Introduction

The Network is a coalition of 60+ LGBTQ-specific organizations and programs whose mission is to increase the capacity to serve LGBTQ communities through funding and policy advocacy, technical assistance, capacity-building and coalition work.

The New York State LGBTQ+ Health and Human Services Network Needs Assessment is among the most comprehensive LGBTQ health surveys in the U.S. It aims to highlight the needs and service barriers faced by this underserved community, offering detailed insights into disparities influenced by race, ethnicity, age, gender, disabilities, religion, region, education, income, and more. Conducted online from September to November 2021 during the pandemic peak, the survey involved over 2,300 respondents and captures the profound impact of COVID-19 on LGBTQ individuals, exacerbating pre-existing inequalities.

This digital overview of the report highlights key findings, including intersectional disparities in care/access and the critical need for mental health support.

Hover over each visualization in the sections below to explore the survey data.




  • To see the full survey report, click here.

  • To learn more about the Network and member locations, click here.

Generational shifts

A generational shift is underway. The 2021 Survey shows a community that has shifted substantially in terms of gender expression and identity since the last survey in 2015. The community is growing more diverse in gender identity and sexual orientation, such that binary gender identities and lesbian and gay orientations are trending toward minority status in the larger LGBTQ+ community. The shift is most pronounced in the breakdown of gender and orientation by three major age groups (13-34, 35-49, 50+).


  • LGBTQ community members who are over 35 years of age identify primarily (72%) as either men or women (cis and trans), while those under 35 identify growingly as genderqueer, genderfluid, other genders, or non-binary (45%). Those 35+ report a higher need for care for chronic conditions and seem to need more information and education on mental health, while those under 35 report a higher need for mental health care (57.7%).

  • These differences in orientation and gender expression point to substantially different lived experience in different age groups. To address the needs of the LGBTQ+ community today means creating appropriate resources and responses for youth, those in middle adulthood, and community members who are ageing.

Gender identity and sexual orientation by age group

  Hover over the points on the triangles below to see the % breakdown.



For more information, consult section 2A of the full report.

Disparity in access to services

Race and ethnicity

Disparities in needs, access, and outcomes in the LGBTQ+ community mirror the patterns of racial and ethnic health disparities at-large in American society. In the majority of needs and issues examined in the survey, non-White respondents report higher levels of needs and lower levels of receiving services than their White counterparts. In some areas the disparities are glaring — especially in terms of food security, obtaining public assistance, and receiving services sought in most service areas including chronic conditions, major health events, mental health, environmental health, and reproductive health. In 20 out of 23 different services non-White respondents reported a lower level of receiving services than White respondents. For more information, consult section 2B of the full report.

The bar chart below shows the percentage of respondents who sought support for    but were unable to access services:

Immigration and asylum status

HIV Risk by Birthplace

  Hover over the chart below to see the % breakdown.



Immigration and asylum experiences affect every aspect of quality of life. HIV prevalence among respondents born outside the U.S. is 4 to 5 times the survey mean (15%-18%) compared to 3-5% for those born in the US. Those born outside the US were also twice as likely to report abuse in relationships or the family, twice as likely to have reported environmental health concerns, and more likely to have experienced major health events (e.g., medical emergencies, surgeries, or major acute illness) but two-to-three times more likely to have not received services for major health events.


For more information, consult section 2C of the full report.

The impact of Covid-19 on access to services


The Covid-19 pandemic exacerbated existing inequalities even further. Most respondents rated obtaining mental health, in-home health, specialty services, substance use services, and dental care more difficult to obtain during the pandemic. 52% of non-White respondents noting difficulty accessing transition care during the COVID-19 pandemic as compared with 43% of White respondents. Overall, non-White respondents reported higher levels of difficulties in obtaining services than White respondents in most service areas. For more information, consult section VII of the full report.


  Hover over the chart below to see the breakdown of those who reported, by care type, increased difficulty in obtaining services during Covid-19, by category and ethnicity.


Covid-19 Infection Rate, by race and ethnicity

Approximately 10% of respondents had tested positive for COVID-19 at the time of the survey. As in the population as a whole, the effects of the pandemic were more strongly felt by non-White respondents, with respondents who identified as Black, another race or ethnicity, or Latinx/Hispanic reporting the highest rates of Covid-19 infection.



Hover over each point on the spider chart below to see the % breakdown.

Mental health

Mental health is both the largest support need and greatest opportunity area for improving the well-being and quality of life of the LGBTQ community in New York State. 77.4% of respondents reported mental health needs, yet 23.6% did not receive services. This mental health crisis is highly associated with experiences of discrimination, as well as high levels of medical mistrust, lower self-reported health, low self-reported quality of life, and a lack of social inclusion and support.

Respondents reported feeling (at least ‘half the time’ or ‘most of the time’ in the prior 12 months) anxious/nervous (51%), down/depressed/hopeless (36%), little interest in doing things (33%), and scared for their life (12%). 27% of respondents reported feeling isolated, 22% reported 'lacking companionship', and 21% reported feeling left out 'often or mostly.' There is a strong overlap of mental health and substance use service needs. 89% reported some substance use (including alcohol and tobacco), with half reporting using only one or two substances. 18% reported using three substances, and another 21% reported using four or more substances.

