Injustice at

Every Turn
A Report of the National
Transgender Discrimination Survey

Lead authors in alphabetical order:

Jaime M. Grant, Ph.D.

Lisa A. Mottet, J.D.
Justin Tanis, D.Min.

with Jack Harrison

Jody L. Herman, Ph.D.
and Mara Keisling
 INJUSTICE AT EVERY TURN:
A REPORT OF THE NATIONAL
TRANSGENDER DISCRIMINATION SURVEY

Lead authors in alphabetical order:

Jaime M. Grant, Ph.D.

Lisa A. Mottet, J.D.
Justin Tanis, D.Min.

with Jack Harrison, Jody L. Herman, Ph.D., and Mara Keisling

About the National Center
for Transgender Equality
The National Center for Transgender Equality is a national
social justice organization devoted to ending discrimination
and violence against transgender people through education and
advocacy on national issues of importance to transgender people.
By empowering transgender people and our allies to educate and
inluence policymakers and others, NCTE facilitates a strong and
clear voice for transgender equality in our nation’s capital and
around the country.

About the National Gay

and Lesbian Task Force
The mission of the National Gay and Lesbian Task Force is to build
the grassroots power of the lesbian, gay, bisexual and transgender
(LGBT) community. We do this by training activists, equipping
state and local organizations with the skills needed to organize
broad-based campaigns to defeat anti-LGBT referenda and advance
pro-LGBT legislation, and building the organizational capacity of
our movement. Our Policy Institute, the movement’s premier think
tank, provides research and policy analysis to support the struggle
for complete equality and to counter right-wing lies. As part of a
broader social justice movement, we work to create a nation that
respects the diversity of human expression and identity and creates
opportunity for all.

© 2011 The National Gay and Lesbian Task Force and the National Center for
Transgender Equality. We encourage, and grant permission to, reproduction and
distribution this publication in whole or in part, provided that it is done so with
attribution. Further written permission is not required.

RECOMMENDED CITATION
Grant, Jaime M., Lisa A. Mottet, Justin Tanis, Jack Harrison, Jody L. Herman,
and Mara Keisling. Injustice at Every Turn: A Report of the National Transgender
Discrimination Survey. Washington: National Center for Transgender Equality
and National Gay and Lesbian Task Force, 2011.
TABLE OF CONTENTS

Acknowledgements .......................................................................................................................................................... 1
Executive Summary ........................................................................................................................................................ 2
Introduction ..................................................................................................................................................................... 10
Methodology .................................................................................................................................................................... 12
Demographic Composition of Sample ......................................................................................................... 16
The Findings
A Portrait of Transgender and Gender Non-Conforming People ...................................................... 20
Education ................................................................................................................................................................ 32
Employment ........................................................................................................................................................... 50
Health ....................................................................................................................................................................... 72
Family Life .............................................................................................................................................................. 88
Housing .................................................................................................................................................................. 106
Public Accommodations .................................................................................................................................. 124
Identiication Documents ............................................................................................................................... 138
Police and Incarceration ................................................................................................................................. 158
Cross-Dressers .................................................................................................................................................... 174

Policy Priorities ............................................................................................................................................................. 178

Conclusion ...................................................................................................................................................................... 179
Appendices
Appendix A —Glossary .................................................................................................................................... 180
Appendix B — Survey Instrument—Issues and Analysis ................................................................... 182
Appendix C — Survey Instrument (paper version) ................................................................................... 204
About the Authors ....................................................................................................................................................... 221
 ACKNOWLEDGEMENTS 1

ACKNOWLEDGEMENTS

T his study was undertaken with the dogged commitment

of the National Center for Transgender Equality and the
National Gay and Lesbian Task Force to bring the full extent of
Our organizations are especially grateful to the Network for
LGBT Health Equity, formerly the Network for LGBT Tobacco
Control, for providing $3,000 in funding for health and outreach
discrimination against transgender and gender non-conforming workers to reach underserved racial and ethnic populations in this
people to light. Executive directors Mara Keisling and Rea Carey endeavor.
committed considerable staf and general operating resources to
Both organizations would also like to thank their foundation
this project over the past three years to create the original survey
funders for their support in making this work possible: Arcus
instrument, collect the data, analyze thousands of responses and,
Foundation, Gill Foundation, Open Society Institute, as well as an
inally, present our indings here.
Anonymous donor. In addition, the Task Force would like to thank
Key Task Force and NCTE staf, as well as our data analyst, are additional foundation funders who supported this work, including
credited on the masthead of this report but many former staf, the David Bohnett Foundation, Evelyn and Walter Haas, Jr. Fund,
pivotal volunteers and visiting fellows put their unlagging efort Ford Foundation, Kicking Assets Fund of the Tides Foundation,
and best thinking to this enormous task. and the Wells Fargo Foundation.

