In previous years, Pride Month was met with visible support from corporations, institutions and communities. Rainbow logos and corporate sponsorships have typically been commonplace. However, in 2025, nearly 40% of corporations in the USA have scaled back or entirely withdrawn their Pride sponsorships or engagements, including major, longstanding urban events. This shift has raised concerns among advocates, who fear it signals a retreat from public allyship at a time when it is most needed.

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Credit: A-Digit/ DigitalVision Vectors / Getty, and Marina Spence

Pride celebration themes clearly reflect the underlying reality. For example, San Francisco’s 2025 Pride Month theme, ‘Queer Joy is Resistance’, stands in sharp contrast to the climate of growing polarization and anti-LGBT+ sentiment. It calls for unity and resilience amid a year marked by legislative rollbacks and social regressions.

Within the LGBT+ community, the spotlight has intensified on transgender individuals, who have been subjected to pointed scrutiny from governments and oppositional social and cultural factions around the world. Transgender individuals are facing growing political hostility, diminished protections and increasing social stigma, which makes it more important than ever to emphasize mental health care, human rights and community support.

In the USA, the situation for LGBT+ people has been nothing short of shocking. Federal efforts to remove or to restrict the term ‘gender’ have prompted the cancellation of research grants and funding for understudied populations and have led to the redaction and removal of official and historical documents, reports and web pages. Efforts to eliminate the recognition of transgender identities in favor of binary biological sex categories or sex at birth have created profound implications for transgender individuals, such as the reissue of discordant identity documents that can affect employment and the ability to freely travel. These actions, which target transgender, gender-nonconforming and non-binary people, many of whom already face discrimination in education, housing, public facilities and healthcare, undermine previous gains in civil rights and deepen social exclusion.

But across the globe, LGBT+ individuals are facing mounting challenges, from subtle marginalization to overt criminalization. In Hungary, the government passed a constitutional amendment in March 2025 that bans public gatherings advocating for LGBT+ rights. Across Africa, several countries, including Uganda, Ghana, Malawi, Zambia and Kenya, have witnessed troubling developments that threaten to strip LGBT+ people of legal recognition and safety.

The UK, which has in recent history been considered one of the most progressive countries for LGBT+ support and protections, has also seen a rise in anti-trans rhetoric and erosion of legal and social protections. The UK’s Supreme Court recently ruled that the legal definition of a woman must be based on biological sex, effectively excluding many transgender women from protections and rights. These shifts in policy are not isolated — they are symptomatic of a larger backlash that seeks to delegitimize transgender existence altogether. But they also call into question the role that the medical and mental health establishments can and should have in guiding discourse and evidence-based policymaking.

The mental health implications of policies such as the UK’s Supreme Court ruling or the anonymously authored US Department of Health and Human Services report on medical intervention for gender-affirming care for children and adolescents are profound. Ketil Slagstad, physician–historian of transgender medicine and research fellow at the Institute of the History of Medicine and Ethics in Medicine at Charité Berlin, emphasizes the historical complicity of the medical profession in pathologizing trans identities: “Throughout the twentieth century, psychiatrists and physicians developed diagnostic concepts that pathologized trans people….We now have an opportunity to reflect and reform.”

Federal policies have both psychosocial impacts and physical impacts. The psychological toll includes the potential for increased anxiety, chronic stress and depression. Alarmingly, passage of anti-transgender legislation contributes to large increases in suicide attempts among transgender and non-binary youth. The implications for physical health are also severe. For example, bathroom-ban legislation has created unsafe conditions for individuals with chronic gastrointestinal issues, who may avoid using restrooms altogether, owing to fear of harassment and the risk of violence.

Social stigma has also intensified, driven in part by online misinformation, divisive rhetoric and the rise in ‘gender critical’ ideologies, formerly associated with trans-exclusionary radical feminism. These perspectives often disregard scientific evidence and research that supports the importance of inclusive, gender-affirming care. Such polarization not only contributes to mental health disparities but also obstructs meaningful dialogue. It erodes public understanding and empathy, turning issues of identity into battlegrounds rather than matters of dignity and human rights.

Clinicians, researchers and educators have a responsibility to counteract this trend. As Slagstad notes, there is historical precedent for physicians to act as allies by listening to the needs of trans communities and using their knowledge to provide inclusive and compassionate care: “A patient-centered approach, grounded in collaboration and acknowledgment of past harms, is vital.” Understanding transgender identity as a legitimate and personal form of gender expression is fundamental to dismantling stigma and improving health outcomes. Emphasizing patient-centered approaches is not only good clinical practice but also an ethical imperative.

In line with our tradition of highlighting LGBT-related content during Pride Month, Nature Mental Health presents a range of features in our June 2025 issue. In a new Article, Li et al. investigate the associations among sociodemographic factors, gender-affirming treatment intentions (for example, surgery or hormone therapy) and mental health conditions, such as gender dysphoria, self-harm, depression and suicidality, in more than 7,500 young transgender people in China. The findings show distinct treatment intentions by mental health symptom profiles, underscoring the need for personalized clinical approaches in gender care.

A Q&A with John Pachankis, clinical psychologist and director of Yale’s LGBTQ Mental Health Initiative, discusses some of their group’s work and the value of community-driven care and peer-based interventions. “LGBT+ people have a reputation for doing remarkable things against huge odds,” he says, stressing the resilience and innovation that define the community even in the face of adversity. The implementation of culturally competent and evidence-based care in community settings is a quintessential example of successful bridging between mental healthcare practitioners, researchers and members of the LGBT+ community.

In support of continued exploration in this area, we are proud to announce the launch of a new Nature Mental Health LGBT+ Mental Health Collection. This curated set of primary research, reviews and opinion pieces aims to amplify under-represented voices and populations, helping to foster more-equitable and evidence-based approaches to care.

With Pride Month now underway, it is crucial to uplift marginalized voices and to join the call for protecting the rights and safeguarding the mental health of all members of the LGBT+ community. Pride is more than a celebration; it is an opportunity to fortify and cultivate community and to improve and protect mental health.