Safe, seen, supported: Better social and healthcare systems for LGBTQ+ communities

Author: Aparna Anantharaman

Publisher, Nature Partner Journals and Co-Chair, Springer Nature SDG 10 Working Group

In June, Pride Month is an important reminder that equity still requires our efforts. In this special blog, Aparna Anantharaman, the Co-Chair of Springer Nature’s SDG 10 Working Group, showcases a selection of publications that highlight the challenges facing the LGBTQ+ community. Research that supports the efforts to achieve equity, inclusion, and justice for all.

June is Pride Month, a time to celebrate LGBTQ+ (lesbians, gay, bisexuals, transgender, queer, and others represented by the plus sign) communities and reflect on the progress made toward equality, while acknowledging the discrimination and harm these communities have historically faced. As conversations around equity, inclusion, and justice grow louder, the call to build better social and healthcare systems for LGBTQ+ communities has never been more urgent.

For LGBTQ+ individuals to thrive, systems must be reimagined to prioritise safety, visibility, and support. This aligns closely with Sustainable Development Goal 10: Reduced Inequalities (SDG 10), which aims to reduce inequality within and among countries, highlighting the importance of inclusive policies and practices that leave no one behind.

In this blog, I bring together a selection of research and insights from content published in Springer Nature that highlights key considerations for creating more inclusive social and healthcare systems that better serve the LGBTQ+ community. You’ll find links to the articles and book chapters I mention, which cover the topics of higher education, mental health, inclusion in clinical research, transgender healthcare, and utilising emerging technologies for inclusion.

This pride month, I urge you to both celebrate the LGBTQ+ community as well as recognise and understand the challenges they face. The research shared below brings these important topics to light and supports the efforts to address them.

To build systems that make LGBTQ+ individuals feel safe, seen, and supported, transformations across every level are essential. And in making these changes, we don’t just improve outcomes for LGBTQ+ individuals — we build stronger and more compassionate systems for all.

Equitable education for LGBTQ+ students: Learning without fear

There are many challenges to creating equitable learning environments. In the journal Learning Environments Research, a recent article presents a model to support lecturers in establishing an inclusive learning environment by building on students’ different perspectives and talents in higher education.

Supporting inclusive education is important already in the school system, where LGBTQ+ students face bullying and exclusion. A chapter in a book on violence against LGBTQ+ persons describes the negative mental health and academic concerns that this bullying leads to, such as depression, anxiety, increased truancy, and poorer grades.

The authors identify strategies that educators can use to foster a safe and inclusive environment for sexual and gender diverse youth. In a book on transforming unequal gender relations, one chapter suggests mechanisms to prevent and mitigate bullying. These suggestions for strategies and mechanisms aim to enable a safe and nurturing learning environment for LGBTQ+ students. They include implementing anti-bullying policies, raising awareness about gender and sexual diversity, establishing safe reporting systems, and more.

LGBTQ+ mental health: Addressing a crisis

As global conversations around equity and inclusion evolve, intentional support for LGBTQ+ mental health must become a priority in both clinical and social policy frameworks to create a more just and supportive world. Affirmative, inclusive mental health services — both in-person and virtual — are crucial for reducing minority stress and improving resilience, self-esteem, and overall well-being.

LGBTQ+ youth often struggle to access mental health services due to a lack of affirming providers, consent barriers, or geographic limitations. A chapter published in a book on telemental healthcare showed that telehealth presents a promising solution for LGBTQ+ youth due to the broader accessibility it offers.

LGBTQ+ mental health remains a critical yet underexplored area in many parts of the world. This is certainly the case in India, where academic focus on sexual and gender minorities has only recently extended beyond HIV/AIDS prevention.

Transgender individuals, in particular, face unique challenges such as parental rejection in a society that places high value on familial ties, discrimination in healthcare settings, and complex dynamics within queer-trans communities. In a book chapter about a study undertaken in India, researchers revealed key themes related to transgender individuals’ relationships with parents, healthcare experiences, and community interactions, all of which impact their well-being.

