New research highlights growth, vibrancy and unique challenges facing LGBTQ+ people in Massachusetts
May 13, 2025
Boston – A new report from The Fenway Institute and the Equality Fund at the Boston Foundation finds that the population identifying as lesbian, gay, bisexual, transgender or other sexual and gender minorities (SGM) in Massachusetts is growing and dispersed geographically across the Commonwealth. However, data show notable disparities between SGM people and straight, cisgender adults in areas including health care, mental health, employment, and economic stability that require advocacy, progress and vigilance against potential threats.
The report, entitled LGBTQ+ People in Massachusetts: Strengths, Challenges and Opportunities in a Diverse Community, was released this morning at an event at the Boston Foundation. The report examines changes in LGBTQ+ demographics, health and wellness, employment, and economic well-being, building upon research first laid out in the 2018 report Equality and Equity: Advancing the LGBT Community in Massachusetts.
“While the data show the remarkable vibrancy, vitality, and growth of Massachusetts’ LGBTQ+ population, this report comes at a time when this vital part of the fabric of our Commonwealth is under ever greater attack,” said M. Lee Pelton, President and CEO of the Boston Foundation. “This report shines an important light on the many dimensions of the fight for equity that LGBTQ+ people and their allies must, and will, continue to make good on our promises for a truly equitable Commonwealth.”
The researchers used population-based surveys, including the Massachusetts Youth Risk Behavior Survey (YRBS), the Massachusetts Youth Health Survey (MYHS), and the Massachusetts Behavioral Risk Factor Surveillance System (BRFSS) survey, to compile demographic and other data. This data was complemented with online listening sessions and interviews to provide robust anecdotal and qualitative data on the lived experiences of SGM people across the state.
“We must acknowledge that true equality for LGBTQ+ people in the Commonwealth remains unfinished work—especially for those outside Greater Boston, and particularly for individuals who are Black, Indigenous, or people of color, older adults, and those facing economic insecurity,” said Jordina Shanks, CEO of Fenway Health.
Demographics: A Growing, Diverse, Statewide LGBTQ+ population
The report first explores how the number of people identifying as LGBT or some other identity has changed over time, using data from several state surveys. The data show that 9.1 percent of Massachusetts adults identified as LGBT+ (LGBT or some other sexual orientation) on the 2020-2022 BRFSS survey.* This is a 26% increase from the 7.2% of Massachusetts adults who identified as LGBT+ on the 2016 BRFSS survey. However, as was highlighted in the 2018 report, significant age-related differences exist. Among students, 23.2 percent of Massachusetts high school students identified as LGBT or were unsure of their sexual orientation or gender identity in 2023; for adults, 23.4% of 18-24 year-olds identified as LGBT+, versus under 6 percent in all age cohorts older than 45. (The percentages of people identifying as LGBT+ rose sharply from 2016 for all groups under age 45.)
Racial and geographic data highlight the breadth and statewide presence of LGBT+ households – the racial demographics of Massachusetts’ LGBT+ population align closely with the state’s overall racial diversity, and county-by-county data show that concentrations of LGBT+ adults and cohabiting same-sex couples exist across Massachusetts. Same-sex couple households are more common in every Massachusetts county compared to other U.S. counties, according to U.S. Census Bureau data cited in the report. Hampshire and Franklin Counties ranked among the top 4 counties in the U.S. in percentage of female-female couple households in 2020; Suffolk County ranked fourth in percentage of male-male couple households, behind San Francisco, Washington, DC, and New York City.
Health Care: Affordability, Access and the Strain on Mental Health
While the growth in the number of people identifying as part of a sexual or gender minority has grown, the data on health care access and affordability show room for improvement. LGBT+ adults in 2020-2022 were 1.6 times more likely to say their health was fair or poor than straight, cisgender adults. A similar gap can be seen in issues of access to health care. LGBT+ adults were 1.8 times more likely to report they were unable to see a doctor at some time in the previous year due to cost.
And where cost was not a barrier, commenters in listening sessions highlighted concerns over finding quality, culturally competent care, or caregivers with knowledge of their specific needs. Transgender and gender diverse people found that the challenges of getting appropriate needed care were exacerbated by getting insurance to help cover the costs.
