Rising Negative Sentiment on Gender-Affirming Care in America

Using social intelligence to examine the diverging narratives on gender-affirming care

Since June is Pride month, we decided to address a crucial concern affecting the transgender community today – the increasing barriers to gender-affirming care.

According to the World Health Organization, gender-affirming care covers the range of social, psychological, medical, and behavioral treatments and support designed to affirm an individual's gender identity when it conflicts with the gender they were assigned at birth. In this discussion, we will examine how sentiment towards gender-affirming care has changed over the past decade, who's participating in this conversation, and why people feel the way they do. Ten years ago, gender-affirming care received little attention. While they certainly existed, people identifying as transgender didn't occupy much space within our national consciousness. However, in the past year, we have witnessed an astounding growth of 223,935% in discussions related to this type of medical care.

Let's look at the reasons behind the spike in volume and negative sentiment in the conversation.

Figure 1: Post volume of posts mentioning "gender-affirming care" (June 2013 - Present); Infegy Atlas data.

Rising negativity against trans people in America

The backlash against gender-affirming care in America didn't occur in a vacuum or overnight. Over the last few years, people identifying as transgender have become the latest victim of the American culture wars. The New York Times tracked and reported how this was a planned effort by conservative activists to mobilize voters after same-sex marriage was legalized in 2015. Social listening data revealed an unprecedented surge in negativity around transgender topics after 2015. Going back to 2007, we saw that negative social media posts around transgender issues had risen 839%, with the majority of the increase occurring from 2020 through the present.

Figure 2: Positive, negative, and neutral documents mentioning "transgender" (Jan. 1, 2007 - Present); Infegy Atlas data.

Rising Anger metrics within the discussion

In the earlier years of the decade, the perception surrounding gender-affirming care was generally positive. We observed that Love was mentioned in over 28% of the posts, while Trust appeared in about 29%. Even as the volume of posts increased over time, Love and Trust consistently remained the top two emotions associated with gender-affirming care discussions until 2022.

However, in 2022, Infegy Atlas recorded a significant 540% surge in the presence of Anger within these discussions. In 2023, Anger has become 311% more likely to appear in posts discussing gender-affirming care than Love, which used to be the dominant emotion in such conversations.

Figure 3: Sentimental subject sentences for "gender-affirming care" (June 2013 - Present); Infegy Atlas data.

Showing how very different communities reacted

We wanted to understand who was behind these waves of Trust and Love and who or what pushed the tide of Anger that occurred more recently. We discovered that two distinct groups were driving these different emotions. To identify these groups, we examined the source bios of various accounts, looking for self-appointed indications of conservative and LGBTQ+ identities. Our clustering algorithm categorized LGBTQ+ identifying individuals or allies in brown and conservative-aligning individuals in teal (Figure 4).

We found that earlier in the decade, LGBTQ+ individuals made up a more significant portion of the positive conversation. However, over the past year, conservative voices have grown louder and have overshadowed the positive discussions surrounding gender-affirming care.

Figure 4: Source bio word for people discussing gender-affirming care (June 2013 through June 2023); Infegy Atlas data.

Examining hashtags around the backlash

Finally, we looked at hashtags to gauge the impact of this growing hostility. We focused on more recent hashtags and discovered a cluster of hashtags related to state legislatures, specifically Missouri, Nebraska, Texas, and Colorado. These states have recently passed bills that either support or restrict gender-affirming care.

In the sentiment-colored hashtag word cloud, we observed that the hashtags associated with states that banned gender-affirming care displayed a negative sentiment. On the other hand, the hashtags linked to states that expanded gender-affirming care showed a strong positive sentiment. This suggests a direct correlation between state actions and the feelings expressed through hashtags. This indicates that the USA is as polarized on this issue as ever.

Figure 5: Hashtags for people discussing gender-affirming care (January 2023 through June 2023); Infegy Atlas data.

Takeaways around gender-affirming care

As our data shows, conversations on gender-affirming care have grown increasingly hostile and polarized over the last few years. Data also shows how this shift has been perpetuated not by social or medical concerns but by conservative political agendas. Sadly, the impact has real consequences on the lives and mental health of trans people. Infegy social listening on suicide prevention highlights how suicide has become an epidemic amongst two significant communities – veterans and LGBTQ+ people.

Figure 6: Linked hashtags showing how LGBTQ+ and Veterans are frequently linked to discussions around suicide online (January 2022 through September 2022); Infegy Atlas data.

Fostering inclusive and accepting communities will go a long way to alleviating the growing epidemic of suicide amongst LGBTQ+ youth. Pride Month 2023 may be a good time to commit to resisting harmful polarization within our community and actively support gender-affirming care.

Key Insights on Gender-Affirming Care Discussions

Explore the dramatic rise in conversations surrounding gender-affirming care, noting a 223,935% increase over the past decade.

Anger vs. Love: Emotional Shifts in Dialogue

Observe a crucial shift in emotions from Love and Trust to Anger in 2022, as negative sentiment grows 540%.

Communities Driving the Conversation

Identify the diverging voices: LGBTQ+ positive discourse overshadowed by rising conservative influence.

State Legislation and Sentiment

Notice how state-led initiatives on gender-affirming care create polarized sentiment; supportive states show positive sentiments.

Political Agendas and Real-Life Impact

Understand that political agendas fuel hostile narratives, affecting the mental health of trans individuals.

Call for Inclusivity and Suicide Prevention

Highlight the link between LGBTQ+ voices and suicide prevention, advocating for inclusive community efforts.