The State of Disabled LGBTQI+ People in 2024

Authors’ note: The disability community is rapidly evolving to using identity-first language in place of person-first language. This is because it views disability as being a core component of identity, much like race and gender. Some members of the community, such as people with intellectual and developmental disabilities, prefer person-first language. In this report, the terms are used interchangeably.

Wisconsinite Penni Klein, who identifies as a disabled lesbian, is a fourth-generation farm owner who worked in public service for 32 years—during which time she faced housing and health care discrimination due to her identities.¹ Across the United States, LGBTQI+ people with disabilities face persistent and compounding barriers in nearly every area of life, including health care, housing, education, employment, and economic opportunity. Their experiences are shaped by the intersection of ableism, homophobia, transphobia, and structural discrimination.

Klein said that she has faced discrimination all her life. While working in the national parks, for example, she was denied the ability to have her partner live with her in employer-supported housing. “Housing was available for employees, but my partner and I were excluded because of our sexual orientation and our inability to be married,” Klein shared. “This isolation in a male-dominated job left me without a clear group to belong to. I had to pay three times the cost for housing compared to my colleagues.”

Health care discrimination has also been a prevalent issue in Klein’s life. She reported having difficulty obtaining health insurance for her partner before federal employee health care protections were changed by the Obama administration.² And even with the policy changes, Klein still had to jump through hoops to get health insurance for her partner, as the law required her to list her partner and her partner’s child as dependents on her income taxes. Klein also reported that her OB-GYN discriminated against her after she disclosed that she was a lesbian who did not want children. She felt that the gynecologist delayed her surgery for three years because she was not a priority. In contrast, Klein’s sister, who is a straight mother, received treatment from her own doctor in less than six months for the same condition. Klein has also worried about how hospitals would treat her partner during an emergency: “If I’m hospitalized, who gets to make decisions for me?”

Unfortunately, Klein’s story is not unique. Disabled LGBTQI+ people across the country report similar experiences of discrimination, economic instability, and barriers to care. This report examines the experiences of disabled LGBTQI+ people across five areas:

• Discrimination in public settings
• Discrimination in education
• Employment discrimination and economic insecurity
• Housing discrimination and affordability
• Health care access and barriers to receiving care

In addition, survey data from the Center for American Progress and NORC show that anti-LGBTQI+ legislation has significantly affected LGBTQI+ people’s mental health,³ with 59 percent of disabled LGBTQI+ people stating that the recent slate of anti-LGBTQI+ bills makes them feel less safe.

In response to all these issues, this report offers a series of policy recommendations aimed at addressing disparities and advancing equity. These include increasing public benefits, improving access to health care, enhancing civil rights protections, and collecting more intersectional data to inform policymaking. Disabled LGBTQI+ people such as Penni Klein deserve to be able to live full lives in their communities with the people they love.

The third wave of the CAP LGBTQI+ Community Survey,⁴ which was conducted in partnership with NORC at the University of Chicago, examined how LGBTQI+ people experience discrimination. CAP provided NORC with a survey questionnaire, which NORC submitted to an institutional review board for approval before programming the survey. The survey was conducted from July 1, 2024, to July 25, 2024. It included a nationally representative sample of 3,360 U.S. adults ages 18 and older, 1,703 of whom identified as LGBTQI+ and 1,657 of whom did not. Individuals were contacted by U.S. mail, telephone, and field interviewers. The margin of error was +/- 3.

The survey, which included a question on disability,⁵ found that a total of 48 percent of LGBTQI+ people in the United States identify as having a disability. The most frequently reported disabilities were mental health disabilities (24 percent), emotional or behavioral disabilities (14 percent), and chronic illnesses (13 percent). The data also reveal that a significant proportion of transgender people in the United States (70 percent) identify as having a disability.

Disabled LGBTQI+ people consistently reported worse outcomes across public services, education, employment, housing, health care, and more, compared with both nondisabled LGBTQI+ people and disabled non-LGBTQI+ people. These findings point to widespread inequities and the urgent need for inclusive policy solutions.

