The public health consequences of officer discretion in arrests affecting LGBTQ+ communities in the United States: a scoping review.

backgroundLGBTQ + communities in the United States disproportionately experience policing practices that involve high officer discretion, contributing to wide-ranging health disparities. These interactions, often involving low-level offenses or perceived violations, introduce significant subjectivity that can reinforce racial, gender, and sexual bias. While the broader health effects of criminal-legal involvement have been studied, the specific public health consequences of these discretionary enforcement practices remain underexplored, particularly among LGBTQ + populations.​.

methodsGuided by Arksey and O’Malley’s framework and reported in accordance with PRISMA-ScR, we first submitted an Open Science Framework protocol, then we searched six databases for peer-reviewed empirical studies examining the health impacts of police discretion on LGBTQ + populations in the contiguous United States. Because the term “discretionary arrest” is rarely used in published literature, studies were included if discretion was described in participant narratives or author analysis. Studies were analyzed through a holistic health lens encompassing physical, mental, emotional, and spiritual well-being.

resultsFour empirical studies met inclusion criteria. Thematic synthesis revealed eight cross-cutting themes: (1) health impacts from policing, (2) racialized enforcement patterns, (3) discretion in arrest outcomes, (4) criminalization of gender expression and identity, (5) sexual risk and surveillance, (6) social withdrawal and isolation as coping, (7) mistrust in public systems, and (8) intersectional marginalization. Black, Latine, transgender, and gender-expansive individuals were most frequently targeted and harmed.​.

conclusionsOfficer discretion in the decision to arrest functions as a structural determinant of health and a key target for policy and intervention. Findings underscore the urgent need for community-led, trauma-informed, LGBTQ+-affirming interventions. With only four studies meeting inclusion, interpretations should remain cautious and context-specific. Community-academic partnerships can prioritize harm reduction and guide structurally grounded health-justice interventions that curb discretionary arrest and improve access to LGBTQ+affirming care.