christian nationalism, it's white Christian nationalism," says Maureen O'Leary, director of field and organizing at Interfaith Alliance, a religious freedom and civil rights advocacy network. "It's white Protestant Christians that are being elevated."

That exclusionary ethos can be found throughout the modern Republican party, which is, not coincidentally, the beating heart behind much of the anti-LGBTQ legislation currently circulating. In 2023, more than 525 anti-LGBTQ bills were introduced nationwide, more than any other year on record, according to the Human Rights Campaign. Those bills included the implementation of Florida's high-profile "Don't Say Gay" policy, which restricts classroom discussions about sexuality and gender identity in public schools. Dozens of copycat bills have emerged since the Florida Board of Education approved the initial policy in 2022.

Florida, North Dakota, Missouri, Tennessee, and North Carolina all have restrictions on gender-affirming health care for minors, and at least five states are currently targeting gender-affirming health care for both minors and adults. Meanwhile, the Alliance Defending Freedom (ADF), a shadowy, right-wing legal organization, is using its deep pockets, allegiance to Christian nationalism, and wide reach to roll back civil rights in the courts. ADF is the legal powerhouse behind lightning-rod Supreme Court cases such as 303 Creative, Inc v. Elenis, where a self-proclaimed Christian website designer won the right to refuse to serve same-sex couples, in defiance of Colorado's nondiscrimination law, as well as the overturning of Roe v. Wade. Taken together, these attacks target the rights and dignities of queer, and especially trans, people on all fronts: restricting access to health care, public spaces like bathrooms, and education.

This discrimination is often legitimized through the guise of Christian morality and language. In practice, this frequently looks like portraying LGBTQ people, and progressive values more generally, as a threat to a Christian way of life. At the 2022 Conservative Political Action Conference, former president Donald Trump told the audience: "School prayer is banned, but drag shows are allowed to permeate the whole place. You can't teach the Bible, but you can teach children that America is evil and that men are able to get pregnant."

Meanwhile, Florida governor and 2024 presidential hopeful Ron DeSantis used the words of Jesus Christ to woo potential voters and call for a "war on woke"-or more accurately, a war on LGBTQ rights, diversity and equity initiatives, reproductive and voting rights, critical race theory, and education. While speaking to a group of roughly 10,000 evangelical college students in April 2023, DeSantis said, "Yes, the truth will set you free. Because woke represents a war on truth, we must wage a war on woke."

As these right-wing politicians demonstrate, "Christian nationalism is a political ideology," says Interfaith Alliance's O'Leary. "It's not a religious tradition." But the conflation of the two mean that many queer and trans folks feel exiled from their faith. A truly affirming church must do more than skirt extremism or offer conditional shelter for LGBTQ people. It must imagine a God, a faith, and a tradition that engages directly with justice and queerness.

Sacred and Strange

Rev. Naomi Washington-Leapheart, a Christian minister, movement organizer, and professor of theology and religious studies at Villanova University and Harvard Divinity School, reasons that a God who disregards the most vulnerable in service of the most powerful is not a God who will inspire a congregation to change a world that already reproduces cycles of dominance and dispossession. "An affirming, radically hospitable, justice-oriented congregation has to reject an idea of God that reinforces the very thing that causes exclusion and non-affirmation and injustice in our world," Rev. Naomi says. "The conceptualization of God in an affirming, justice-seeking space has to be, first of all, radically inclusive."

The Rev. M Jade Kaiser envisions God, and spiritual life more broadly, as something literally of the flesh: bodily, pleasure oriented, and inseparable from material liberation. In 2017, Rev. Kaiser and Rev. Anna Blaedel co-founded enfleshed, a spiritual community that publishes resources for collective liberation, including queer liturgies, a podcast on trans spirituality, and poems and anthologies exploring ritual, blessings, and identity.

"Our greatest gifts to the world will not come through acceptance from dominant systems or those constructions of 'God,' but in recognizing how sacred it is to be strange," says Rev. Kaiser. "There is so much God in how we create chosen family, love queerly, resist compulsory gendering, and collectively organize with pride that counters shame."

Sacred texts and traditions, too, are ripe for reconceptualization. Theologian Espinoza, for instance, believes creating radically inclusive faith practices requires more than just reconciling a faith tradition with sexuality. It also invites us to identify where these traditions are already queer via destabilized, counter-hegemonic, and counter-normative narratives. "Queerness is wild and feral," says Espinoza. "[It] is an undomesticable animal that we have not yet been able to contain or domesticate out of the tradition."

Traditions like communion, for example, have the potential for queerness, Espinoza explains. Christians all over the world consume the actual or symbolic body and blood of Christ, and in so doing, engage with the (trans)formative potential of the body. Recently, one of Espinoza's students risked their clergy credentials by serving communion in drag. "The student embodied God by feeding people bread and wine in drag," Espinoza recounts. "[It was] a wonderful reminder that we are bound by our materiality, but when we imagine another possible world, shit gets real!"