We are deeply grateful to Dr. Susan (Sue) Rankin of Pennsylvania We are thankful to the following for translating the questionnaire
State University, a nationally recognized LGBT researcher, for into Spanish: Terra Networks, NCTE founding board member
hosting our study through Penn State’s Consortium on Higher Diego Sanchez, and Task Force communications manager Pedro
Education. This allowed the survey to go through the Institutional Julio Serrano.
Review Board process, to ensure the conidentiality and humane
We are thankful to the National Black Justice Coalition for
treatment of our survey participants. We are most grateful to
assistance in reaching transgender and gender non-conforming
M. Somjen Frazer who irst as a volunteer and then later as a
people of color.
staf analyst made a crucial contribution in the questionnaire
development, data cleaning and variable development phase of We are thankful to Beth Teper, Executive Director of COLAGE,
the research. Former Task Force Policy Institute staf member for providing guidance on what subjects to cover relating to
Nicholas Ray also did a wonderful job convening and guiding the family life.
many staf and volunteers who participated in developing the
Thanks go to Donna Cartwright for editing the entire report, as
questionnaire.
well as Brad Jacklin, Vanessa Macoy, Richael Faithful and Laurie
A number of Vaid Fellows at the Task Force made crucial Young for editing portions. We are thankful to Heron Greenesmith
contributions to this work in the data cleaning, ield work and for pouring through the respondent’s open-ended answers to
early analytical stages of this report including Morgan Goode, select quotes for inclusion throughout the report. We are thankful
Amanda Morgan, Robert Valadéz, Stephen Wiseman, Tey Meadow to Caitlin Fortin for research on comparable data. We are also
and Chloe Mirzayi. Morgan’s work interfacing with staf at thankful to Harper Jean Tobin for assistance with facts and policy
homeless shelters, health clinics and other direct service programs recommendations in portions of the report.
serving transgender and gender non-conforming people greatly
Finally, we thank Steven K. Aurand, who has volunteered at the
increased participation in the study by transgender people often
Task Force for over 20 years, using his expertise in statistics to
shut out of research projects.
greatly increase our capacity to work with a very complex data set.
Transgender community leaders made a major contribution to
This study has obviously been a labor of love by a community of
our thinking in developing the survey and ield work, including
dedicated advocates, and we are honored to be able to ofer the
Marsha Botzer, Moonhawk River Stone, M.S., LMHC and Scout,
collective fruits of our labor to the community.
Ph.D. All of these leaders made important suggestions in the
development of the questionnaire and our data collection process.
We are grateful to Marsha, as the Task Force board chair, and
Hawk, a member of the Task Force board, for championing this
work institutionally.
2 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

EXECUTIVE SUMMARY
This study brings to light what is both patently obvious and far too often dismissed from the
human rights agenda. Transgender and gender non-conforming people face injustice at every
turn: in childhood homes, in school systems that promise to shelter and educate, in harsh
and exclusionary workplaces, at the grocery store, the hotel front desk, in doctors’ oices and
emergency rooms, before judges and at the hands of landlords, police oicers, health care
workers and other service providers.
The National Gay and Lesbian Task Force and the National Center for Transgender Equality are
grateful to each of the 6,450 transgender and gender non-conforming study participants who
took the time and energy to answer questions about the depth and breadth of injustice in their
lives. A diverse set of people, from all 50 states, the District of Columbia, Puerto Rico, Guam and
the U.S. Virgin Islands, completed online or paper surveys. This tremendous gift has created the
irst 360-degree picture of discrimination against transgender and gender non-conforming people
in the U.S. and provides critical data points for policymakers, community activists and legal
advocates to confront the appalling realities documented here and press the case for equity and
justice.