Another book chapter of a study undertaken in India and exploring sexual orientation and mental health among young adults shows that heterosexual individuals tend to report higher levels of resilience and self-esteem compared to their homosexual, bisexual, and asexual peers. And in the workplace, according to a book chapter on awareness towards LGBTQ+ inclusion, members of the LGBTQ+ community face discrimination and job insecurity, despite growing visibility and policy discussions around inclusion.

LGBTQ+ inclusion in health and clinical research

Promoting LGBTQ+ health equity requires such efforts as inclusive study designs, improved data collection, legal protections, stigma reduction, and targeted health interventions. Representation in clinical trials is essential to fair and effective healthcare.

Nature Reviews Urology used the Pride month celebrations as an opportunity to consider how the field of urology can improve inclusion and healthcare for LGBTQ+ patients. In 2021, the NRU Pride collection brought together research on LGBTQ+ healthcare.

But most biomedical, health, and care research continues to inadequately account for the sex and gender dimensions of health and illness, reducing scientific rigour and leading to less effective treatments, particularly for women and sex and gender diverse populations. A recent article in npj Women’s Health sets out key actions for the UK research sector to embed meaningful accounting for sex and gender as a new norm for research practice.

In Nature Medicine, an article provides a roadmap for engagement and inclusion of LGBTQIA+ people in clinical research to confront their underrepresentation, which can result from binary gendered eligibility criteria that exclude participation by transgender, gender diverse, and intersex people.

Sexual and gender minority (SGM) communities also face unique cancer risks. A book chapter discusses opportunities to address challenge globally, through legal protections, prevention efforts, and others.

Healthcare for transgender and nonbinary individuals

Transgender and gender diverse (TGD) individuals face numerous and deeply entrenched barriers to high-quality healthcare, including challenges related to gender identity, race, socioeconomic status, education, immigration status, employment, and insurance. To reduce healthcare disparities for TGD populations, systemic and institutional changes are essential, alongside efforts to eliminate stigma.

Increasing numbers of transgender and nonbinary youth are seeking gender-affirming care, which has been shown to improve health and well-being. An article in Nature Reviews Endocrinology examines standard therapies and introduces novel approached as it explores how individualised gender-embodiment care can address the needs of youth up to age 18.

A study of dosing behaviour in Humanities and Social Sciences Communications analysed survey data from 379 trans individuals, to better understand deviations from prescribed doses of gender-affirming hormones, which improve psychological functioning and quality of life for transgender and nonbinary (trans) people. Overuse (24% took more hormones than prescribed) was linked to having the same provider for primary and gender-affirming care and to gender-based discrimination, while underuse (57% took less) was associated with income and insurance barriers. This article highlights the need to address access and affordability to support safe, effective hormone use.

AI and LGBTQ+ Inclusion

The use of technology is revolutionising healthcare, education, and social services. But without careful design, it risks reinforcing existing biases.

Men who have sex with men (MSM) who use dating apps are more likely to engage in condomless anal sex than those who do not. In npj Digital Medicine, a two-arm randomised controlled trial evaluated an interactive web-based intervention aimed at promoting safer sex practices. This kind of intervention has proven to be effective in sexual health promotion, and the articles shows results demonstrating a significant reduction in risky sexual behaviour.

An article in Nature Computational Science shows how digital safety systems used by artificial intelligence (AI) companies, though intended to protect users from offensive or inaccurate content, have sometimes inadvertently censored LGBTQ+ material. While many examples presented in the article stem from systemic bias rather than intent, efforts to create representational equity face many challenges.

Research that supports LGBTQ+ individuals and beyond

To build systems that make LGBTQ+ individuals feel safe, seen, and supported, transformations across every level — daily public life, higher education, mental health, technology development, and clinical research — are essential. Research and publications, like those presented in this blog, pave the way to identifying challenges and achieving progress. And in making these changes, we don’t just improve outcomes for LGBTQ+ individuals — we build stronger and more compassionate systems for all.

Celebrating the LGBTQ+ community: Explore more research in honour of Pride Month 2025 and in support of SDG 10.
 

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