The Map That Was Never Made: What Science Knows About Rural LGBTQ+ Health

LGBTQ+
Written By Yoyce Geronimo

Learn more on Episode 1. Watch here: https://www.youtube.com/watch?v=GeSthD9IlQ0

By Yoyce Geronimo Galvan, M.A. | Held & Seen Coaching

 

If you are queer and rural, you already know the feeling. You drive an hour to see a doctor who still uses the wrong pronouns. You look up therapists and find a waiting list, no affirming providers, or both. You learn early that the system was not built with you in mind.

What you may not know is that science has been part of that problem. In 2026, researchers at Texas A&M asked a question that should have been asked much sooner: what do we actually know about the health of rural LGBTQ+ people in this country? They searched 24 years of published research, combing through more than 13,000 articles, and found 167 studies that qualified. I want you to understand that a single year of general mental health research produces over 300,000 articles. That number is not a footnote. It is the whole story.

What the Research Found

  • Being included in a study is not the same as being the subject of one. Sexual minority men appeared in 83% of studies. Sexual minority women were the dedicated subject of only 6%. Transgender and gender diverse people, LGBTQ+ elders, and queer adolescents? Even thinner.

  • Nearly half of all studies focused on sexual health. Mental health, substance use, chronic illness, aging, and basic healthcare access are almost entirely unstudied.

  • 85% of the research was descriptive. It documented what was wrong. Only 15% tried to figure out what to do about it.

  • After 2013, rural LGBTQ+ research started picking up from about three studies a year to twelve. That momentum is now being actively dismantled. As of 2025, the NIH has terminated over 300 active LGBTQ+ health research awards. The studies that were supposed to come next may not get written.

What This Means for Your Life

Your invisibility in the research is not a reflection of your importance. The gaps are structural, products of funding decisions and institutional priorities that were never built to find you. The research did not skip you because your life does not matter. It skipped you because the system was never designed to look for you. That belongs to the system. Not to you.

When you struggle to find care that fits your life, there is a documented reason. You are not asking for too much. The evidence base that would train providers, justify funding, and build real programs simply was not built. Your difficulty finding affirming care is a policy outcome. Not a personal failing. Remember that the next time you wonder if you are the problem.

If you are a queer woman, a trans person, an LGBTQ+ elder, or a queer adolescent, the research gap is even more specific. You were not just understudied. You were largely absent. The field built its understanding of rural LGBTQ+ health almost entirely around the experience of sexual minority men, not because your experience matters less, but because the recruitment infrastructure was never built to find you. Being counted in someone else's study is not the same as being seen. You deserved research that started with you. You did not get it. That is a failure worth naming.

The fact that only 15% of 24 years of research tried to figure out what actually helps rural LGBTQ+ means that even the providers who want to support you are working very limited evidence. There are fewer affirming providers not because people do not care, but because there is not enough data to train them, fund programs, or justify building the infrastructure your community needs. The shortage of care you experience is not a coincidence. It is the direct result of a research field that spent two decades documenting suffering without turning toward solutions. If you are looking for support that was actually built with your reality in mind, that is the work Held & Seen Coaching exists to do. heldseen.com/lgbtq

What is happening to research funding right now makes all of this more urgent. As of mid-2025, the NIH had cancelled or substantially reduced 669 grants, of which at least 323 addressed the health of sexual and gender minority groups, and thousands more have been flagged for review. Lambda Legal has since filed a federal lawsuit against the NIH over the terminations. A May 2026 study published in The Lancet confirmed what many already suspected: the cuts disproportionately affected researchers from the very communities those studies were designed to serve. The studies that were supposed to finally examine rural queer women, trans elders, and LGBTQ+ adolescents with the rigor they deserve may not get written now. For rural LGBTQ+ communities, what gets studied and what gets funded is not a policy abstraction. It is a question of whether your life gets counted at all. Paying attention to research funding right now is part of taking care of each other.

We all know that the LGBTQ community never waiting for the research to catch up. Peer support networks, community health workers, telehealth programs, faith communities that chose inclusion over tradition exist because people inside rural LGBTQ+ communities decided that waiting was a luxury they could not afford. That is how marginalized communities have always survived. Not by waiting for the system to study them into worthiness. By building what they need with what they have. You have been doing that your whole life. That is not a small thing. That is everything..

Resources for LGBTQ+ People

Crisis and immediate support:

Find affirming providers and community:

  • Held & Seen Coaching: LGBTQ+ affirming support for people navigating identity, relationships, belonging, and self acceptance with greater confidence and authenticity. heldseen.com

  • CenterLink: directory of LGBTQ+ community centers including rural and smaller-city organizations (lgbtcenters.org)

  • PFLAG: chapters in smaller communities and rural areas; support for individuals and families (pflag.org)

  • GLBTQ Legal Advocates and Defenders (GLAD): legal resources for LGBTQ+ people (glad.org)

About This Series

Connecting the Dots takes peer-reviewed research relevant to LGBTQ+ adults, trauma survivors, and family caregivers and translates it into plain language, with the data, the context, and the resources that the research itself rarely provides.

Study referenced: Croan V et al., "A scoping review of the methods, content, and populations of rural LGBTQ health research since the new millennium." Rural and Remote Health 2026; 26: 10258. https://doi.org/10.22605/RRH10258

Yoyce Geronimo Galvan, M.A., is a queer Latina behavioral health strategist and the founder of Held & Seen Coaching. She holds a Master's in Clinical and Counseling Psychology and spent over a decade designing national behavioral health programs for Latine and LGBTQ+ communities. She coaches in English and Spanish.