Saint Louis University Journal of Health Law & Policy

Document Type



The lesbian, gay, bisexual, transgender (inclusive of nonbinary), and queer (collectively, LGBTQ) community is experiencing health inequities at alarming rates. From behavioral health issues, to violence issues, to increased rates of homelessness, structural stigma impacts LGBTQ communities at a disproportionate rate. Suicide numbers are particularly concerning. The LGB community rate of suicide is two to three times that of the general population. For the transgender and nonbinary community, that number soars to nearly nine times that of the general population. In this article, we examine the social determinates of health impacting the LGBTQ community and the ways structural stigma supports health inequity. Given the health data, the article analyzes how policymakers could include an explicit rationale in antidiscrimination laws to shift social norms and lower stigma in pursuit of improving population health. Even when a policy is anti-discriminatory on its face, naming the intent of shifting norms and lowering stigma matter. When the explicit rationale is named, it can serve two purposes: 1) articulating a clear public health purpose of the antidiscrimination law and 2) educating the public on the need for norm change and its public health impact. Making it clear that the goal of social norm change is to protect and improve the population’s health may make the state’s compelling state interest case stronger, particularly in the face of Religious Freedom Restoration Acts, in challenges to antidiscrimination laws.