Legislative Protection of Identity Variables in Mental and Behavioral Health Research

We are writing to express our grave concern regarding Executive Order [EO]14168 (regarding Gender Ideology) and Executive Order [EO] 14151 (regarding Government DEI Programs). Executive Order 14168 mandates that federal agencies stop using gender identity-related terms in all official agency business, materials, and policies. Executive Order 14151 directs the termination of all mandates, programs, and activities relating to “diversity, equity, inclusion, and accessibility.” The EOs  have the potential to severely limit scientists’ ability to study the nature, causes, and treatment of mental disorders. This restriction on scientific freedom poses a significant threat to American health and economic wellbeing.

Mental and behavioral health plays a critical role in saving lives and supporting the United States (U.S.) economy. Approximately one in five adults in the U.S. suffer from a diagnosable mental disorder, and 12 million seriously consider suicide each year (Substance Abuse and Mental Health Services Administration, 2020). This burden represents not only profound human suffering but also significant societal and economic costs. For instance, the economic toll of depression alone in the U.S. exceeds $380 billion annually in healthcare costs, lost productivity, and absenteeism (Greenberg et al., 2023). Evidence-based treatments, including psychotherapy and psychotropic medications, have been shown to reduce the likelihood of suicidal behavior (van Ballegooijen et al, 2025; Huang et al., 2022) and effectively treat conditions such as depression (Guidi & Fava, 2021). These life-saving and cost-effective interventions were developed through decades of federally-funded mental health research (e.g., Swift et al., 2021; Wilkinson et al., 2021). Continued support for research on psychotherapy and psychotropic medication is crucial for refining these treatments and strengthening America’s public health and economy.

The inclusion of identity variables in mental and behavioral health research has proven essential for developing more effective interventions. Tailoring treatments to individuals’ identities—such as gender, sexual orientation, and religion—has been shown to enhance the effectiveness of psychotherapy (Bouwhuis-Van Keulen et al., 2024; Pachankis et al., 2022). Similarly, research examining identity factors has been vital to ensuring the safety and effectiveness of psychotropic medications across diverse populations, including different racial and ethnic groups (Storosum et al., 2023). In fact, addressing patients’ identities in mental healthcare is so essential that leading mental healthcare professional organizations have developed practice guidelines for the treatment of patients who hold various backgrounds and identities, such as those with disabilities (Hanson et al., 2023), diverse national origins (American Psychiatric Association, n.d.), and culturally diverse populations (American Psychological Association, n.d.). Identity-inclusive mental and behavioral health is necessary to maintain best practices that improve treatment for all Americans.

It is important to note that while Executive Orders 14168 and 14151 do not explicitly ban the use of identity variables in federally-funded scientific research, they have impacted researchers at federal agencies (such as the U.S. Department of Veterans Affairs and the Centers for Disease Control and Prevention [CDC]) and other federally-funded institutions. Some researchers have started removing and omitting identity variables from their research due to concerns over potential noncompliance with the vague and sweeping language of these orders. In some cases this concern is not merely theoretical; a directive prohibiting the use of gender-identity variables in scientific research was sent by the CDC’s chief science officer to staff members on January 31, 2025, with the intention of bringing the CDC into compliance with Executive Order 14168 (Heidt, A, 2025). We urge lawmakers to pass clear and specific laws that explicitly protect the inclusion of identity variables in federally-funded research.

In summary, mental disorders impose a heavy toll on both the wellbeing and economic stability of Americans. Research that includes identity variables leads to more effective treatments. We urge elected officials to safeguard scientists’ ability to include identity variables—such as age, sex, gender identity, race/ethnicity, culture, national origin, religion, sexual orientation, disability, language, and socioeconomic status—in mental and behavioral health research. We call on lawmakers to introduce and support legislation that ensures these identities remain in research, advancing public health and prosperity. Restricting the study of identity variables would not only hamper basic scientific quality, but also jeopardize the health and wellbeing of Americans, regardless of their individual identities.

Sincerely,

Wilson Trusty, Ph.D.*

Jocelyn Sze, Ph.D.*

Stephanie Budge, Ph.D.*

Louis Castonguay, Ph.D.*

*Licensed psychologist and member of the Society for the Advancement of Psychotherapy

This statement has been endorsed by the Society for the Advancement of Psychotherapy (Division 29 of the American Psychological Association).