KEY FINDINGS
Hundreds of dramatic indings on the impact of anti- Household Incomes of Respondents3
transgender bias are presented in this report. In many cases,
50
a series of bias-related events lead to insurmountable
45
challenges and devastating outcomes for study participants. 40
Several meta-indings are worth noting from the outset: 35 32% 33%
30 28% 27%
• Discrimination was pervasive throughout the entire 25
25%

sample, yet the combination of anti-transgender bias 20

15% 14%
and persistent, structural racism was especially 15 12%
9%
devastating. People of color in general fare worse 10
4%
5
than white participants across the board, with African
0
American transgender respondents faring worse than all Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K
others in many areas examined.
Our Sample General Population

• Respondents lived in extreme poverty. Our sample was

nearly four times more likely to have a household income
of less than $10,000/year compared to the general
population.1

• A staggering 41% of respondents reported attempting

suicide compared to 1.6% of the general population,2
with rates rising for those who lost a job due to bias
(55%), were harassed/bullied in school (51%), had low
household income, or were the victim of physical assault
(61%) or sexual assault (64%).
 EXECUTIVE SUMMARY 3

HARASSMENT AND DISCRIMINATION IN EDUCATION EMPLOYMENT DISCRIMINATION AND

ECONOMIC INSECURITY
• Those who expressed a transgender identity or gender
non-conformity while in grades K-12 reported alarming • Double the rate of unemployment: Survey respondents
rates of harassment (78%), physical assault (35%) experienced unemployment at twice the rate of the general
and sexual violence (12%); harassment was so population at the time of the survey,5 with rates for people
severe that it led almost one-sixth (15%) to leave of color up to four times the national unemployment rate.
a school in K-12 settings or in higher education. • Widespread mistreatment at work: Ninety percent
• Respondents who have been harassed and abused by (90%) of those surveyed reported experiencing
teachers in K-12 settings showed dramatically worse health and harassment, mistreatment or discrimination on the
other outcomes than those who did not experience such abuse. job or took actions like hiding who they are to avoid it.
Peer harassment and abuse also had highly damaging efects. • Forty-seven percent (47%) said they had experienced
an adverse job outcome, such as being ired, not
Harassment, Assault and Discrimination in K-12 Settings hired or denied a promotion because of being
transgender or gender non-conforming.
100

90 • Over one-quarter (26%) reported that they

80 78% had lost a job due to being transgender or gender
70
non-conforming and 50% were harassed.

60 • Large majorities attempted to avoid discrimination

50 by hiding their gender or gender transition (71%)
40 35% or delaying their gender transition (57%).
30 • The vast majority (78%) of those who transitioned
20
12%
from one gender to the other reported that they felt
10 6% more comfortable at work and their job performance
0 improved, despite high levels of mistreatment.
Harassed Physical Assaulted Sexual Assaulted Expelled
• Overall, 16% said they had been compelled to
work in the underground economy for income
(such as doing sex work or selling drugs).
Respondents Income by Mistreatment in School4
• Respondents who were currently unemployed
No school experienced debilitating negative outcomes, including
General Mistreated
Population
mistreat-
in school
nearly double the rate of working in the underground
ment economy (such as doing sex work or selling drugs),
Under $10K 4% 12% 21% twice the homelessness, 85% more incarceration, and
more negative health outcomes, such as more than
$10K - under $20K 9% 11% 15% double the HIV infection rate and nearly double the
rate of current drinking or drug misuse to cope with
$20K - under $50K 28% 31% 33% mistreatment, compared to those who were employed.
• Respondents who had lost a job due to bias also
$50k - under $100k 33% 30% 21%
experienced ruinous consequences such as four times the
rate of homelessness, 70% more current drinking or misuse
$100k+ 25% 16% 9%
of drugs to cope with mistreatment, 85% more incarceration,
more than double the rate working in the underground
economy, and more than double the HIV infection rate,
compared to those who did not lose a job due to bias.
4 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Loss of Job by Race HOUSING DISCRIMINATION AND HOMELESSNESS

• Respondents reported various forms of direct housing

50
discrimination — 19% reported having been refused
45
a home or apartment and 11% reported being evicted
40
36% 36%
because of their gender identity/expression.
35 32%
30%
30 • One-ifth (19%) reported experiencing homelessness
26%
25 24% at some point in their lives because they were transgender
20 or gender non-conforming; the majority of those trying
14%
15 to access a homeless shelter were harassed by shelter
10 staf or residents (55%), 29% were turned away altogether,
5 and 22% were sexually assaulted by residents or staf.
0
Overall American Asian Black Latino/a White Multiracial • Almost 2% of respondents were currently homeless, which
Sample Indian is almost twice the rate of the general population (1%).6
• Respondents reported less than half the national
rate of home ownership: 32% reported owning their
Unemployment Rates including by Race home compared to 67% of the general population.7