For a population already dealing with persistent societal stigma and mental health, a lack of access to quality care is particularly troubling. Data show LGBT+ adults are more than twice as likely to report being told they had a depressive disorder and are 3.8 times more likely to report seriously considering suicide than straight cisgender peers. Participants in the listening sessions, particularly outside of Boston, noted feelings of loneliness and a lack of social connections. This can be a particular problem for older, less technically savvy people, who may lack access to even online connections.
Housing and Economic Stability: Challenges and Insecurity
The research shows that sexual and gender minorities continue to lag behind straight, cisgender peers across housing and economic issues. As a group, LGBT+ people are more likely to have household incomes under $25,000, and less likely to have household incomes over $100,000. They are also, across age demographics, less likely to own their own homes, which play a critical role in asset building and retirement savings.
LGBTQ+ households also feel the burden of food insecurity at significantly higher rates than other groups. A 2023 report found that 34 percent of Massachusetts households experience food security, but for LGBTQ+ households, the number rose to 56 percent. 2024 data from the Greater Boston Food Bank showed 53 percent of LGBTQ+ households with children were food insecure, a higher percentage than for Black, Hispanic, Asian or White households.
The challenge of lower incomes is compounded by other elements, including discrimination (especially against trans and gender diverse people) and a lack of welcoming, affordable options for older LGBTQ+ people. In conversations, BIPOC LGBTQ+ individuals noted that finding housing that is welcoming and safe for their multiple, intersecting identities can pose extreme difficulty. Across all SGM demographics, there have been increased concerns that the current national climate only enhances the threats against people’s rights, and jeopardizes their safety from discrimination, harassment and physical violence.
Building a Safer, Stronger, More Equitable Commonwealth
“While the survey data and listening sessions raise important issues that must be addressed, we are grateful that Massachusetts continues to lead in protecting, recognizing, and empowering LGBTQ+ people, including at the highest levels of state government,” said Sean Cahill, Ph.D., Director of Health Policy Research at The Fenway Institute and the report's lead author. “We must maintain Massachusetts as a beacon of hope and provide a state and local policy framework in which all LGBTQ+ residents of the Commonwealth can thrive.”
With that in mind, the report lays out recommendations for policy work in six areas that can build upon the state’s historic track record in an environment where anti-LGBTQ+, and particularly anti-transgender, rhetoric and policy are expected to only intensify at the federal level. They include:
HEALTH-CARE ACCESS: Expand affirming health care, especially in underserved areas outside the Boston area, with a focus on mental health.
HEALTH DISPARITIES: Public health officials should partner with health professionals and LGBTQ+ community-based organizations to target and reduce chronic disease and behavioral health disparities, including tobacco and alcohol use, depression, and suicidality.
HOUSING AND ECONOMIC STABILITY: Support more affordable, SGM-friendly housing and enforce nondiscrimination laws in housing and employment.
COMBAT SOCIAL ISOLATION: Foster both physical and digital spaces for SGM individuals to gather and create community. These spaces are particularly needed in rural areas in the Commonwealth.
SAFE SCHOOLS AND COMMUNITIES: Promote school environments that are safe for SGM students with supportive and inclusive general curricula and health education. Vigorously enforce state and federal laws prohibiting discrimination on the basis of sexual orientation, gender identity, race, religion, sex, age, disability, and other factors.
HEALTH EQUITY: Ensure data collection on sexual orientation and gender identity (SOGI) information is widespread to inform health and human services programs and policies. Strengthen intersectional approaches to advance health equity by acknowledging and addressing the complex interplay of multiple marginalized identities within the SGM community.
In addition to these more policy-driven recommendations, the report includes a series of other recommendations from listening group participants for state and local actions that could improve the day-to-day lives and well-being of sexual and gender minorities of all ages. It also calls for a greater commitment from philanthropy to invest in LGBTQ+ communities and issues, and especially notes the need for greater investment to support and advocate for trans and gender-diverse communities.
“Reports like this are important not just because they capture where we are, but they identify the places where we need to invest resources—including greater philanthropy from LGBTQ+ allies, time, and creative advocacy—to develop solutions that improve the lives of LGBTQ+ people across Massachusetts,” said M. Scott Knox, Executive Director of the Equality Fund. “If we do that, we will improve not only our community members’ lives, but those of millions across the Commonwealth.”
* The press release and the full report use “LGBT+” where it reflects the terminology used in the survey data.