I was driving southbound on I-25 recently, on my way to present at a conference about creating inclusive assisted living communities. Three of every four older LGBTQ adults feel like they need to go back in the closet when they enter these communities, just to stay safe.

As I slowed to exit the freeway, a stainless-steel semitrailer truck with a bright red cab passed on my left. On the back of the truck was a large red sign that said, “VOTE Heidi” (referencing Heidi Ganahl, who’s running for governor). 

That sign brought me back to an event that happened a few months ago, here in Colorado. A group of people, including Heidi Ganahl, gathered to support limiting the participation of transgender people in public life. At the event, Heidi shared a story about a dorm room assignment at the University of Colorado between her friend’s daughter and a student who identified as transgender. Heidi, a university regent, contravened campus policy by intervening so that her friend’s daughter got a new roommate. They hadn’t even met yet.

You might take for granted that you can be who you are and love who you want to. But, for members of the LGBTQ community, doing so is a highly risky and consequential decision. 

Last year, Lisa was denied admission by dozens of long-term care communities in Colorado because she is transgender. Leonard, who’s been out for 4 years, told me he didn’t come out sooner because he was afraid he’d be shunned by his peers in his community. He’s 84. When Esther’s wife of 30+ years was sick in the hospital, they hid their relationship because the care got worse when staff realized they were a couple. No one offered Esther grief support or acknowledged her loss when her wife died – she was just the “good friend,” the “emergency contact,” not a grieving spouse who had just lost the love of her life. 

The fear of rejection and mistreatment is valid: according to the American Heart Association, 56% of LGBTQ adults in 2021 experienced discrimination from a healthcare professional. Seventy percent of trans or gender non-conforming adults did so.

End-of-life care is compromised as well. A 2020 survey of 850+ hospice and palliative care professionals revealed that 24% of staff had directly observed discriminatory behaviors towards LGBQ patients, and 21% observed discriminatory behaviors towards transgender patients. Behaviors like eye-rolling when couples were holding hands, not involving the patient’s partner in care conversations, and blatant disregard for patient wishes. 

Can you imagine being treated this way when your loved one was a patient? Or being treated this way yourself?

When I saw that “VOTE Heidi” sign, I saw the faces of the Esthers, the Lisas, the Leonards, and all the students judged for who they are by people who haven’t even met them.

The semitrailer truck had a soul for a split second.

On Oct. 14,  the Washington Post reported that more legislation has been filed to restrict the lives of trans people in 2022 than at any other point in history: 155 bills in 2022. I had to read the number and say it out loud a few times – one hundred and fifty-five. In just the first 10 months of this year, lawmakers have come together 155 times with the common goal of making it even harder for people, especially trans youth, to be who they are. 

I met Renn, (whose name is a pseudonym to protect their privacy), a few months ago. We ate dinner and had chocolate ice cream with Palisade peaches on top for dessert. Renn is 17. It was impossible to not fall in love with their spirit. They’re like a heart with two legs.

They told me they’ve wanted to take their own life and that it had been getting worse recently.  They showed me signs of fresh cuts on the inside of their forearms, over old scars. It was an external sign of how hard it really is on the inside to live in a world that judges you.

“What’s the hardest thing for you right now?” I asked Renn.

“I don’t have much to live for,” they told me sitting at my kitchen counter.

When we hugged like two octopuses would, they said, “You’re a safe person. I don’t have a lot of safe people in my life right now.” I handed Renn a key to my house that they added to the chain they wear around their neck.


Renn speaks 3 languages. They can tell you the most elaborate history of almost anything you ask – lightbulbs, dinosaurs, Neil Armstrong. They’re beautiful. Funny. They make a killer mustard salad dressing. Renn has supportive and loving parents.

But every single day Renn — and kids just like them — wake up to an army of 155+ strangers whispering, or driving by in semis, that there is something wrong with them. Insisting that their life doesn’t matter.

Before bed, I pulled out Andrea Gibson’s book and then listened to them read their poem about queer youth. In it, they say, “queer youth are five times more likely to die by suicide.”

I ask you: who on earth can survive the kind of culture that makes people — especially kids — feel like it’s easier to take their own life than to be themselves?

I wonder if the lawmakers who introduced these 155 bills will look back on their life and say, “Damn – I lived a really good life: I spent it trying to limit the participation of some of the most vulnerable and magnificent members of our community.”

I hope not.

These same kids — just like their LGBTQ elders — are 155 times more likely in need of a look, a hug, a signal from a stranger saying: “I see you. You’re safe with me, you’re welcome here, you’re loved, I got you.” 

Now, that’d make a helluva sign for the back of a semitrailer truck.  

Carey Candrian, of Boulder, is an associate professor in the Division of General Internal Medicine at the University of Colorado School of Medicine. She has spent much of her career investigating how health care suffers when patients aren’t able to be open with medical professionals about who and what matters most to them. The views expressed in the column are hers, not those of the university.

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Carey Candrian, of Boulder, is an associate professor in the Division of General Internal Medicine at the University of Colorado School of Medicine. She has spent much of her career investigating how health care suffers when patients aren’t...