A CNBC report on the ten worst states for quality of life found every single one is deep-red and anti-trans. Vermont, the most LGBTQ-inclusive state, has ranked first for six straight years. The data makes a blunt point: when you build policy around persecuting a minority, you are not protecting everyone else, you are just failing them more slowly.

What the CNBC data actually shows

CNBC's quality-of-life rankings are not a progressive wish list. They measure things like healthcare access, air quality, childcare affordability, workers' rights, minimum wage, and firearm mortality. These are practical, material facts about what it costs to live somewhere and how well a state looks after its people. And every single state in the bottom ten is Republican-controlled, with sweeping anti-trans legislation on the books.

Fox News called it a "woke" hit job. But the report doesn't score states on their Pride flags; it scores them on whether their residents can breathe clean air, find affordable childcare, and earn a living wage. Arkansas, at number ten, has widespread food insecurity and fourteen anti-trans bills targeting both trans adults and the professionals who care for trans youth. Tennessee, the very worst, bans transition care for minors, excludes Medicare from covering gender-affirming care for adults, has bathroom bans, and a high rate of drug deaths. Its governor marked June as "Nuclear Family Month." That tells you something about where his priorities lie, and it isn't with the health of his constituents.

State by state, the same pattern

Oklahoma has passed sixty anti-trans pieces of legislation since 2024, still pays its workers $7.25 an hour, and this year passed a bill permitting state entities including schools to ban Pride flags. Utah keeps the same $7.25 minimum wage, has poor air quality, lacks childcare support, and passed legislation allowing landlords to discriminate against trans people in housing, alongside protections for health professionals who refuse to treat patients on religious grounds. Georgia enforces the "Riley Gaines Act," requiring separate changing facilities based on "biological sex," bars trans women from girls' sports, and has made it illegal for minors to access trans care. Louisiana has gutted the Voting Rights Act, holds the second-highest firearm mortality rate in the country, and offers no workplace protection if a colleague misgenders you. Indiana still places trans women in men's prisons based on the sex marker on a birth certificate.

Texas is listed as a strict no-travel state on Erin Reed's anti-trans legislative map. Greg Abbott's attack on trans people started in 2022 and has continued: a 2024 law could out a trans person simply for showing their driving licence, and Abbott has publicly declared that Texas recognises only two sexes. Even cisgender Texans are struggling to access healthcare in a state that ranks among the least healthy in the nation.

Missouri bans DEI spending, has effectively unchecked gun access, and was assessed by the FBI as one of the most violent states in the country. Alabama ignores the existence of trans people, intersex people, and even cisgender people with differences in sex development, offers almost no worker or disability protections, has poor mental health outcomes, and has too few professionals to address them.

Vermont has led for six years straight

While all of this was happening, Vermont sat at the top of the list for the sixth consecutive year. Vermont is not a wealthy state by conventional measures. It is small, cold, and rural. What it has consistently offered its residents is inclusion, investment in public life, and a refusal to make its most vulnerable people the target of political sport. The correlation is not subtle.

I find myself thinking about this a lot. When I hear people argue that anti-trans legislation is simply a matter of political opinion, or that it only affects a small number of people, I want to point them at this data. It isn't just trans people paying the price. It is everyone who lives in a state whose lawmakers have decided that persecution is a more useful tool than governance.

The harm is structural, not accidental

What this report makes visible is something I have been saying for years: the harm of anti-trans policy is not a side effect. It is a structural choice. When a legislature decides that keeping trans people out of bathrooms, off sports teams, and away from healthcare is the priority, it has already made a decision about whose welfare counts. And that decision does not stay contained. Workers lose protections. Wages stagnate. Healthcare becomes inaccessible. Air quality suffers. Children go without childcare. Drug deaths climb. The same political culture that licenses cruelty toward one group turns out to be rather relaxed about cruelty in general.

The Queerty piece ends with a simple observation: when you ignore the needs of one marginalised group, everyone else considered a second-class citizen suffers too. That is exactly right, and the data backs it up. Trans people experience the sharpest, most direct harm because they are the stated target. But the communities around them are not insulated from the consequences of being governed by people who have decided that some lives matter less.

What this means for trans people living in these states

If you are trans and living in any of these states, you already know the weight of this. You have probably felt it every time you needed to see a doctor, every time you looked at your pay cheque, every time a new bill passed. The data is not news to you. What I hope it does is confirm something you may already feel: this is not your failure, it is not a reflection of your worth, and it is not inevitable. These are political choices, and political choices can be changed.

The families I hear from in places like Tennessee and Texas are not statistics. They are parents who moved across state lines to keep their children safe, young people who are counting the years until they can leave, adults managing complex healthcare needs with shrinking options. They deserve better, and this report is one more piece of evidence that they are being failed on purpose.

If there is a news story you would like me to cover then just let Sammy know.

Dr Helen Webberley is a gender specialist, medical educator, and founder of GenderGP. She writes about gender diversity, trans healthcare, and the lives of trans people and their families.