Due to widespread discrimination, transgender Americans face many barriers to health, economic security, education and more, according to the results of a new survey from the National Center for Transgender Equality.
The report exposes the many hardships and barriers transgender Americans face on a daily basis. The survey encompassed the views and experiences of 27,715 transgender Americans.
"It is clear that there is still much work ahead to ensure that transgender people can live without fear of discrimination and violence," the report states, despite several gains in the past years.
Here's an overview of the numbers:
Trouble begins in the family
While 60% of transgender respondents said that they grew up with a supportive family, 45% of survey respondents from unsupportive families said they experienced homelessness. As for those from supportive families, over a quarter (27%) still experienced homelessness. Over half of respondents from unsupportive families also reported attempting suicide.
Only 11% of transgender respondents said that all their identifying documents match their gender identity. On the opposite end, 68% reported that none of their documents reflect their gender identity. Around one-third of those surveyed said cost was the main barrier between them and an ID that matched their gender identity. And just under a third of people (32%) who had identification that matched their gender identity reported either violence, denial of benefits or assault because of it.
Health and health insurance, psychological distress and HIV
Transgender Americans face staggering health disparities. Of those surveyed, a quarter experienced health insurance problems because of their trans status, including denial of coverage. Fifty-five percent who sought coverage for gender-affirming surgery were denied, and 25% were denied coverage for hormones.
But it's more than bureaucracy, it's also bedside manner. A third of trans people reported having a negative experience with their health care provider in the last year, including being refused treatment, experiencing verbal harassment and physical or sexual assault. Twenty-three percent of respondents had not seen a doctor for fear of being mistreated while a third didn't see a doctor because it was too expensive.
Mental health can be just as difficult to maintain as physical health. According to the survey, "39% of respondents experienced serious psychological distress in the month before completing the survey," which compares to 5% of the general U.S. population. According to the report, 40% of respondents attempted suicide in their lifetime, which is more than nine times the nationwide rate. Seven percent attempted suicide in 2015, about 12 times the national rate.
Of those surveyed, 1.4% were living with HIV, which is five times the overall U.S. rate. Rates were much higher among transgender women (3.4%), black transgender women (19%), Native American transgender women (4.6%) and Latina trans women (4.4%).
Schools and employment
Even the schoolhouse may not be the safest place for transgender students. The survey found that more than three-quarters (77%) of respondents experienced one or more kinds of harassment including verbal harassment, limiting their gender expression and being punished for fighting back against bullies.
Those experiences of discrimination continue into the world of work, as well.
One in six respondents said they've lost a job because of their gender identity or expression in their lifetime. In 2015, 27% of those who held or applied for jobs reporting being terminated, denied a promotion or not being hired because of their gender expression or identity. Fifteen percent of respondents were verbally harassed or physically or sexually assaulted at work.
Even getting into the workplace can be difficult for trans people: the survey showed that the transgender unemployment rate (15%) was three times higher than the current estimated unemployment rate nationwide (5%).
Housing, sex work and police interaction
Overall, 30% of respondents experienced homelessness at one point in their lives. Of those who experienced homelessness, 26% avoided homeless shelters because of fear of mistreatment. And their fears aren't unfounded. Of those who stayed in shelters, 70% experienced harassment, sexual or physical assault or being kicked out because of their trans status.
One in five respondents participated in an underground economy for income at some point in their lives, including 12% who have engaged in sex work. That includes 9% of trans people in the year prior to taking the survey, with higher rates for trans women of color. For those trans people who engage in sex work, or are perceived as being sex workers, harassment from law enforcement officials is typical. Eighty-six percent of respondents report being harassed, physically or sexually attacked or mistreated by the police.
Trans people who engage in sex work are also more likely to experience intimate partner violence. Of those surveyed, 77% experienced IPV and 72% have been sexually assaulted.
Fifty-eight percent of respondents say they've experienced some form of mistreatment — verbal harassment, physical or sexual assault — from police. And 57% of respondents said they'd be uncomfortable seeking help from police if they needed it.
Harassment and public treatment
Almost half — 46% — of those surveyed reported harassment in the year prior to taking the survey because of their trans status. Forty-seven percent reported sexual assault in their lifetime, while 10% experienced sexual assault in preceding year. Those who have engaged in sex work, experienced homelessness or live with a disability were more likely to be sexually assaulted.
Discrimination extends to places like retail stores, hotels or even public buildings. Thirty-one percent of trans people said they experienced mistreatment in public settings, while 14% were denied equal treatment or service. One in five said they had avoided some kind of public accommodation for fear of mistreatment.
That public discrimination extends to public places like restrooms, as well. Nine percent of respondents reported being denied use of a bathroom in the year leading up to the survey because of their gender identity. And more than half, 59%, avoided a bathroom for fear of harassment.