The survey data reveal that disabled LGBTQI+ people face disproportionately high rates of discrimination across a wide range of settings. Fifty-one percent of disabled LGBTQI+ adults in the United States reported experiencing some form of discrimination in the year prior to the survey. This rate is nearly double that of nondisabled LGBTQI+ adults (23 percent) and disabled non-LGBTQI+ adults (26 percent). Disabled LGBTQI+ adults also were found to experience discrimination at more than three times the rate of adults who are neither disabled nor LGBTQI+ (14 percent).

In addition, 36 percent of disabled LGBTQI+ adults reported experiencing discrimination in public spaces such as stores, restaurants, public restrooms, and public transportation. Disabled LGBTQI+ adults also experienced discrimination in their interactions with law enforcement (12 percent) and their attempts to access government-funded goods or services such as Meals on Wheels (5 percent). In every queried environment, disabled LGBTQI+ adults were found to experience equal or higher rates of discrimination than all other groups.

Educational environments should foster opportunity and inclusion. Yet more than 1 in 5—21 percent of—disabled LGBTQI+ adults reported experiencing discrimination in school settings, more than double the rate for disabled non-LGBTQI+ adults (10 percent) and more than four times the rate for adults who are neither disabled nor LGBTQI+ (5 percent). Meanwhile, 15 percent of nondisabled LGBTQI+ adults experienced discrimination in a school setting. This discrimination can include cyberbullying and microaggressions due to intersecting identities, which can lead to higher rates of social isolation and suicidal ideation.⁶

Disabled LGBTQI+ adults were slightly more likely to not have completed high school or equivalent (6 percent) compared with their nondisabled LGBTQI+ and nondisabled non-LGBTQI+ peers (3 percent and 5 percent, respectively). Interestingly, at the same time, disabled non-LGBTQI+ adults had a higher high school or equivalent noncompletion rate (11 percent) than disabled LGBTQI+ adults. Nondisabled LGBTQI+ and nondisabled non-LGBTQI+ adults were also more likely to report having a bachelor’s degree or higher (46 percent and 44 percent, respectively) compared with disabled LGBTQI+ adults (32 percent). A contributing factor to these disparities may be a lack of financial resources. Disabled LGBTQI+ adults are nearly twice as likely to receive federal financial aid such as Pell Grants than their nondisabled LGBTQI+ peers (19 percent versus 10 percent).

Research indicates that disabled⁷ and LGBTQI+⁸ workers often have lower household incomes than their nondisabled and non-LGBTQI+ peers. In 2024, 33 percent of disabled LGBTQI+ adults reported a household income of less than $30,000 per year, compared with only 15 percent of nondisabled LGBTQI+ adults. To put these numbers into context, using the latest available federal data from 2023, 20 percent of all U.S. households had incomes below $33,000 that year, putting disabled LGBTQI+ households far outside the national norm.⁹ This could be a result of the employment discrimination disabled people face.

Disabled LGBTQI+ people reported significantly higher rates of discrimination in the workplace (30 percent) than nondisabled LGBTQI+ people (19 percent). Indeed, disabled LGBTQI+ people experience higher amounts of certain forms of discrimination or harassment at work or in employment than their nondisabled LGBTQI+ peers, including being fired or not hired; denied a promotion, a raise, equal wages, or training opportunities; excluded from work events; denied equal access to benefits; subjected to verbal, physical, and sexual harassment; and denied access to restrooms and other facilities.

Disabled LGBTQI+ adults also indicated they are more likely to receive government safety net benefits. They were nearly 2 1/2 times more likely to report receiving unemployment benefits (14 percent) than disabled non-LGBTQI+ people (6 percent), nondisabled LGBTQI+ people (6 percent), and people who do not self-identify as disabled or LGBTQI+ (3 percent). As Figure 4 shows, when compared to all other demographic groups, disabled LGBTQI+ adults were more likely to receive benefits from the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), and the Earned Income Tax Credit (EITC). However, they were slightly less likely to receive Supplemental Security Insurance (SSI) than disabled non-LGBTQI+ people, which may be due to the increased administrative burdens required to apply for these benefits.¹⁰ SSI, unlike the other benefits, requires an individual to be evaluated for disability status and requires an application process that can take years to complete. In 2022, 41.9 percent of applicants became eligible for SSI through the initial application process and more than 212,000 applications were ineligible for technical reasons outside their disability status.¹¹

