This editorial examines the global state of LGBTQ+ health equity, reviewing legal, political, and epidemiological trends affecting LGBTQ+ populations worldwide, including rollbacks in the USA, Africa, and Russia, and areas of progress such as Spain.
Same-sex sexual activity is criminalised in 65 UN member states (up since 2025), punishable by death in 7; HIV infections are rising in gay men and transgender people per a 2024 UNAIDS report; US polling shows an 8-point drop (to 38%) in Americans who view gender change as morally acceptable, and only 62% view gay/lesbian relationships as moral—the lowest since 2016.
As an editorial, it draws on secondary sources and selected statistics rather than original research; it does not systematically grade the quality of the cited evidence; and the scope is broad, limiting depth on any single intervention or population.
Clinicians should be aware that LGBTQ+ patients face elevated risks of poor mental health, suicide, substance misuse, cardiometabolic disease, and avoidance of care due to discrimination—screening and affirming clinical environments are essential. Restrictive legislation in a patient's country of origin or residence should prompt proactive, sensitive assessment of health barriers.
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