In 2016, the UCLA School of Law’s Williams Institute estimated that 27% of LGBTQ+ adults had experienced food insecurity in the past year, compared to 17% of non-LGBTQ+ adults.[1] The Williams Institute also reported that the likelihood of experiencing food insecurity was even higher for LGBTQ+ people of color and for LGBTQ+ individuals who were unmarried or raising children.[2] In 2014, Legal Services NYC reported that 62% of LGBT New Yorkers surveyed had experienced difficulty paying for a basic need in the past year.[3] Though estimates vary and data are relatively limited, there is significant evidence that members of the LGBTQ+ community are disproportionately living in poverty.[4] This pervasive inequality stems from many interconnected factors and contributes to adverse economic and health outcomes for LGBTQ+ individuals and their families.

In 2020, more than one in three LGBTQ+ people, and more than three in five transgender people, surveyed reported that they had faced discrimination in the past year.[5] Systemic discrimination against LGBTQ+ people impacts opportunities for economic advancement and perpetuates a cycle of poverty in the LGBTQ+ community. This cycle begins in childhood, with many LGBTQ+ students reporting that discrimination negatively affects their school environment.[6] In a Center for American Progress survey conducted in 2020, eighty percent of Generation Z LGBTQ+ respondents reported that discrimination had negatively affected their school environment in the last year.[7] After school, many LGBTQ+ people experience workplace discrimination and may face barriers to career advancement.[8] In addition to discrimination impacting the income of LGBTQ+ people, discrimination impacts the ability of LGBTQ+ people to secure housing or home loans.[9] For example, a 2019 study found that same-sex couple applicants were 73% more likely to be denied a mortgage than similarly situated opposite-sex couples and that same-sex couples who were approved for a mortgage were charged higher average interest rates compared with opposite-sex couples.[10] The cumulative effect of these layers of discrimination is that LGBTQ+ people are more likely to experience economic insecurity than their non-LGBTQ+ peers.[11]

Living in poverty or financial instability has many deleterious effects on the health and wellbeing of LGBTQ+ individuals and their families. Adults living in poverty are more likely than higher-income adults to develop non-communicable diseases or physical disabilities.[12] Children who grow up in households experiencing poverty or income volatility are more likely than their peers to experience developmental issues, low educational attainment, and negative health outcomes.[13] Negative health outcomes can also hinder an individual’s ability to achieve higher educational or career attainment and may lead to medical debt, thus trapping low-income individuals in a “health-poverty trap.”[14] In order to mitigate the health effects of poverty, many LGBTQ+ individuals and families rely on access to public benefits.

The term “public benefits,” or “public assistance,” refers to a category of services provided by federal or state governments to its citizens.[15] Public benefits may come in the form of social welfare programs, which are intended for people below a certain income level, or social insurance programs, which are available for certain classes of people based on criteria like age or employment status.[16] Examples of public benefit programs include the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), unemployment insurance and workers’ compensation, public housing assistance, and Medicaid.[17] SNAP benefits allow recipients to combat food insecurity, a key social determinant of health,[18] though the amount available per person is often too low to provide adequate nutrition.[19] TANF benefit programs are funded by block grants to states and are intended to help recipients pay for necessities during times of financial strain,[20] but program eligibility varies considerably by state and TANF benefits are only meeting a small portion of the need in each state.[21] Medicaid provides health insurance for low-income people,[22] though several states have not expanded the program to include non-disabled, low-income adults without children.[23]

As a function of the high prevalence of poverty in the LGBTQ+ community, utilization of public benefits by LGBTQ+ individuals is higher than that of non-LGBTQ people.[24] In 2018, the Center for American Progress reported that, compared to non-LGBTQ+ individuals, LGBTQ+ individuals were 134% more likely to receive SNAP, 152% more likely to receive public housing assistance, and 62% more likely to receive Medicaid.[25] These disparities are even more pronounced for transgender individuals, LGBTQ+ individuals with a disability, and LGBTQ+ people of color.[26] An individual living in poverty who faces barriers to accessing to public assistance may remain trapped in a cycle of poverty and may suffer from short- and long-term health effects. Because systemic discrimination makes LGBTQ+ individuals more likely to experience poverty and more likely to encounter certain barriers to accessing public benefits, this compounding inequity disproportionately impacts the health of the LGBTQ+ community.

