A growing number of U.S. states are enacting laws that allow health care providers to refuse treatment based on personal or religious beliefs. New research shows measurable health impacts of these laws on LGBTQ+ communities. As of April 2026, 11 states have passed conscientious objection laws that specifically affect queer patients.
The Conversation analyzed data from over 109K adults collected by the Centers for Disease Control and Prevention between 2016 and 2018. It found that lesbian, gay, bisexual, and queer adults living in states with refusal laws were 28% less likely to report receiving a first-time HIV test compared to peers in states without conscientious objection laws.
No similar decline was observed among heterosexual adults. The study also found that LGBTQ+ adults in those states were 71% more likely to report being in fair or poor health after the laws were enacted. Researchers identified these disparities by comparing changes in health outcomes before and after the laws took effect, across multiple states, isolating the impact of the policies from preexisting differences.
The findings come as additional policy changes affect LGBTQ+ health care access nationwide, including reduced funding for HIV programs, limits on gender-affirming care, and legal exemptions allowing employers to deny insurance coverage for preventive medications like PrEP.
HIV preexposure prophylaxis, or PrEP, can lower the risk of contracting HIV from sex by 99%. However, patients need to receive an HIV test before PrEP can be prescribed. If providers refuse to engage with Queer patients on their sexual health, people who could benefit most from PrEP may never receive it.
