The rate of individuals receiving gender-affirming care - care received by a person whose assigned sex at birth doesn't match their gender identity - has risen more than 300% from 2016 to 2021, according to new analysis by the Center for Improving Value in Health Care.

Dr. Liz Kvach - medical director of LGBTQ+ Health Services with Denver Health - said steps that anyone can take to support a person's gender identity, including using their preferred pronouns "she," "him" or "they," can make a big difference, especially for young people.

"There's a lot of data that actually helps improve resiliency and improve mental-health outcomes," said Kvach, "including reduction of depression and anxiety and suicidality, if youth are supported. Especially by parents and schools and other social support networks that they have around them."

A 2011 study found that 41% of transgender adults had attempted suicide, but Kvach said when people have access to gender-affirming care, suicide attempts drop significantly.

Last year Colorado became the first state to require comprehensive gender-affirming care as part of minimum, or "benchmark," health-care plans sold on the individual and small-group markets, which accounts for about a quarter of the state's insured population.

Commercial plans are not required to comply until 2023.

The number of gender-affirming care services for teens and young adults covered by Medicaid has increased nearly 11 fold since 2016, but it's estimated that just 20% of transgender, gender diverse and non-binary youths access care through health insurance.

Kvach said the lack of gender-affirming training at medical schools for health-care providers, and training for support staff, continues to be a major barrier to accessing care.

"Up to a quarter or more people have experienced discrimination or negative treatment in a health-care setting," said Kvach. "And that number is probably actually much higher, and will often cause people to not want to seek out care."

Having a positive experience also makes it more likely people will come back for their preventive health-care needs.

Kvach has treated hundreds of people at Denver Health's LGBTQ+ Health Services. She said it's hard to count the number of patients who have told her that gender-affirming care has been life-saving for them.

Legislation to close a loophole that potentially allows discrimination against LGBTQ New Mexicans will be debated by the State Legislature this session.

House Bill 207 would prohibit public entities and contractors from discriminating on the basis of sex, sexual orientation or gender identity when providing services.

Marshall Martinez, executive director of Equality New Mexico, said the state has one of the oldest and strongest nondiscrimination laws in the country, but specific language referencing the LGBTQ community is missing.

"Legally, state departments and agencies, city and county governments and even school districts can legally discriminate in New Mexican law," Martinez explained.

During the bill's introduction, co-sponsor, Rep. Kristina Ortez, D-Taos, said it is critical to explicitly protect LGBTQ youth at a time when attacks against them are occurring across the country. Two similar bills have failed, but Martinez is hopeful the third attempt will succeed before the legislature adjourns in March.

The New Mexico bill to expand LGBTQ legal protections is in contrast to proposed laws in neighboring states such as Texas and Arizona, where lawmakers have proposed bills to restrict rights.

Martinez argued the absence of protections for transgender students and others leaves them vulnerable if agencies do not adhere to the spirit of the Human Rights Act.

"Children, Youth and Services could say for example, if they're investigating parents for child abuse, they could say, 'Oh, and by the way the parents are lesbians,' and you couldn't file a lawsuit against them in state law for discrimination because that's not prohibited," Martinez outlined.

Equality New Mexico is also supporting legislation to give 16-year-olds the right to vote in state, local, and school board elections.

An Arizona LGBTQ+ group has established a partnership with Waymo, the autonomous-driving tech company, to provide what it said will be a safer transportation option.

Angela Hughey, president of the group One Community, said through the partnership, Waymo is providing what she described as "acceptability through innovation."

Hughey explained a person never truly knows what experience awaits them when they hail a traditional ride-share service, and it comes with a sense of vulnerability. She stressed Waymo and One Community have gone the extra mile to eliminate the worry.

"What I really think is so cool about Waymo and the innovation of autonomous driving, is that Waymo doesn't discriminate, right?" Hughey pointed out. "It is about providing safety and an assuredness to every passenger that gets into the car."

Hughey called it a valuable and necessary innovation. A Gender Policy Report from the University of Minnesota found one in four members of the LGBTQ+ community is concerned about safety on public transportation. Waymo currently provides service in the metro Phoenix area, downtown Phoenix and Sky Harbor International Airport.

Hughey added Waymo is just one of 3,500 businesses to have signed One Community's Unity Pledge, which turns 10 years old next month. It is a pledge to advance workplace equality, equal treatment in housing and public accommodations for LGBTQ+ individuals and their allies.

"One of the first things that Waymo did when we started our partnership, is that they signed the Unity Pledge," Hughey noted. "So, that was actionable. They are absolutely supportive of LGBTQ inclusivity in this great state and nation, and taking the United Pledge was very demonstrative on their part."

Hughey added feeling safe and welcome in ride-sharing services is something which should matter to all Arizonans.

Two Republican Arizona state senators have kicked off the new legislative session wanting to limit and restrict drag shows.

State Sen. Anthony Kern, R-Glendale, filed two separate bills: one banning drag shows during certain hours - targeted primarily at eliminating drag brunches - and the other would prohibit drag performances from occurring on public property or any location where a minor could see the show.

State Sen. John Kavanagh's - R-Fountain Hills - bill bans the use of state funds for drag shows targeting minors.

Staff Attorney with Lambda Legal Kell Olson said drag performances are important because they communicate a message of diversity, inclusivity and celebration.

"They show people they are not alone," said Olson. "There are very important purposes for drag shows. These laws do not do what legislators should be doing if they really are concerned about certain content that is inappropriate, they should be focused on that."

For Olson, these bills are what he calls "the latest chapter in a series of laws attempting to shame and demonize LGBTQ-plus people."

Olson said he does expect pushback, but the bills may advance as Republicans hold majorities in the Arizona Senate and House. However, newly elected Democratic Gov. Katie Hobbs would be likely to veto the bills.

The senate sponsors have said drag shows' sexually explicit nature is concerning, especially for minors.

Olson said one of the biggest issues he sees with the bills is the aim to define what drag is.

He said the broad definitions present in the legislation could target many transgender and non-conforming individuals executing a performance of any type which he says presents a practical problem.

Olson said legal complications could also follow since the laws seek to suppress ideals of the First Amendment and free expression.

"The fact that these laws have a lot of problems that they trigger because they seek to suppress people's performance and expression based on a particular viewpoint," said Olson. "That is the kind of thing our Constitution doesn't stand for."

Olson said Kavanagh's bill not only targets state funds for the use of drag shows, but also targets funding for any entity that has or operates a drag show.

He said this means a possible youth center that allows drag performances, but receives state funding, could also be cut off.