In 2020, the Center for American Progress published the results of a survey in which 66% of transgender LGBTQ respondents and 23% of cisgender LGBTQ respondents reported some degree of difficulty obtaining accurate identification documents due to discrimination.[27] Identifying documents must be presented while applying for public benefits,[28] and  transgender or gender nonconforming people who cannot obtain accurate documents report feeling distressed by being forced to present inaccurate documents.[29] Additionally, the 2015 Transgender Equality Report captured that “[a]s a result of showing an ID with a name or gender that did not match their gender presentation [in public], 25% of [respondents] were verbally harassed, 16% were denied services or benefits, 9% were asked to leave a location or establishment, and 2% were assaulted or attacked.”[30] In addition to facing barrier s to achieving the basic requirements to receive public benefits, LGBTQ+ individuals face less obvious barriers. In 2020, the Center for American Progress reported that 19% of LGBTQ+ individuals surveyed had avoided getting necessary services for themselves or their families to avoid experiencing discrimination.[31] Of the LGBTQ+ individuals receiving public benefits who were surveyed by Legal Services NYC in 2014, 46% reported problems applying for benefits, 40% believed they were not receiving the correct amount of assistance, 22% had their public assistance case sanctioned or closed, and 15% specifically reported being mistreated by staff at the New York City Human Resources Administration (HRA), the organization tasked with administrating public benefit programs in the city, because of their gender or sexuality.[32] Respondents reported being referred to by the incorrect name or pronouns, treated rudely because their gender presentation did not match the staff member’s expectations, and threatened with expulsion from the premises for speaking out about mistreatment.[33] Respondents reported that even staff at the HIV/AIDS Services Administration, a specialized section of the HRA meant to serve the LGBTQ+ community, mistreated LGBTQ+ clients.[34]

In order to address the multi-layered problems faced by LGBTQ+ individuals, with anti-LGBTQ+ discrimination creating disproportionate poverty as well as barriers to accessing support for people living in poverty, advocates must utilize multiple strategies to sustain the movement toward equality even in the face of considerable political opposition. In an upcoming piece, I will discuss these strategy options, including improving federal and state policy, leveraging the expertise of grassroots and community organizations, and focusing on better data collection.

 

[1] Taylor N.T. Brown et al, Food Insecurity and SNAP Participation in the LGBT Community, UCLA Sch. of L. Williams Inst. (July 2016), https://williamsinstitute.law.ucla.edu/publications/lgbt-food-insecurity-snap/.

[2] Id.

[3] Poverty is an LGBT Issue: An Assessment of the Legal Needs of Low-Income LGBT People, Legal Servs. NYC, https://www.legalservicesnyc.org/storage/PDFs/lgbt%20report.pdf [hereinafter Legal Services NYC].

[4] See, e.g., LGBTQ Poverty Collaborative Project, Intersecting Injustice: A National Call to Action – Addressing LGBTQ Poverty and Economic Justice for All (New York: Social Justice Sexuality Project, Graduate Center, City University of New York, 2018), https://static1.squarespace.com/static/5a00c5f2a803bbe2eb0ff14e/t/5aca6f45758d46742a5b8f78/1523216213447/FINAL+PovertyReport_HighRes.pdf.

[5] Sharita Gruberg, The State of the LGBTQ Community in 2020, Ctr. for Am. Progress (Oct. 6, 2020), https://www.americanprogress.org/article/state-lgbtq-community-2020/.

[6] Lindsay Mahowald et al., Discrimination and Experiences among LGBTQ People in the U.S.: 2020 Survey Results, Ctr. for Am. Progress (Apr. 21, 2021), https://www.americanprogress.org/article/discrimination-experiences-among-lgbtq-people-us-2020-survey-results/.

[7] Id.

[8] Dhruv Khullar & Dave A. Chokshi, Health, Income, & Poverty: Where We Are & What Could Help, Health Affs., Oct. 4, 2018, https://www.healthaffairs.org/do/10.1377/hpb20180817.901935/full/.

