Taxpayers Spent at Least $1.4 Billion on LGBTQ and Gender-Identity Programs, and Likely $3.3 Billion
Between FY2016 and FY2026, federal and state governments spent at least $1.41 billion of taxpayer money on programs, grants, contracts and medical claims aimed specifically at LGBTQ and gender-identity causes. That is only the money with a paper trail. Once you count the spending governments never published, never itemized, or buried inside broad "equity" budgets, the total is most likely around $3.3 billion, within a range of $2.0 billion to $4.9 billion.
Every documented dollar in this article links to a source. Every estimate is labeled as an estimate and explained. The full 12-page report, with a line-by-line state table and 158 sources, is here: Taxpayer Spending on LGBTQ and Gender-Identity Programs in the United States, FY2016–FY2026 (PDF).
The federal government: $1.05 billion documented, peaking in 2023
Washington is the largest single payer. Federal awards whose titles or recipients are specifically LGBTQ, together with dedicated programs, came to $1.05 billion from FY2016 to FY2026. That counts only what we could prove.
- NIH research grants: $613 million, not counting another $351 million in HIV studies limited by title to men who have sex with men. NIH's own office counted far more "sexual and gender minority" research, then stopped publishing the number and deleted the category in March 2025.
- Other domestic grants and contracts: $195 million, from SAMHSA, CDC, the Justice Department, HUD, HRSA and others. Examples include a $1.5 million federal prison contract for a "transgender programming curriculum."
- Foreign programs: $113 million, through the State Department's Global Equality Fund and USAID. U.S. taxpayers funded LGBTQ advocacy overseas while American schools cut staff.
- The 988 suicide line's "Press 3" LGBTQ youth option: $62.7 million in FY2023 and FY2024 alone.
- Military gender-transition care: $52.1 million for about 4,240 service members from 2015 to 2024.
- PEPFAR money tagged for transgender people: $15 million, plus $1.65 million for federal prison hormones and surgery.
Documented federal spending was $71 million in FY2016. It peaked at $258 million in FY2023, more than three and a half times higher, before the 2025 grant terminations brought it down.
On top of that, $3.41 billion in federal grants listed LGBTQ people as one of several target groups. We did not count those in full. Only a stated share appears in the estimates.
The states: Medicaid leads the bill
State governments add at least $354 million in documented spending. The biggest driver is Medicaid paying for gender-transition drugs and surgery:
- Illinois: $40.8 million (2018 to September 2023), including $14.3 million for patients 17 and under
- Oregon: $30.0 million (2018 to 2022)
- Washington: $27.1 million (2018 to September 2023), including $5.8 million for minors
- Virginia: $13.9 million (2020 to 2022)
- Maryland: $11.8 million, and Nevada: $10.1 million
California is the largest state spender in our records at $95.8 million. That includes a dedicated "Transgender Wellness and Equity Fund," $10 million for LGBTQ community centers, $13.4 million a year to cover state-mandated benefits through Covered California, $10 million for gender-transition care for children and youth in the 2026 budget, and more than $4 million in prison sex-change procedures for 157 inmates. New York follows with over $15 million through its Lorena Borjas transgender fund and $12.3 million in LGBT health contracts. Colorado requested $8 million in a single year for transgender prison housing and surgery. Washington set aside $7.8 million for the same purpose.
What governments don't publish
About 20 states pay for gender-transition procedures through Medicaid and have never released what it costs, including New York, New Jersey, Pennsylvania, Massachusetts, Minnesota, Connecticut and California for adults. Prison costs, state employee health plans, federal employee health plans, Medicare and the VA are largely undisclosed too. City and school-district spending isn't tracked nationally at all.
To estimate these gaps, we used each state's own records where they exist. The nine states that released Medicaid totals paid a median of $0.54 per resident per year. We applied that rate, along with a low and a high version, to states that cover the same services but keep the numbers private. The same approach was used for prisons and employee plans, using the costs that California, Washington, Colorado, New Jersey and North Carolina did publish. The report explains every assumption.
| Low | Middle | High | |
|---|---|---|---|
| Documented (sourced) | $1.41B | $1.41B | $1.41B |
| Estimated undisclosed and hidden spending | $0.60B | $1.88B | $3.50B |
| Total, FY2016–FY2026 | $2.0B | $3.3B | $4.9B |
What this is not
These totals leave out HIV treatment and prevention programs (roughly $1.9 billion a year serves mostly gay and bisexual men), because those are disease programs, not identity programs. They also leave out about $1.9 billion in private foundation grants from 2016 to 2024, because that is not taxpayer money. Including either would make the numbers much larger.
Why it matters
While states and Washington built permanent funding lines for gender-identity programs, school districts were cutting teachers. In Eugene alone, the 4J district eliminated 265 positions and issued 177 layoff notices (our earlier report). Billions went to identity programs over the same decade. Taxpayers are entitled to know what their money bought, and most governments still won't tell them.
Sources
The full source list (158 links), every state line item, and the federal year-by-year tables are in the PDF report. Key sources:
- USAspending.gov federal award data
- NIH RePORTER research grant data
- State Department PEPFAR key-population report
- Daily Caller News Foundation state Medicaid records
- Oregon Health Authority records response
- California Legislative Analyst's Office report 5210
- AP on military gender-transition costs
- SAMHSA statement on 988 "Press 3"
- Capital Research Center federal grant review
- Funders for LGBTQ Issues 2024 tracking report
- Oregon 10-year spending report
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