Iowa ranks among the lowest states in the Midwest for LGBTQ+ equality, according to an annual index that evaluates all 50 states based on LGBTQ+ inclusion and its impact on business.

In this year’s index, Iowa ranked 9th out of 12 states, with Illinois leading the region and South Dakota at the bottom.

The State LGBTQ+ Business Climate Index by Out Leadership assesses various factors including legislation affecting LGBTQ+ individuals, access to healthcare, senior elected officials’ views, and responses to discriminatory laws.

This index serves as a resource for employers to determine where to conduct business and how leaders can advocate for inclusion, benefiting both employers, employees, and the communities they serve.

Nationally, Iowa ranks 34th on the LGBTQ+ index with a score of 49.60 out of 100. For comparison, neighboring Illinois scored 88.47. A higher score indicates better protections for LGBTQ+ individuals.

Iowa’s score for 2024 has declined compared to the previous year when it was ranked 24th with a score of 57.73. Notably, Iowa and Florida are tied for the fourth-largest drop in scores in the State LGBTQ+ Business Climate Index.

Recent legislation in Iowa has impacted LGBTQ+ rights, including bills passed in 2023 banning gender-affirming medical procedures for individuals under 18 and prohibiting transgender youth from using school facilities according to their gender identity.

Additionally, a comprehensive education law enacted last summer restricts instruction on gender identity and sexual orientation in Iowa schools, sparking legal challenges.

In February, a bill introduced by Gov. Kim Reynolds aimed to define “sex,” “man,” and “woman” in state law, drawing criticism from LGBTQ+ rights advocates.

New York ranks highest for LGBTQ+ equality with a score of 93.67 out of 100, while Arkansas ranks lowest with a score of 27, marking the lowest score in the index’s six-year history.