ASHEVILLE, N.C. — The Campaign for Southern Equality (CSE) and Western North Carolina Community Health Services (WNCCHS) released “The Report of the 2019 Southern LGBTQ Health Survey,” which provided a groundbreaking look at the health and healthcare experiences of LGBTQ individuals in the southern U.S.

“With 5,617 participants, the 2019 Southern LGBTQ Health Survey is one of the largest samples ever of LGBTQ Southerners talking specifically about their health, their bodies, and their lives,” stated Adam Polaski, CSE’s communication’s director.

The South is home to more than one-third of LGBTQ Americans, but there has been limited research to date on LGBTQ Southerners’ specific experiences with health issues. Key findings of the survey, available in English and Spanish in the full report and in the Executive Summary, include:

• More than half of respondents in the total sample reported fair or poor mental health, and mental health ratings were even worse for individuals who are bisexual+, transgender, 18-24 years old, or those with lower incomes. Especially alarming are the high rates of suicidal ideation, self-harming behaviors, depression and anxiety.

• Respondents’ reported rates of living with HIV are more than 15 times higher than the national rate. Nearly a quarter of all black or African-American respondents (22 percent) said they are living with HIV, as did 13 percent of all gay male respondents. More than half of respondents in the total sample said they never or rarely get tested for HIV.

• Respondents in more rural areas face significant health disparities. People who live in more rural areas rated their overall physical and mental health lower than respondents living in urban areas and reported less access to quality medical care; less comfort-seeking medical care within their community; higher rates of depression, anxiety, suicidal thoughts, and self-harming behaviors; and lower rates of feeling that their health care needs are being met.

Rev. Jasmine Beach-Ferrara, CSE executive director, said, “The survey’s findings are both hopeful and heartbreaking and, above all, a call to action. Access to health care is a basic right, but you need to understand a community’s health care needs before you can meet them. This survey provides a new breadth and depth of insight into LGBTQ Southerners’ health experiences, illuminating the acuity of need in people’s lives, the tremendous resilience of LGBTQ Southerners, and the many reasons to feel hopeful about what’s happening on the ground in the South. Now, armed with this new data, we must work harder than ever to accelerate change and build a South where LGBTQ people can finally access the health care they need in their hometowns.”

Kim Wagenaar, CEO of Western NC Community Health Services, added, “For 24 years, WNCCHS has been on the frontlines of providing care to transgender patients and people living with HIV, and the Southern LGBTQ Health Survey brings to life the stories we hear from patients every day. The Survey findings help move the conversation around health equity from the individual level to the regional and systems-level and point toward the changes that we need to ensure that all LGBTQ people can get the care they need and deserve.”

Led by a team of LGBTQ Southerners, the Southern LGBTQ Health Survey was rooted in community-based research methods, including working with a team of Survey Ambassadors who spanned the region and who included a minister, a nightclub promoter, and grassroots leaders. The project is part of the Southern LGBTQ Health Initiative, a collaboration of CSE and WNCCHS to improve access to LGBTQ-friendly primary care, HIV care and support services across the South. In addition to community-based research, this initiative involves training primary care provides in affirming health care practices and providing direct funding to grassroots groups leading innovations in access to LGBTQ healthcare.

Authors and project leadership members of the survey included Chase Harless, MSW (principal investigator), Megan Nanney, M.S. (lead data analyst), Austin H. Johnson, Ph.D. (CSE research director), Beach-Ferrara, Polaski, Kayla Gore (lead survey ambassador) and Liz Williams (cover design and artist in residence at CSE).

Survey ambassadors included Ace Brooks, Anthony Curry, Rev. Debra J. Hopkins, Yasmyne Hunter, Taryn Jordan, Tamesha Prewitt, Cecilia Saenz Becerra, Estrella Sanchez, Nia Brooke Smith, Renae M. Taylor and Cortez Wright.

Community partners listed are AIDS Services Coalition, Asheville Gay Men’s Chorus, Beer City Sisters, Birmingham AIDS Outreach, Central Alabama Pride, El Centro Hispano, Community Estrella, Equality North Carolina, Gender Benders, ImpactOUT, Nelwat Ishkamewe, Latinos in the Deep South, Mississippi Rising Coalition,  The Montrose Center, Dr. Amy Murphy-Nugen, North Carolina Asian Americans Together, The PAIGE Memphis, POZ-Empowerment, Queer Appalachia,  Relationship Unleashed, South Carolina Equality, Transcend Charlotte, Transcend Memphis, Transform Houston and Twin Oaks Gathering.

Financial support was supplied by Laughing Gull Foundation, Rockefeller Foundation, Oak Foundation, Z. Smith Reynold Foundation, the Solidaire Network and the Amy Mandel and Katina Rodis Fund, as well as by other personal contributions.

Access the full report and executive summary is available at A video is also available for viewing that can give a quick overview of the findings. It can be found at


Lainey Millen was formerly QNotes' associate editor, special assignments writer, N.C. and U.S./World News Notes columnist and production director from 2001-2019 when she retired.