Housing insecurity remains a critical issue for disabled LGBTQI+ people, who face systemic barriers to home ownership and discrimination in housing situations. While 49 percent of disabled LGBTQI+ adults reported owning or purchasing a home in 2024, this was significantly lower than the corresponding rates for disabled non-LGBTQI+ people (66 percent), nondisabled LGBTQI+ people (60 percent), nondisabled non-LGBTQI+ people (74 percent). Notably, homeownership for disabled LGBTQI+ adults is up from 2019, when CAP analysis of data from the 2019 Behavioral Risk Factor Surveillance System showed that while 74 percent of non-LGBTQI+ people without disabilities own their homes, only 41 percent of LGBTQI+ people with disabilities do—including just 30 percent of LGBTQI+ people of color with disabilities.¹²

Disabled LGBTQI+ people were also more likely to report being renters (46 percent) and more likely to report relying on housing assistance (11 percent) and/or low-income energy programs (13 percent) than were all other categories of people. Alarmingly, 14 percent reported facing discrimination in a housing situation—more than twice the rate for disabled non-LGBTQI+ people (6 percent) and nearly five times the rate for adults who are neither disabled nor LGBTQI+ (3 percent).

These data underscore how intersecting forms of discrimination and limited income compound housing instability. Inclusive housing policies and stronger antidiscrimination enforcement are critical to ensuring safe, affordable housing for disabled LGBTQI+ communities.

Health care access remains out of reach for many disabled LGBTQI+ people. They reported postponing or not getting medical care when they were sick or injured due to not being able to afford it at double the rate of disabled non-LGBTQI+ people (43 percent versus 21 percent). Meanwhile, 22 percent of nondisabled LGBTQI+ adults and 12 percent of nondisabled non-LGBTQI+ adults identified having similar issues.

Thirty-one percent of disabled LGBTQI+ adults also reported postponing or not accessing medical care when they were sick or injured due to disrespect or discrimination from doctors or health care providers. In comparison, 17 percent of disabled non-LGBTQI+ people, 8 percent of nondisabled LGBTQI+ people, and 4 percent of individuals who did not identify as disabled or LGBTQI+ reported facing similar experiences. Disabled LGBTQI+ individuals were significantly more likely (46 percent) than non-disabled LGBTQI+ people (22 percent) to report wanting to see a therapist or mental health professional but not being able to afford it.

Disabled LGBTQI+ people were also less likely (14 percent) to report having health insurance than other groups, with 9 percent of non-LGBTQI+ disabled people, 11 percent of LGBTQI+ nondisabled people, and 7 percent of non-LGBTQI+ nondisabled people reporting not having health insurance. Among those that reported having health insurance, disabled LGBTQI+ people were more likely to be covered by insurance from a current or former employer or union (27 percent), Medicaid (23 percent), insurance from a parent’s employer or union (13 percent), and insurance that they or someone else purchased through HealthCare.gov or a health insurance marketplace (11 percent) than were other groups of respondents. Disabled non-LGBTQI+ adults were the most likely to be covered by Medicare (31 percent). Meanwhile, 20 percent of people who did not identify as disabled or LGBTQI+ and 10 percent of disabled LGBTQI+ people reported being covered by Medicare.

Anti-LGBTQI+ laws, including state bans on Medicaid coverage for transgender health care,¹³ have restricted access to medical care for disabled LGBTQI+ people. Eight percent of disabled LGBTQI+ adults reported being denied gender-affirming services due to these recently passed laws. Disabled LGBTQI+ adults were more likely than nondisabled LGBTQI+ people to report being told by a doctor or other health care provider that they could not be treated due to recently passed laws restricting access to medical care (9 percent versus 2 percent).

