Maryland LGBTQIA+ Community Needs Assessment: Comprehensive Findings Report.

Abstract

The Maryland LGBTQIA+ Community Needs Assessment provides one of the clearest pictures to date of the experiences, needs, and barriers facing LGBTQIA+ adults across Maryland. Conducted by the Maryland Commission on LGBTQIA+ Affairs in partnership with the University of Maryland Eastern Shore, this assessment reflects the voices of 1,217 LGBTQIA+ Marylanders who shared their experiences related to community connection, health care, mental health, safety, housing, employment, legal systems, and access to state protections. The findings reveal significant gaps between Maryland’s policy commitments and the lived realities of many LGBTQIA+ residents. Across multiple areas, respondents reported barriers to health care, discrimination, limited access to affirming resources, safety concerns, housing instability, and difficulty navigating systems. These challenges are interconnected and often compound across health, safety, economic stability, housing, identity documentation, and access to information. While many respondents reported positive experiences in some areas, the findings make clear that substantial disparities and unmet needs persist across communities and regions of the state. Health care access emerged as one of the most urgent areas of concern. More than half of respondents (51.8%) reported experiencing an obstacle or delay in receiving health care in Maryland, and nearly half (49.3%) reported avoiding medical care at least some of the time because they expected discrimination in medical settings. Among transgender and gender expansive respondents, this figure rose to 67.9%. These findings indicate that access is not only about whether services exist, but whether LGBTQIA+ Marylanders, and specifically transgender Marylanders can obtain care that is timely, affordable, respectful, and affirming. Mental and emotional health findings also point to serious unmet needs. While many respondents rated their mental or emotional health as good or very good, a meaningful share reported fair or poor mental health. More than 61% of respondents reported having seriously considered suicide at some point in their lifetime, including 70.7% of transgender and gender expansive respondents. These results underscore the importance of expanding access to affirming mental health care, crisis support, and community-based prevention strategies. Safety and hate-motivated incidents remain significant concerns. More than one in four respondents (26.7%) reported being the target of a hate crime while living in Maryland. Hispanic or Latinx respondents reported the highest rate (36.4%), followed by transgender and gender expansive respondents (30.6%). The data point to the need for stronger prevention, reporting, survivor support, and community-based safety strategies. The assessment also shows that access to LGBTQIA+ community resources is uneven across the state. While 61.8% of respondents reported that LGBTQIA+ resources were extremely or moderately available to them, only 40.9% of rural respondents reported similar levels of access. Rural respondents also consistently reported lower levels of community connection and lower perceptions of community inclusiveness, highlighting significant geographic disparities in access to affirming spaces and support networks. Employment and economic findings further demonstrate that discrimination continues to affect LGBTQIA+ Marylanders. Nearly three in ten respondents (28.9%) reported workplace discrimination based on gender, while 21.5% reported workplace discrimination based on sexual orientation. Gender-based discrimination was especially high among transgender and gender expansive respondents (40.5%). These experiences affect not only workplace inclusion, but also economic security and career advancement. Housing findings show that while most respondents were currently housed, 16.2% reported having experienced homelessness at some point in their lives. Lifetime homelessness was especially high among Black respondents (27.8%) and transgender and gender expansive respondents (21.4%). The findings also highlight barriers in navigating state systems. Nearly one-quarter of respondents reported changing their legal name while living in Maryland, and many described the process as difficult. Respondents also identified barriers related to identity documents and gender marker changes. Maryland’s current limitations, including the absence of an “X” gender marker option on birth certificates, continue to affect access to accurate identity documents for some residents. Finally, the assessment reveals a significant gap in awareness of rights and protections. Only 22.9% of respondents reported being very or extremely familiar with LGBTQIA+ state policies and protections, while more than 91% wanted more information. This finding highlights the gap between the existence of legal protections and individuals’ ability to understand and access them. These findings show that while Maryland has made meaningful progress in LGBTQIA+ inclusion, significant gaps remain between policy and lived experience. The data highlight a clear need for sustained state infrastructure, cross-agency coordination, dedicated investment, and stronger partnerships with community-based organizations to ensure LGBTQIA+ Marylanders have awareness and full access to the protections, services, and opportunities intended to support their well-being. The Commission recommends strengthening Maryland’s capacity to implement LGBTQIA+-inclusive policies, including through dedicated infrastructure such as an Office of LGBTQIA+ Affairs, expanded access to affirming care and services, improved navigation of rights and state systems, and stronger prevention and support efforts related to discrimination and hate violence. This assessment provides both evidence and direction for advancing lived equity across the state.