Abstract
The recent surge in anti-LGBTQ+ legislation across the United States has far-reaching consequences that extend beyond civil rights, posing a significant but underrecognized threat to public mental health-particularly for LGBTQ+ individuals living with or at risk for HIV. This article explores how such legislation operates as a form of structural trauma, exacerbating minority stress, anticipatory grief, and psychological distress among clients in HIV care. Drawing on clinical experience, trauma-informed practice, and existing literature, it demonstrates how discriminatory policies compromise mental health, disrupt care engagement, and deepen medical mistrust. Through composite case vignettes and evidence-based analysis, the article highlights the role of the mental health clinician as both a therapeutic and systemic advocate. It concludes with urgent recommendations for culturally competent care, trauma-informed public health systems, and policy advocacy to resist harm and promote resilience among LGBTQ+ populations. Ultimately, the piece calls for a unified public health response that affirms identity, fosters healing, and safeguards the dignity and well-being of marginalized communities.