A legal decision has added a major wrinkle to the movement to adopt gender-affirming care bans for transgender youths. It's unclear how it might affect North Dakota's new law, but LGBTQ advocates have taken notice.

This week, a federal judge issued a permanent injunction against a law in Arkansas - the first state to ban such care - declaring it unconstitutional. Earlier this year, North Dakota joined other conservative-led states in adopting their own bans.

Samantha Chapman, advocacy manager at the ACLU of South Dakota, said the court's decision is significant because it sets a legal precedent in challenging these laws. She noted that the judge said Arkansas' defense relied on testimony grounded in ideology, not science.

"There is, I think, more than 300 factual findings included in that ruling," she said, "and a lot of them were about the lack of credibility on the specific subject matter by the state's expert witnesses."

Opponents of gender-affirming care have contended it's too risky for minors, arguing they might regret the decision. However, advocates for trans youths have said these decisions often involve a lot of planning with parents and doctors. Meanwhile, Arkansas officials have said they plan to file an appeal.

Faye Seidler, a suicide-prevention advocate who specializes in LGBTQ populations in North Dakota, said these conversations are complex and it's hard to label all the motivations behind North Dakota's ban, but suggested it too lacked an evidence-driven approach.

"A lot of the in-favor testimony to try to ban care - it didn't seem like it really had a central place it was coming from, at least from a medical or scientific standpoint," she said. "It was just kind of folks putting their feelings out there, about feeling like this was harmful care."

Seidler said opponents of these bans often cite established medical groups, such as the American Medical Association, that lay out research on the importance of this type of care. Meanwhile, she said laws restricting care can be scary not just for trans youth, but their parents, too.

"Regardless of how affirming or accepting or anything that parent is, they're going to know that if their kid is trans, that is going to be, maybe, a pretty tough life," she said. "And there's going to be a lot of things they have to contend with, a lot of things they're going to have to deal with."

She urged families to avoid feeling hopeless and said a good first step is ensuring access to therapy.


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Rural LGBTQ+ youth in Indiana face greater mental health challenges, but have found ways to build community online, according to a new report. 48% of the state's LGBTQ-plus youth live in a small city or town, according to the 2024 Survey on the Mental Health of LGBTQ+ Young People in Indiana study. The next largest region is the suburbs.

Michael Parent, principal researcher with HopeLab, said the demographic has difficulty finding support in their communities, compared to their urban peers, but noted that there are some positive trends too.

"They had a lot of sense of internal pride in their identity," he said. "So despite being in some more challenging circumstances, they also had really positive internal feelings about themselves."

Parent added that, while young LGBTQ+ people in rural areas struggle to connect in person, they often find friends online. Those communities can be based around a shared LGBTQ+ identity but can also involve a shared passion for gaming or art. 53% of this demographic in Indiana are aged 18-to-24, while 47% are between 13 and 17.

Data from the survey found that family and community are seen as places of affirmation - an environment of validation through a sense of belonging, safety, and respect. Parent agrees community plays an important role, but pointed to a lack of in-person support for rural LGBTQ+ youth.

"Rural LGBTQ+ young people are having a lot of challenges in their circumstances and environments," he added. "But finding that they had a lot of internal sense of pride in their identity is really positive and was surprising, because we didn't really think that would show up."

Other ways to show support for the community include not supporting politicians that advocate for anti-LGBTQ+ legislation, accepting their partner, and doing research about gender identities.


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Advocacy groups are speaking out about how they believe congressional cuts to Medicaid will disproportionately affect caregiver LGBTQ+ communities in Illinois.

Jaimie Worker, senior director of policy and research for the advocacy group Caring Across Generations, said Medicaid can be a lifeline for LGBTQ+ people who are aging or living with disabilities, especially those without traditional family support. She explained for many, care is provided by "chosen family" or friends, with support from Medicaid largely making that possible.

"LGBTQ+ communities are impacted in a unique way when it comes to self-directed care: being able to choose who your care provider is as an older adult or person with a disability," Worker pointed out. "Many of these programs are heavily supported by Medicaid."

She noted as people already face barriers to receiving the care they need, Medicaid cuts would unnecessarily force some into institutional settings like nursing homes, where they would never have chosen to receive care.

An estimated 700,000 people nationwide are on waiting lists to receive home- and community-based care through Medicaid. Last year, more than 15,000 were in Illinois. No matter how dire their need, Worker stressed people can wait years to access these services and LGBTQ+ individuals face additional barriers.

"Those are the folks who already know about the services; not everyone is aware about the services that are available. LGBTQ folks are also more likely to experience discrimination while trying to access care needs."

Currently, people who make less than $22,000 a year in Illinois could qualify for Medicaid. Worker predicts new federal qualifications will make it more difficult for people to qualify, even with extremely limited resources.

"And make it harder for people to live and age with dignity, and largely in their own homes and communities where most people would prefer to live and age," Worker underscored.

She reported starting July 24, Caring Across Generations will host a 60-hour vigil for Medicaid in Washington, D.C., to amplify the stories of caregivers, people with disabilities, older adults and families from across the country.

This week, the law guaranteeing same-sex marriage equality turned 10. But advocates are concerned about the growing number of threats it now faces.

A decade after the Supreme Court's historic Obergefell v. Hodges decision, most Americans are onboard with gay marriage. While President Donald Trump has never stated outright opposition, members of his conservative base do. And with a conservative Supreme Court majority, Justices Samuel Alito and Clarence Thomas have also signaled they'd like to revisit the issue.

Despite pressure from the far right, said Jenny Pizer, chief legal officer at Lambda Legal, ending same-sex marriage isn't something that has public support.

"I think what is key for people to have in mind is, there's no case in front of the Supreme Court pending for a court review at this moment," she said, "and the Supreme Court can't review a case and consider a case without there being a case -- and there is none at this point."

She reminded folks that Congress passed the Respect for Marriage Act in 2022, which codified marriage protections for same-sex and interracial couples. It also repealed the Defense of Marriage Act, a 1996 law that exclusively recognized marriage between one man and one woman.

In 2020, Nevada became the first state to enshrine gay couples' right to marry in its state Constitution.

Even if the law were overturned and certain states were what she called "hostile" to same-sex couples who want to marry, Pizer said, states would have to continue to respect and honor same-sex marriages. She added that folks should not be panicking, but should be paying attention.

"The bottom line is that we have to keep our eye on this," she said. "We know that there are those on the far right who want to raise money on this issue, want to gin up fears on this issue, use it for organizing."

Since the Supreme Court's decision in June 2015, almost 600,000 same-sex couples have married legally. In the United States alone, there are about 823,000 married gay couples, according to the Williams Institute at the UCLA School of Law.