Psychological and traumatic stress, effects of racism:

  • Multiracial and Latinx/Latiné respondents reported the highest levels of psychological distress in all the categories measured in the community survey: low motivation, depression, anxiety, and being afraid for one’s life. 

  • Non-White respondents were more likely to report feeling left out and isolated, with much higher levels of 'feeling rarely or never supported.’

  • Statistically significant percentages of Black (63%), Asian (55%), and Latinx/Latiné (39%) respondents reported that their feelings of psychological distress were affected by the experience of racism in everyday life. This also held true for lack of social support and inclusion.

  • Traumatic stress is most highly experienced by non-White respondents. 15% to 19% of non-White respondents reported feeling 'scared for my life' over half the time in the previous year, while less than 10% of White respondents reported the same feeling.

For more information, consult section 3A and 3C of the full report.

Social inclusion and support, by New York State region

To improve mental health outcomes, it is important to address social inclusion and specific community supports for individuals. This can be through social programming and community centers, but also through the affirmation of the LGBTQ+ community in health fairs, schools, libraries, parks, and other public places. For more information, consult section 4F of the full report.

Hover over the map below to see the % breakdown by New York State region of respondents who answered 'Somewhat' or 'Major' for each question related to social isolation/support in the drop-down menu.

Barriers to service

While there is a significant demand for services within the LGBTQ community, a large proportion (62.6%) of respondents did not seek out the care or services they need. Among these, individuals under 35 represented over half of those who refrained from seeking support. Among those who did seek non-behavioral services but were unsuccessful, 29% said they could not find the required services locally in their area. In terms of mental health services, 47% of respondents who looked for but did not obtain services/care cited the absence of such services locally as the primary obstacle. Telehealth services can provide a cheaper and simpler alternative to improve accessibility.

Hover over the map below to see the % breakdown by New York State region of respondents who answered 'Somewhat' or 'Major' for each question related to barriers to care/service in the drop-down menu.



Top barriers to seeking care and services

The main reason for not accessing services is economic. Affordability and insurance issues are consistently ranked as one of the main problems to accessing health services. A lack of LGBTQ-affirming services is one of the leading reasons why people do not access or look for services. Increasing medical transparency and the rights of patients, providers and families are key elements to tackling this. With "I could not find services in my area”, time and transportation constraints consistently rated as major reasons for not accessing healthcare services, telehealth provides an affordable and straight-forward mechanism for improving accessibility.

  Hover over the bubbles below to explore the top barriers to obtaining services:




Conclusions and Policy Recommendations


The Network members specialize in providing life-saving and LGBTQ-affirmative services in all regions of New York State, reaching over 1.5 million New Yorkers every year. In many cases, we are the only LGBTQ-affirming provider in a radius of several counties. For the state, sustaining and expanding the capacity of Network members to reach out and serve their communities and meet them where they are is one of the most efficient ways to improve the health outcomes of LGBTQ New Yorkers. Each dollar invested in The Network returns up to 16 dollars in savings on future medical costs.

Building off the findings of the survey, key points for policy action are:

1) Expand the availability and accessibility of LGBTQ-affirmative mental health services

Fund organizations and programs providing mental health services that are:

  • LGBTQ-affirming
  • Free or low cost and affordable
  • In multiple languages with diverse racial/ethnic backgrounds
  • Adapted to the needs of underserved communities


2) Guarantee the expansion of Telehealth Services and close the gap for Medicaid reimbursement for telemedicine

'I could not find services in my area' is one of the most common reasons why people do not access health services. Telehealth is a cheaper and simpler option to improve accessibility. Incentivize service providers to increase service availability by compensating behavioral and non-behavioral telehealth services at competitive rates for organizations.

3) Expand In-Person and Remote Service Capacity, improve LGBTQ sensitivity training among current providers

Fund and support the training, technical assistance, and support to public and private service providers to increase the state's capacity to serve its LGBTQ constituents. We recognize the importance and work to educate the public about the importance of extended LGBTQ cultural competency training and improved LGBT-affirming policies, regulations, and service standards.


4) Increase targeted awareness about mental health issues and available services targeted to underserved communities

Invest in developing targeted programming to reach historically marginalized groups within our communities: BIPOC communities, younger and aging clients, people with disabilities, immigrants, and TGNC clients. Support pathways to bring minority candidates into the profession, or supporting certified and trained peer positions that address issues of discrimination, fear, and mistrust in the community.


For more information:

  • To find out more about the Network, please visit our website.

  • To read the findings of the survey in full, click here.

  • For more information on this survey, please e-mail Vladimir Tlali, Network Director, vtlali@gaycenter.org

The Network Map

The Network is a coalition founded in 1994 and administered by The Center. We aspire to increase the safety, freedom, quality of life, and wellbeing of every LGBTQ+ person in New York State.

  • 60+ LGBT-specific and LGBT-supportive nonprofit organizations that provide care to LGBT New Yorkers, serving all of New York State’s 62 counties, including upstate, downstate, rural, and urban populations.
  • Together, we increase our shared capacity as LGBTQ+ specific organizations and programs to serve our communities through funding and legislative advocacy, capacity enhancement, and coalition building.

The map to the right shows where each Network member is located throughout the state, as of 2022.

  Hover over each point learn more about a particular service.

Toggle different layers to see how barriers to seeking care and services interact with Network member locations.