[9] See Housing Discrimination and Persons Identifying as Lesbian, Gay, Bisexual, Transgender, and/or Queer/Questioning (LGBTQ), U.S. Dep’t of Housing & Urb. Dev., https://www.hud.gov/program_offices/fair_housing_equal_opp/housing_discrimination_and_persons_identifying_lgbtq#:~:text=It%20is%20prohibited%20under%20the,that%20constitutes%20sex%20based%20discrimination (Feb. 1, 2022); see also Anneliese Lederer & Jake Lilien, Lending Discrimination Faced By Same-Sex Couples in the Mortgage Arena, Nat’l Cmty. Reinvestment Coal., Aug. 19, 2020, https://ncrc.org/lending-discrimination-faced-by-same-sex-couples-in-the-mortgage-arena/.

[10] Hua Sun & Lei Gao, Lending practices to same-sex borrowers, Proc. Nat’l Acad. Scis., Apr. 16, 2019, https://www.pnas.org/doi/epdf/10.1073/pnas.1903592116.

[11] M.V. Lee Badgett et al., LGBT Poverty in the United States, UCLA Sch. of L. Williams Inst. (Oct. 2019), https://williamsinstitute.law.ucla.edu/publications/lgbt-poverty-us/.

[12] Khullar & Chokshi, supra note 8.

[13] See Khullar & Chokshi, supra note 8; Elaine Magg, The 2021 Child Tax Credit: Implications for Health, Health Affs., Feb. 10, 2022, https://www.healthaffairs.org/do/10.1377/hpb20220119.943898/; Pamela A. Morris et al., Univ. of Wis.-Madison Inst. for Rsch. on Poverty, Income Volatility in U.S. Households with Children: Another Growing Disparity between the Rich and the Poor?, at 4–5 (July 2015), https://www.irp.wisc.edu/wp/wp-content/uploads/2018/05/dp142915.pdf.

[14] See Jacob Bor & Sandro Galea, Opinion: The cost of economic inequality to the nation’s physical health, The Bos. Globe, Apr. 25, 2017, https://www.bostonglobe.com/opinion/2017/04/25/the-cost-economic-inequality-nation-physical-health/JTsEP3XkNx3425ypbw4KRI/story.html.

[15] About Public Assistance, U.S. Census Bureau, https://www.census.gov/topics/income-poverty/public-assistance/about.html (last visited May 6, 2022).

[16] Id.

[17] Id.; see also Public Charge Rule Update, Keep Your Benefits, https://keepyourbenefits.org/en/na/ (Feb. 24, 2022).

[18] Margaux Johnson-Green & Clara Claflin, Gender and Racial Justice in SNAP, Nat’l Women’s L. Ctr. 2 (July 2021) https://nwlc.org/wp-content/uploads/2020/10/SNAPbrief.pdf.

[19] Id. at 4.

[20] Policy Basics: Temporary Assistance for Needy Families, Ctr. on Budget Pol’y Priorities, https://www.cbpp.org/research/family-income-support/temporary-assistance-for-needy-families (Mar. 1, 2022).

[21] Id.

[22] Kellan Baker et al., The Medicaid Program and LGBT Communities: Overview and Policy Recommendations, Ctr. for Am. Progress, Aug. 9, 2016, https://www.americanprogress.org/article/the-medicaid-program-and-lgbt-communities-overview-and-policy-recommendations/.

[23] Id.

[24] Caitlin Rooney et al., Protecting Basic Living Standards for LGBTQ People, Ctr. for Am. Progress (Aug. 13, 2018), https://www.americanprogress.org/article/protecting-basic-living-standards-lgbtq-people/.

[25] Id.

[26] Id.

[27] Mahowald, supra note 6.

[28] See, e.g., Benefits – Verification Requirements, Va. Dep’t of Soc. Servs., https://www.dss.virginia.gov/benefit/verification.cgi (last visited May 15, 2022).

[29] See Jody L. Herman & Kathryn O’Neill, Gender Marker Changes on State ID Documents: State Level Policy Impacts 2 (UCLA Sch. of Law, Williams Inst., June 2021), https://williamsinstitute.law.ucla.edu/wp-content/uploads/Gender-Markers-Jun-2021.pdf.

[30] The Report of the 2015 U.S. Transgender Survey, Nat’l Ctr. for Transgender Equal. 82 (Dec. 2016), https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf.

[31] Mahowald, supra note 6.

[32] Legal Services NYC, supra note 3, at 23.

[33] Legal Services NYC, supra note 3, at 23.

[34] Legal Services NYC, supra note 3, at 23.