A survey conducted in 2021 found that around 97.3 percent of people assigned male at birth still identify as male, while 0.4 percent identified as female, and 0.6 percent identified as transgender.

In 2023, 7.6 percent of adults surveyed in the United States stated they identify as lesbian, gay, bisexual, or transgender (LGBT). This is an increase from 2012, when 3.5 percent of surveyed adults identified as LGBT. These four categories are among the most common sexual orientations and gender identities outside cis-heterosexuals.

Differences across ages and genders 

Zooming in, it is possible to see how the share of people identifying as LGBT changed considerably according to different demographics. Only two percent of Baby Boomers, indeed, reported being part of the LGBT community. On the other hand, among Generation Z individuals, this share reached almost 16 percent. Moreover, surveys suggest that women were more likely to identify as LGBT than men.

An ever-understanding society 

The fact that an increasing amount of people feel free and safe to openly identify as LGBT might be a consequence of the improved acceptance of the different sexual orientations and genders by the American people at large. While in 2001 more than half of U.S. citizens considered homosexual relationships to be morally wrong, 20 years later this percentage dropped to 30 percent. Support for same-sex marriage has also been consistently increasing, even among traditionally conservative political groups. Despite this, it is important to remember that every year hundreds of people are still victims of hate crimes in the United States simply because of their gender or sexual orientation.

In 2022, around 85.5 percent of transgender people assigned female at birth had considered suicide, compared to 77.2 percent of transgender people assigned male at birth. Approximately 42.7 percent of transgender people assigned female at birth had attempted suicide, compared to 37.2 percent of transgender people assigned male at birth.

The HIV/AIDS epidemic in Central America remains concentrated among MARPs, primarily in and around networks of men who have sex with men (MSM). Throughout the region, the HIV prevalence among MSM is approximately 10% (UNAIDS 2009). Sexual transmission accounts for the vast majority of HIV infections in the region. Other populations with a notable burden of infection include transgender populations (Trans), male and female sex workers (SW) and their clients, and certain mobile and ethnic groups (e.g., migrants, uniformed services, individuals of Afro-Caribbean descent). Social stigma, however, has kept many of these epidemics hidden and unacknowledged (UNAIDS 2010). In 2010, PSI/PASMO, together with partners IPPF/WHR, Cicatelli Associates and Milk'an Cookies, was awarded a grant from USAID to implement the HIV Combination Prevention Program for MARPs in Central America and Mexico (2010-15) beginning on October 1, 2010. The program uses a combination prevention approach, which comprises a mixture of behavioral, structural and biomedical interventions and is based on scientifically-derived evidence and ownership of communities. The program's approach has been developed with guidance from the U.S. Government's Partnership Framewo rk Document to Support Implementation of the Central American Regional HIV/AIDS Response (March 2010) and embodies several key principles from that document, including using evidence-based approaches to decision making, prioritizing interventions targeting MARPs, involving MARPs more actively in programming, considering gender, increasing local capacity to mount an effective response, increase coordination among stakeholders and implementing agencies, and sharing best practices widely and actively (PSI/PASMO). Over the period 2010-15, the program seeks to achieve the following results: Result 1: Reduced prevalence of high-risk behaviors among MARPs and PLHIV. Result 2: Increased effective interventions implemented to decrease hostility in social environments that foment and tolerate homophobia and stigma and discrimination attitudes related to sexual orientation, occupation or status. Result 3: Increased access by MARPs to a minimum package of essential prevention and health services , that includes but is not limited to access to condoms, VCT services and STI diagnosis and treatment, emphasizing in the involvement of private health providers. Result 4: Strategic information obtained through the research and monitoring process, being used to design or modify prevention activities. As part of Results 2 and 3, the Program aims not only to increase access by MARPs to essential health services but also to ensure that these populations receive high-quality care, free of stigma and discrimination, beginning with private-sector facilities participating in the Program. In program monitoring and evaluation, including in the area of HIV/STI/AIDS health service provision, mystery clients have been used to identify and monitor areas for improvement (Center for Population Studies, Zimbabwe 2003; Family Health International 2007; Sarma and Oliveras 2011). Mystery clients provide a way to gather information about the service delivery process while minimizing bias that could result from potential modification of provider behavior when direct observation of patient-provider interaction is used (Pathfinder International 2006). In addition, this method allows program staff to capture the perspective and voice of the client, which is an important component of ensuring quality of care, particularly when serving vulnerable and hidden populations, whose perspectives are often unsolicited or unacknowledged. As such, beginning in the second year of the HIV Combination Prevention Program (2011-12), the Program team proposes to evaluate the quality of service provision at participating facilities on an annual basis employing mystery clients. Participating facilities include i) clinics of IPPF/WHR Member Associations in six countries in Central America (Belize, Costa Rica, El Salvador, Guatemala, Nicaragua and Panama) and ii) other private-sector facilities that offer VCT services (e.g., laboratories). The annual assessment will be used to identify areas for improvement in service provision to MARPs at each participating facility and the results will be used as a basis for discussion with and to make recommendations to facility managers and providers regarding potential changes.