At the same time, anti-abortion laws have made it more difficult for disabled LGBTQI+ people to receive care. LGBTQI+ disabled people (7 percent) were more likely than non-LGBTQI+ disabled adults (1 percent), nondisabled LGBTQI+ adults (2 percent), and non-LGBTQI+ nondisabled adults (less than 1 percent) to report being unable to access abortion. Of those who received abortion, reproductive care, or maternal care, disabled LGBTQI+ people were more likely to report traveling to another state (7 percent). Only 1 percent of non-LGBTQI+ disabled people, nondisabled LGBTQI+, and non-LGBTQI+ nondisabled people reported the same.

When attempting to receive health care, disabled LGBTQI+ people faced significant discrimination. They were more likely to have a doctor or other health care provider intentionally refuse to recognize family (8 percent) compared with nondisabled LGBTQI+ people (2 percent). Doctors or other health care providers were also more likely to refuse seeing disabled LGBTQI+ people than nondisabled LGBTQI+ people due to religious beliefs or because of the stated religious tenets of the hospital or health care facility (9 percent versus 2 percent). Disabled LGBTQI+ people (25 percent) were also more likely than nondisabled LGBTQI+ people (8 percent) to feel uncomfortable speaking about their sexual orientation, gender identity, or intersex variation to their therapist or mental health counselor.

Health insurance companies also seemed to discriminate more against disabled LGBTQI+ people. Twelve percent of disabled transgender adults reported being denied gender-affirming surgery. Health insurance companies were reportedly more likely to deny gender-affirming hormone therapy to disabled transgender people (15 percent) than to nondisabled transgender people (2 percent). Disabled LGBTQI+ people were also more likely to report being denied fertility preservation services (7 percent) and assisted reproduction or fertility treatment (6 percent), compared with nondisabled LGBTQI+ people (2 percent for both services).

The Trump administration has significantly curtailed protections against disability and LGBTQI+ discrimination through executive orders¹⁴ and layoffs by the Department of Government Efficiency (DOGE).¹⁵ Yet there are still numerous ways to protect the disabled and LGBTQI+ communities:

• Reestablish and protect sexual orientation and gender identity (SOGI) data. A few days after President Donald Trump signed Executive Order 14168, “Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,”¹⁶ SOGI data began to disappear from government websites.¹⁷ This data is critical for understanding and addressing health disparities and improving health care quality for the LGBTQI+ community. Legislation could require federal departments to reestablish the lost SOGI data and ensure it is included in future federal data collections.
• Strengthen and expand access to Medicaid. In 2023, at least 15 million disabled people relied on Medicaid.¹⁸ Yet it is estimated that congressional Republicans’ recently passed One Big Beautiful Bill Act (OBBBA) would cause 10.5 million people,¹⁹ many of whom have a disability, to lose their Medicaid coverage by 2034.²⁰ The bill would also result in decreased federal Medicaid dollars and, subsequently, likely decreased Medicaid spending in states, significantly curtailing services.²¹ Medicaid is one of the most cost-effective and comprehensive health care programs in the United States.²² It is essential that policymakers reject Medicaid cuts. Ten states have yet to expand their Medicaid;²³ legislators in these states should expand their Medicaid programs so more individuals are eligible for coverage. Policymakers must also increase state Medicaid reimbursement rates to help increase provider participation.²⁴
• Protect access to transgender medical care. Extensive scientific evidence shows that transgender medical care is effective in improving transgender people’s mental and physical health.²⁵ Decisions around accessing affirming care should be made between patients, including the parents or guardians of minor patients, and their team of medical providers.
• Restore the SSI program. The SSI program has changed little since its inception in 1972.²⁶ Disabled people face significant administrative burdens that can make it impossible to receive material assistance, save for a rainy day, or even get married.²⁷ Legislation such as the SSI Savings Penalty Elimination Act²⁸ and the Supplemental Security Income Restoration Act of 2024²⁹ could help modernize the program.
• Protect and enhance civil rights enforcement across federal agencies. The Trump administration has decimated civil rights offices across the country through DOGE.³⁰ It is essential that these offices are restaffed and provided the funding that Congress has allocated to them.
• Preserve departments, agencies, and offices that serve LGBTQI+ disabled people. The Trump administration has proposed or tried to enact funding and staffing cuts at major departments, agencies, and offices that provide services for disabled people.³¹ In particular, it is essential to protect and fully staff the U.S. Department of Education; Administration for Community Living (ACL); National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR); and Rehabilitation Services Administration (RSA) Client Assistance Program:
  • President Trump signed an executive order in March 2025 to shut down the Department of Education,³² which helps enforce disabled students’ rights to a free appropriate public education through the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act.³³
  • ACL, which provides grants and guidance on keeping seniors and disabled people in their communities,³⁴ lost a number of employees³⁵ and will eventually be dismantled according to a March 27, 2025, U.S. Department of Health and Human Services announcement.³⁶
  • NIDILRR, which resides within ACL, provides research grants, training, technical assistance, and other services to help disabled people become and remain independent.³⁷
  • RSA’s Client Assistance Program provides advice and assistance to disabled people through services offered under the Rehabilitation Act of 1973, such as vocational rehabilitation.³⁸ The Department of Education’s fiscal year 2026 budget request eliminates all federal funding for the RSA program, forcing states to pay for it if they want to abide by vocational rehabilitation service requirements.³⁹
• Pass a federal bill to eliminate Section 14(c). Section 14(c) of the Fair Labor Standards Act allows employers to pay disabled workers subminimum wages.⁴⁰ On December 4, 2024, the Wage and Hour Division of the U.S. Department of Labor (DOL) released a proposed rule to phase out Section 14(c).⁴¹ Due to the change in administration, however, this proposal remains stalled. It is essential that the DOL finalize the rule to help reduce the disability pay gap. Paying disabled people subminimum wages is dehumanizing and exploits the individuals who make up the disability community and the work that they do.
• Pass federal legislation to protect access to abortion and contraceptives. In Dobbs v. Jackson Women’s Health Organization, the U.S. Supreme Court overturned Roe v. Wade, eliminating the constitutional right to an abortion and leaving abortion up to the states.⁴² Since then, several states have banned or severely restricted legal access to abortion⁴³ and emergency contraceptives.⁴⁴ Federal legislation must be passed to protect individuals’ right to an abortion and contraceptives. This legislation should also protect providers’ right to provide this care without excess barriers or delays.
• Pass the Equality Act. The Equality Act would modernize federal civil rights laws to explicitly protect people from discrimination based on sexual orientation, gender identity, and sex characteristics in the areas of employment, housing, credit, and federally funded programs, such as those for health and education, as well as in public places.⁴⁵
• Expand and enforce insurance protections. As stated earlier, disabled LGBTQI+ people are less likely to have insurance. This is likely due to various barriers around how laws and regulations define relationships and families. The Affordable Care Act bans discrimination against LGBTQI+ people⁴⁶ and ensures health insurance coverage for same-sex partners and their children.⁴⁷ However, federal and state governments need to expand these protections to include domestic partnerships and enforce them to affirm all types of relationships among LGBTQI+ and disabled adults.

Disabled LGBTQI+ people are facing significant discrimination in public spaces, health care, employment and economic security, education, and housing. If the federal government fails to directly address the intersection of the disability and LGBTQI+ communities, it will fail to address some of the nation’s most vulnerable people. The list of policy recommendations in this report is not meant to be exhaustive, but it offers critical starting points to address the overlapping barriers identified by the 2024 LGBTQI+ Community Survey data.

Ensuring full inclusion for disabled LGBTQI+ people requires bold, intersectional policymaking that centers those most affected and recognizes that equity cannot be achieved through a single-issue approach.

The authors would like to thank William Roberts, Caleb Smith, Andrea Ducas, Natasha Murphy, Kierra Jones, Sara Estep, and Weadé James for their review; the Legal, Editorial, and Art teams for their guidance; and Chandler Hall for his assistance in fact-checking.