Rural and LGBTQ+: finding care far from a big city
Millions of LGBTQ+ people live in rural America. Fewer nearby options can make a bad experience at the only clinic in town much harder to recover from.
Key takeaways
- An estimated 2.9 to 3.8 million LGBT people live in rural areas.
- When the local hospital is the only option, being turned away is a bigger problem.
- Rural LGBTQ+ young people report more discrimination and less access to care.
Stories about LGBTQ+ life often focus on big cities, but millions of LGBTQ+ people live in small towns and rural areas. The Movement Advancement Project estimates that 2.9 to 3.8 million LGBT people live in rural America.
“Being LGBT doesn't mean you want to go live in a coastal city.”
Fewer options, higher stakes
In cities, a bad experience usually means finding another provider. In rural areas, there may not be another one. MAP found that over 40% of LGBTQ people outside metropolitan areas said it would be very difficult or impossible to find another option if their local hospital turned them away, compared with 18% of LGBTQ people overall.
40%+
of rural LGBTQ people say finding another hospital would be very hard or impossible
18%
of LGBTQ people overall say the same
What young people are saying
The Trevor Project's 2025 survey found that rural LGBTQ+ young people were more likely to face discrimination based on their sexual orientation than those in large cities (38% vs. 26%). Only half said they could get the mental health care they wanted, compared with 59% in large cities.
Ways to widen your options
- Telehealth can connect you with affirming providers who aren't nearby, depending on your state's rules.
- Regional LGBTQ+ centers often keep lists of welcoming providers across a wide area.
- Online community groups can share which local providers are good. See how to find peer support.
Sources
- Movement Advancement Project, Where We Call Home: LGBT People in Rural America, 2019 (via NBC News)
- The Trevor Project, What does the 2025 U.S. National Survey say about LGBTQ+ young people living in rural areas, May 2026
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