Benzodiazepine Prescribing Patterns Following Mass Traumatic Events.

There have been both positive and negative changes for the lesbian, gay, bisexual, transgender, and queer people and other sexual and gender minorities (LGBTQ+) in the U.S. in the recent past. Same-sex marriage is now the law in the U.S. and 22 states and the District of Columbia have passed LGBTQ+ civil rights protections. There is also greater societal acceptance of LGBTQ+ people. However, there has been a rise in reports of discrimination and hate crimes throughout the U.S., particularly toward people who identify as transgender and gender diverse. The American Civil Liberties Union is tracking 616 anti-LGBTQ+ bills in state legislatures, of which 141 are intended to restrict healthcare (as of January 7, 2026). GLAAD tracked at least 918 anti-LGBTQ+ incidents in 2024, of which 48% were against transgender and gender nonbinary people, including fatal violence, even as the crime rate in the U.S. has declined. While the U.S. Supreme Court has protected transgender individuals from discrimination in employment, it most recently upheld a Tennessee state law that banned gender-affirming care for transgender youth. This decision likely supports similar laws restricting gender-affirming care, currently existing in 27 states, opening the door to greater backlash against the transgender community. It will likely lead to more challenges against gender-affirming care for transgender adults. We have reported disparities in the care of seriously ill LGBTQ+ individuals that is disrespectful and inadequate due to the patient’s sexual orientation or gender identity in a study of healthcare professionals, and in a study of seriously ill patients and their spouses, partners, and widows (hereinafter: partners). Deficiencies reported include being made to feel invisible, feeling judged and made fun of, having their partners ignored and disrespected, provider discomfort with their identities, and lack of awareness of LGBTQ+ health needs and sexual health concerns. Furthermore, LGBTQ+ patients fear discrimination, isolation, safety, and loss of dignity at end of life.