The Human Rights Campaign Foundation has released its biennial 2026 Healthcare Equality Index (HEI), the longest-running national benchmark for LGBTQ+ inclusion in U.S. healthcare settings. Now in its 17th edition, the index evaluated nearly 2,300 healthcare facilities nationwide, of which 741 actively participated in the survey — including 49 new participants this cycle.

The results point to strong continued buy-in from participating facilities even amid political headwinds: 323 facilities (44%) earned the top “LGBTQ+ Healthcare Equality Leader” designation with a perfect score of 100, while another 343 (46%) achieved “High Performer” status. In total, close to 90% of all participating facilities earned one of HRC’s top two designations, and 53 facilities improved their designation from the previous survey cycle.

At the same time, HRC issued a nationwide advisory alongside this year’s index, warning that medically necessary healthcare for transgender people — commonly referred to as gender-affirming care — is under threat in much of the country. Some states now restrict or ban this care outright by law, while providers in states where it remains legal report facing federal investigations, subpoenas, and funding pressure. HRC Foundation President Kelley Robinson described the current state of LGBTQ+ healthcare access as marked by both meaningful progress and serious setbacks, a framing echoed across the report. The HEI scores facilities across categories including non-discrimination policy and staff training, patient services, employee benefits, and community engagement, and HRC continues to recommend that patients confirm current service availability directly with providers, since access can change quickly.