In 2023, 8.5 percent of female respondents in the United States stated they identify as LGBT, while 4.7 percent of male respondents said the same. This is an increase from 2012, when 3.5 percent of female respondents and 3.4 percent of male respondents identified as LGBT.

A survey conducted in 2024 found that a plurality of Americans felt that transgender people face a lot of discrimination in the United States. American women were more likely than men to say that is the case.

Abstract In Central America, HIV/AIDS is remains concentrated among most-at-risk populations (MARPs), primarily in and around networks of men who have sex with men (MSM), transgender populations, male and female sex workers (SW), and certain mobile and ethnic groups (e.g., migrants, uniformed services, individuals of Afro-Caribbean descent). A USAID-funded HIV Combination Prevention Program for MARPs in Central America and Mexico is being implemented by PSI/PASMO, together with partners IPPF/WHR, Cicatelli Associates and Milk and Cookies in the period 2010-15, which aims to i) reduce prevalence of high-risk behaviors among MARPs and people living with HIV, ii) decrease homophobia, stigma and discrimination related to sexual orientation, occupation or HIV status, iii) increase access by MARPs to a minimum package of essential health services, and iv) use strategic information to design or modify prevention activities. As part of the Program, we plan to assess the quality of service provision to MARPs at health facilities participating in the program with the goal of ensuring that these populations receive high-quality care, free of stigma and discrimination. Our descriptive study will use mystery clients to collect data. Our findings will provide guidance to participating facilities on improving services to MARPs. Introduction and Rationale The HIV/AIDS epidemic in Central America remains concentrated among MARPs, primarily in and around networks of men who have sex with men (MSM). Throughout the region, the HIV prev alence among MSM is approximately 10% (UNAIDS 2009). Sexual transmission accounts for the vast majority of HIV infections in the region. Other populations with a notable burden of infection include transgender populations (Trans), male and female sex workers (SW) and their clients, and certain mobile and ethnic groups (e.g., migrants, uniformed services, individuals of Afro-Caribbean descent). Social stigma, however, has kept many of these epidemics hidden and unacknowledged (UNAIDS 2010). In 2010, PSI/PASMO, together with partners IPPF/WHR, Cicatelli Associates and Milk and Cookies, was awarded a grant from USAID to implement the HIV Combination Prevention Program for MARPs in Central America and Mexico (2010-15) beginning on October 1, 2010. The program uses a combination prevention approach, which comprises a mixture of behavioral, structural and biomedical interventions and is based on scientifically-derived evidence and ownership of communities. The program™s approach has been developed with guidance from the U.S. Government ™s œPartnership Framework Document to Support Implementation of the Central American Regional HIV/AIDS Response (March 2010) and embodies several key principles from that document, including using evidence-based approaches to decision making, prioritizing interventions targeting MARPs, involving MARPs more actively in programming, considering gender, increasing local capacity to mount an effective response, increase coordination among stakeholders and implementing agencies, and sharing best practices widely and actively (PSI/PASMO). Over the period 2010-15, the program seeks to achieve the following results: Result 1: Reduced prevalence of high-risk behaviors among MARPs and PLHIV. Result 2: Increased effective interventions implemented to decrease hostility in social environments that foment and tolerate homophobia and stigma and discrimination attitudes related to sexual orientation, occupation or status. Result 3: Increased access by MARPs to a minimum package of essential prevention and health services , that includes but is not limited to access to condoms, VCT services and STI diagnosis and treatment, emphasizing in the involvement of private health providers. Result 4: Strategic information obtained through the research and monitoring process, being used to design or modify prevention activities. As part of Results 2 and 3, the Program aims not only to increase access by MARPs to essential health services but also to ensure that these populations receive high-quality care, free of stigma and discrimination, beginning with private-sector facilities participating in the Program. Objectives The specific objectives of this evaluation are to: 1. Assess the quality of service provision to MARPs by private-sector health-service providers participating in the HIV Combination Prevention Program for MARPs funded by USAID in Central America (Belize, Costa Rica, El Salvador, Guatemala, Nicaragua and Panama). 2. Compare the quality of services provided to MARPs to the quality of services provided to the general population by private-sector health-service providers participating in the Program in the countries of interest. 3. Identify areas for improvement in service provision to MARPs at participating facilities and provide recommendations. Study Design This is a descriptive, mystery client study that will be conducted annually over the course...

