While "LGBTQ+" is a political alliance, there has historically been transphobia within gay/lesbian spaces (e.g., lesbian separatists excluding trans women; "LGB without the T" movements). Most mainstream LGBTQ+ organizations now strongly affirm trans rights.

The next decade will determine whether the "T" in LGBTQ remains a faction or becomes fully integrated. Three trends point toward integration:

Unlike sexual orientation, which requires no medical validation, being trans often (though not always) involves navigating healthcare systems for hormone replacement therapy (HRT) or surgeries. The struggle for insurance coverage, the long waitlists for gender-affirming care, and the pathologization of trans identity (the historical diagnosis of "Gender Identity Disorder") create a unique form of trauma. LGBTQ culture has responded by creating mutual aid funds for top surgery and community-led mental health support.

Understanding the Transgender Community and LGBTQ+ Culture: Inclusion, Challenges, and Evolution

To be a member of LGBTQ culture today is to take a side. Silence on trans issues is complicity with transphobia. For cisgender LGB people, the call is to remember history: Marsha and Sylvia did not throw bricks at Stonewall so that you could celebrate your wedding and then vote against trans health care.

Transgender people, particularly trans women of color, experience disproportionately high rates of violence and discrimination.