For others, revisiting religious texts also means questioning-and reimagining-what is considered sacred. For Della V. Mosley, a healing arts practitioner and counseling psychologist raised in a Black Baptist church in Illinois, exploring their connection to faith meant finding truth in alternative systems and spiritual homes. "For me, that path led to Black feminism, justice and liberation spaces, and a deep connection with nature," says Mosley. "These spiritual homes resonate more closely with who I am, the realities of the world today, and who I aspire to be." Recently, Mosley used Black feminist writings as sacred texts during a Sunday service at NorthStar Church of the Arts in Durham, North Carolina.

Some spaces imagine spirituality outside of specific religious affiliation or institutions altogether. At The Greenhouse, a grief and healing sanctuary for Black, Indigenous, and other students of color at Harvard, the point isn't to emulate or become a religious institution. Instead, co-founder Frances S. Lee, a pastor's kid who is now an ex-evangelical, says The Greenhouse fosters spiritual leadership and moral boldness for those who are barred from, or simply uninterested in, traditional religious authority.

"The Greenhouse invites us to access emotional safety, wonder, and belonging outside of religious institutions," says Lee. "At the foundational level, it is a refuge of tenderness, laughter, and meaningful silence." The community meets twice monthly and offers dinner, ritualized reflection, grounding exercises, and emotional release. Like Mosley and Espinoza, Lee makes spaces for queer and trans interpretations of Christianity, while also incorporating new sacred texts and traditions. They've taught trans spirituality and shape-shifting bodily presentations in their Christian classes and preached with Audre Lorde's 1978 essay "Uses of the Erotic: The Erotic as Power."

Taken together, these three tools-the reconceptualization of God, the queering of sacred texts and traditions, and the incorporation of alternate practices-form a sort of holy trinity on which a queer church may thrive. And much like queerness, this church, this connection with the divine, can happen anywhere: on a subway ride, in the pews, in passionate debate with your pastor. It may happen with music, in the silence of nature, in scripture, in a glance. It can happen while reading radical trans scholarship or Black feminist poetry. Queer church might look like a dance floor, a kiss, good sex. It may be reclaiming a saint or simply imagining Jesus at a gay bar.

New Sacred Spaces

Spiritual organizer Bex Mui's queer church began on Instagram. Raised Roman Catholic by her Polish mother and introduced to Buddhist principles by her Chinese father, Mui left the church at 20, in large part due to her burgeoning queerness and growing critical eye toward religion. To manage her grief, Mui threw herself into LGBTQ activism.

"As a professional speaker and trainer, I delivered 'the Word' of gender terminology and the rituals of creating safe spaces," says Mui, who works as an LGBTQ equity consultant. But by 2020, Mui was burnt out. She knew she needed to reconnect with not only her spirituality but with other queer people as well.

Beginning in January 2021, Mui got on Instagram Live every Monday to share prayers, spells, and astrology readings and use tarot as a tool for reflection, a ritual she called Queer Church. While discussing the power of a lunar eclipse in October 2023, Mui recontextualized interactions between Mary Magdalene and the newly risen Christ. "He's often interpreted as saying, 'Don't touch me,' a slut-shamey interpretation perpetuating the stereotype that [Magdalene] was dirty and unworthy of his love and attention," says Mui. "In reality and the truer Greek translation, he says, 'Don't cling to me.'" From Mui's perspective, in that moment, both the gospel and the eclipse were inviting people to let go of what is ready to leave.

Eventually, Queer Church expanded to become House of Our Queer, a sex-positive and people-of-color-centered community for spiritual exploration and well-being. House of Our Queer offers spaces and tools for spirituality, including workshops, rituals, and in-person community gatherings. And the community has responded. Mui says around 200 people tune in to Queer Church every week, and as many as 500 people attend the monthly Queer Magic Dance Party in Oakland, California.

The focus of both Queer Church and House of Our Queer is to support people who were raised religious, or feel curious about spirituality, and affirm that queerness isn't just part of religion but a blessing all its own. Rather than a set religious doctrine or denomination, Mui uses reclamation techniques-like adapting a Catholic prayer into a queer activist spell or honoring saints like Mary Magdalene-to affirm queerness and incorporate her religious upbringing.

"Whether I like it or not, I was raised Catholic, and that's a part of my culture. Reclaiming [my spirituality] started for me when I realized that I was actually putting a lot of effort into keeping that door shut," says Mui. "Queer Church is needed because queer people are human, and we need, just like everyone else, a place to gather for celebrations, shared ways to mark the passing of time, and places to turn to when we're in pain."


Sara Youngblood Gregory wrote this article for Yes! Magazine.


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