Citing escalating attacks against LGBTQ youth in Massachusetts and across the country, a commission released recommendations Tuesday for the Legislature, Gov. Maura Healey and state agencies to bolster child welfare, public health, education, economic opportunities and housing initiatives.

More than 500 pieces of anti-LGBTQ legislation have been filed nationally, including bans against educational materials, gender-affirming care, and books that feature LGBTQ characters, according to a new report from the Massachusetts Commission on Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Youth.

The commission, an independent agency that advocates for LGBTQ individuals under age 25, said anti-LGBTQ activity is unfolding across Massachusetts municipalities “with little explicit action from the state to support local schools, communities, families, and youth.”

“The attacks being seen on the ground by advocates and youth include book bans, LGBTQ flag removals in schools, graffiti, drag story hour protests, drag show bans, curriculum disputes, harassment at school committee meetings, doxxing against LGBTQ librarians and teachers, and much more,” the report states. “Combining these with the alarming rise in racist hate crimes being seen across the state, the Commission has serious concerns for the safety of LGBTQ youth, families, providers, librarians, and educators in Massachusetts. The Commission urges the Commonwealth to take direct and explicit action to protect LGBTQ youth, educators, librarians, and caregivers.”

The report, released days before the start of Pride Month, identified “challenges to LGBTQ freedoms” in Abington, Arlington, Andover, Barnstable, Bedford, Beverly, Boston, Brewster, Brookline, Bridgewater-Raynham, Bristol County, Clarksburg, Concord-Carlisle, Danvers, Dudley, Edgartown, Fitchburg, Florida, Foxborough, Greater Fall River, Hamilton-Wenham, Hanover, Ludlow, Mansfield, Medway, Mendon-Upton, Middleborough, Millbury, Milton, Nauset, Needham, Newton, Norfolk County, North Brookfield, Old Rochester, Pepperell, Plymouth, Revere, Rockland, Scituate, Somerville, South Hadley and Sutton.

To strengthen child welfare protections, the commission has endorsed legislation to protect federal benefits owed to foster children and establish a foster child bill of rights. Those proposals remain before committees and House and Senate Democrats have not signaled plans to take them up in the roughly two months remaining for formal lawmaking this session.

Redrafted legislation to update parental rights for LGBTQ families was reported favorably out of the Judiciary Committee Tuesday.

Without invoking a specific proposal, the commission urged the governor and lawmakers to improve child abuse laws to safeguard access to gender-affirming care.

“With the significant rise in public transphobia across the state, the Commission has serious concerns about the wellbeing of trans and gender expansive youth in the home, and advises that the state examine current laws around child abuse and welfare to ensure that the unique situations faced by LGBTQ youth are being addressed,” the report states.

Aiming to eliminate youth homelessness, the commission calls for increasing funding for shelter spaces and living programs to support LGBTQ youth, boosting access to rental assistance, and mandating LGBTQ training and nondiscrimination policies at shelters. The commission also recommended improving access to state ID cards for youth experiencing homeless, a policy that won Senate approval last summer.

The commission’s sprawling recommendations also deal with expanding community-based public health programming, especially among youth in rural communities; decriminalizing sex work; ensuring anti-bullying and anti-harassment policies at public schools and colleges; funding more statewide research to support mental health and suicide prevention efforts for LGBTQ youth; investing in culturally competent LGBTQ health care in rural and undeserved communities; expanding coverage of gender-affirming care; and funding employment programs designed for LGBTQ youth experiencing homelessness.

Half of LGBTQ youth in Massachusetts are not able to access the mental health care they need, the report said. They experience barriers such as being afraid to discuss their mental health, not wanting to seek their guardian’s permission, and not being able to afford care.

Among broader policies, the commission is lobbying for improved data collection efforts, as well as developing a plan that would update state forms to ask about sex, gender and sexual orientation. The commission also wants to see an updated state plumbing code to allow for multi-stall, gender-neutral bathrooms.

The commission supports allowing residents to change their gender identity on birth certificates. The Registry of Motor Vehicles in 2019 began letting people select a “Gender X” option on their driver’s licenses and state ID cards. The Senate last July passed a bill to codify that practice and provide similar options for birth certificates, though top House Democrats have yet to take action on it.