Supreme Court Decision about LGBTQ Protections Impact Health

This week the Supreme Court will being hearing arguments about whether the Civil Rights Act (1964), Title VII statute–barring discrimination based on race, color, national origin, and religion–also includes sexual orientation and gender identity. For the LGBTQ community, this decision has far reaching consequences as it would provide the final say on whether or not LGBTQ people can be fired because of their sexual orientation or gender identity. Nurses must be aware that structural discrimination (ie. laws) impact health by contributing to minority stress and poor health outcomes among the LGBTQ community. 

There are 26 states with no non-discrimination laws protecting sexual orientation or gender identity, according to the Movement Advancement Project (2019). About half of the LGBTQ community live in states that do not provide these protections. The Supreme Court is hearing two cases regarding employment dismissal due to sexual orientation, and one case regarding gender identity, this week.

The Supreme Court is comprised of majority conservatives who traditionally do not support LGBTQ rights and protections under the law. Furthermore, the White House has already expressed that they do not support Title VII covering sexual orientation or gender identity. There are other probable ripple effects on LGBTQ people’s ability to obtain lines of credit, apply for mortgages, and seek education if the Supreme Court determines Title VII does not apply.

From a health perspective, inequality, homophobia, and fear of discrimination can create minority stress for LGBTQ people resulting in poor health outcomes and illness. Support for local anti-discrimination legislation to protect the LGBTQ community will be increasingly important if the Supreme Court deems sexual orientation and gender identity are outside the scope of Title VII protections. Nursing advocacy in the 26 states without these protections will be increasingly crucial as lack of adequate legal protections has a profound impact on LGBTQ community members and their well-being.


Vanessa Shields-Haas is a radical nurse, nurse practitioner student, and activist for harm reduction, comprehensive sexual education, LGBTQ rights, and reproductive freedom.

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