The National Institutes of Health (NIH) is the world’s largest public funder of biomedical research, and for years its spending on transgender health has been at the centre of public debate. A cross-sectional study published in JAMA Network Open now puts figures on that investment: between 2012 and 2024 the agency issued 97 awards and 42 supplements, totalling $158.3 million (in 2024 dollars), for research about the health of transgender and nonbinary youths under 18. That amount represents 0.06% of the NIH’s entire grant portfolio.
How it was done
The authors, from the Department of Family Medicine and Community Health at the University of Minnesota, searched the public RePORTER grant database and included only projects whose abstracts focused explicitly on the health of transgender and nonbinary youths. They then coded those abstracts systematically to classify health topics and the population subgroups addressed. No participants were involved: it is an analysis of administrative documents, not of clinical outcomes.
What has been funded
- Mental health: $78.0 million (49.3% of the identified investment), with a clear rise from 2021 onwards.
- HIV and AIDS: $68.8 million (43.5%).
- Gender-affirming medical care, including hormone therapy and puberty blockers: $38.3 million (24.2%), with moderate growth over the period.
The percentages overlap, because a single award can address several topics at once. Overall, spending grew year after year, but it was concentrated among institutions in states with currently protective policies on access to gender-affirming medical care.
Measuring the gap
The authors themselves estimate the scale of the distance: for investment in the health of transgender and nonbinary youths to be proportional to the size of that population, the NIH would need to multiply it by 3.5 to 9.8. And some subgroups barely appear: nonbinary youths and racially and ethnically minoritized youths receive minimal funding within a budget that is already small. The authors frame this as a reflection of historical underfunding and structural barriers in research prioritisation.
Why the money matters
What gets researched depends largely on who pays for it. A marginal budget in a given area translates into fewer cohorts followed over time, fewer clinical trials and less data to answer concrete questions: which testosterone dose works best in the long term, how puberty blockers affect bone density, or how much mental health is gained or lost with each model of care. The study also recalls that funding for this research has been the subject of public debate and of recent policy changes aimed at restricting it, which turns the figure into more than a management statistic: it is an indicator of which questions can still be answered in the coming decade.
Limits that call for caution
It is a portrait of what is funded, not of what is needed. It relies on grant abstracts, which describe what was promised rather than what was ultimately found; there is no patient follow-up and no clinical outcome data; and the classification depends on how each application describes its own project. Nor does it allow comparisons with other countries, because it analyses a single agency. What the work does support is a narrow and uncomfortable conclusion: research specifically about transgender and nonbinary youths has grown, but remains far below what would correspond to the size of the population it concerns.
Source: National Institutes of Health Funding for Research About Transgender and Nonbinary Youths. Weideman BCD, Parchem B, Reigada T, Rider GN. JAMA Network Open 2026;9(10):e2641377. DOI: 10.1001/jamanetworkopen.2026.41377.
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