An increasing number of U.S. states have passed laws that allow health care providers – including doctors, nurses and pharmacists – to refuse to treat patients based on their personal or religious beliefs. While these have long existed for , their effects on LGBTQ+ people have not been well studied.
As of April 2026, have enacted conscientious objection laws specifically targeting LGBTQ+ people. As who study the on the , we wanted to examine how these laws have affected the roughly living in a state where a provider can legally refuse them care.
Specifically looking at sexual minorities, our research found that lesbian, gay, bisexual and queer adults living in states that passed conscientious objection laws were , compared to peers in states without conscientious objection laws. These laws did not affect HIV testing rates for heterosexual adults.
Similarly, LGBQ+ adults in affected states were after the laws passed, compared to those in states without the laws.
Measuring the harm
We analyzed data from the on the health outcomes of more than 109,000 lesbian, gay, bisexual, queer and heterosexual adults from 2016 to 2018. We focused on eight states, comparing two that enacted conscientious objection laws during that period (Illinois and Mississippi) and six that did not (Louisiana, Minnesota, Ohio, Texas, Wisconsin and Virginia).
To isolate the effect of the laws themselves, we compared changes in health outcomes among LGBQ+ and heterosexual adults living in states with or without religious exemptions to health care, both before and after the laws passed. Making all these comparisons at once allowed us to identify differences in health outcomes due to the laws rather than preexisting differences between states.
We found that conscientious objection laws were associated with significant harms to LGBQ+ adults, including a .
Our findings highlight how laws permitting clinicians to refuse to provide health care to LGBQ+ patients deepen existing health disparities. Notably, conscientious objection laws are just one type of policy .
The Trump administration has slashed budgets for the federal and state-level AIDS drugs assistance programs, . States have also moved to for both minors and adults, despite its additional benefit of helping . Employers have successfully of highly effective HIV prevention medications under religious freedom laws.
Worsening disparities
LGBTQ+ people already face greater health challenges than their heterosexual peers, including and .
, can lower the risk of contracting HIV from sex by 99%. However, patients are required to receive an HIV test before PrEP can be prescribed. If providers are unwilling or unable to engage with LGBQ+ patients on their sexual health, people who could benefit most from HIV prevention tools, such as PrEP, may never receive them.
Moreover, since the risk of contracting HIV is closely , such as having safe and stable housing and employment, barriers to HIV testing could further widen health gaps.
Similarly, the worsening in self-rated health among LGBQ+ adults suggests that the is real and immediate. A person’s perception of their own health status is one of the .
What can be done
Acknowledging the health consequences of conscientious objection laws could help policymakers and the public better understand their impact.
A 2026 national study found that Americans were more motivated to support policies that address LGBTQ+ inequality when these laws were framed as rather than economic inequality or sense of belonging. This finding suggests that people perceive health inequality as unjust and are less likely to blame LGBTQ+ individuals for those circumstances.
Health care systems can build that actively reassure LGBTQ+ patients will receive fair and equitable care. This can encourage more , such as vaccinations and cancer screenings.
For LGBTQ+ people, knowing your rights as a patient and seeking out and can help mitigate some of the harms of restrictive laws.
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