As of September 30, 29 transgender and gender-diverse people were murdered in the United States in 2024. This is a slight decrease from the previous year, when 35 transgender and gender-diverse people were murdered.

In a global survey conducted in 2023, three percent of respondents from 30 countries identified themselves as transgender, non-binary/non-conforming/gender-fluid, or in another way. In Switzerland, around six percent of the respondents stated to identify themselves with one of the listed genders.

In 2021, around 14 percent of individuals living in the District of Columbia identified as LGBT. Colorado, Arizona, Nevada, and Oregon also had high rates, exceeding ten percent. Mississippi and North Dakota had the lowest rates of LGBT populations, the only states with less than five percent.

Since 1982, an astonishing 145 mass shootings have been carried out in the United States by male shooters. In contrast, only four mass shootings (defined by the source as a single attack in a public place in which four or more victims were killed) have been carried out by women. Gun ownership in the U.S. Possession of firearms in the United States is protected by the 2nd Amendment of the Constitution and has been a defining aspect of American civil liberties since the writing of the Bill of Rights. It is estimated that the United States has the highest rate of civilian-owned firearms in the world, and Americans continually poll against handgun restrictions. Mass shootings However, with high gun ownership comes high responsibility. The United States consistently faces numerous mass shootings each year, particularly in schools. The five deadliest mass shootings have all occurred since 2007, with the deadliest being the Las Vegas Strip massacre in 2017, which claimed the lives of 58 people and injured 546 more.

In 2022, about 72 percent of male-male couples in the United States were White, compared to 6.4 percent of gay couples who were Black or African American.

Gay marriage in the United States

In the mid-1990s, a majority of the U.S. population believed that same-sex couples should not be recognized by law, although this figure has been on the decline since then. In 2011, more than 50 percent of Americans believed the opposite, saying that homosexual couples should be recognized by law. 2015 saw a spike in support, and on June 26 of that year, the United States Supreme Court legalized same-sex marriage in all 50 states in the case of Obergefell v. Hodges.

Being LGBT in America

The share of Americans who identify as lesbian, gay, bisexual, or transgender (LGBT) has been on the rise since 2012 and it is estimated that there are about one million same-sex couples in the U.S. Additionally, about half of surveyed people in 2019 believe that one is born gay or lesbian – a significant increase from 1977, when only 13 percent of respondents said the same.

In a global survey conducted in 2023, three percent of respondents declared to be homosexual, gay, or lesbian. In Brazil and the Netherlands, for instance, nine percent, instead, identified as bisexual, representing the largest group of bisexual respondents among the 30 surveyed countries. Moreover, two percent of the interviewees in Switzerland said to be pansexual or omnisexual. Pansexuality describes people who feel attracted to other people regardless of their biological sex, gender, or gender identity, whereas omnisexuality refers to people attracted to people of all gender identities and sexual orientations.