50 • Respondents who have experienced homelessness

45 were highly vulnerable to mistreatment in public
40 settings, police abuse and negative health outcomes.
35
30 28% “I was denied a home/apartment” by Race
25 24%
100
20 18% 18%
14% 90
15 12%
10% 80
10 7%
70
5
60
0
General Overall American Asian Black Latino/a White Multiracial 50 47%
Population Sample Indian 38%
40
32%
30 26%
19% 17%
20 15%
10
0
Overall American Asian Black Latino/a White Multiracial
Sample Indian
 EXECUTIVE SUMMARY 5

DISCRIMINATION IN PUBLIC ACCOMMODATIONS BARRIERS TO RECEIVING UPDATED ID DOCUMENTS

• Fifty-three percent (53%) of respondents reported • Of those who have transitioned gender, only one-ifth (21%)
being verbally harassed or disrespected in a have been able to update all of their IDs and records
place of public accommodation, including hotels, with their new gender. One-third (33%) of those who
restaurants, buses, airports and government agencies. had transitioned had updated none of their IDs/records.
• Respondents experienced widespread abuse in the • Only 59% reported updating the gender on their
public sector, and were often abused at the hands driver’s license/state ID, meaning 41% live without
of “helping” professionals and government oicials. ID that matches their gender identity.
One ifth (22%) were denied equal treatment by a • Forty percent (40%) of those who presented ID (when
government agency or oicial; 29% reported police it was required in the ordinary course of life) that did
harassment or disrespect; and 12% had been denied equal not match their gender identity/expression reported
treatment or harassed by judges or court oicials. being harassed, 3% reported being attacked or
assaulted, and 15% reported being asked to leave.
Experiences of Discrimination and Violence in Public Accommodations

Harassment and Violence When Presenting

Incongruent Identity Documents
Denied
Harassed or Physically
Location Equal 50
Disrespected Assaulted
Treatment 44%
45
40%
40
Retail Store 32% 37% 3%
35
Police Oficer 20% 29% 6% 30

25
Doctor’s Ofice or Hospital 24% 25% 2%
20
15%
Hotel or Restaurant 19% 25% 2% 15

10
Government Agency/Oficial 22% 22% 1%
5 3%

Bus, Train, or Taxi 9% 22% 4% 0

Harassed Asked to Leave Assaulted Any of these
Problems
Emergency Room 13% 16% 1%

Airplane or Airport Staff/TSA 11% 17% 1%

Judge or Court Oficial 12% 12% 1%

Mental Health Clinic 11% 12% 1%

Legal Services Clinic 8% 6% 1%

Ambulance or EMT 5% 7% 1%

Domestic Violence Shelter/

6% 4% 1%
Program

Rape Crisis Center 5% 4% 1%

Drug Treatment Program 3% 4% 1%

6 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

ABUSE BY POLICE AND IN PRISON DISCRIMINATION IN HEALTH CARE AND

POOR HEALTH OUTCOMES
• One-ifth (22%) of respondents who have interacted
with police reported harassment by police, with • Health outcomes for all categories of respondents
much higher rates reported by people of color. show the appalling efects of social and economic
marginalization, including much higher rates of
• Almost half of the respondents (46%) reported
HIV infection, smoking, drug and alcohol use and
being uncomfortable seeking police assistance.
suicide attempts than the general population.
• Physical and sexual assault in jail/prison is a
• Refusal of care: 19% of our sample reported being
serious problem: 16% of respondents who had been
refused medical care due to their transgender or
to jail or prison reported being physically assaulted
gender non-conforming status, with even higher
and 15% reported being sexually assaulted.
numbers among people of color in the survey.

Police Harassment and Assault, Due to Bias, by Race • Uninformed doctors: 50% of the sample reported having
to teach their medical providers about transgender care.
50
• High HIV rates: Respondents reported over four times
45
40 38%
36%
the national average of HIV infection, with rates
35 higher among transgender people of color.8
29%
30
24% 23% • Postponed care: Survey participants reported that when they
25 22%
20 18%
15% were sick or injured, many postponed medical care due
15 12%
9% 10% to discrimination (28%) or inability to aford it (48%).
10 6% 6% 7% 8%
3% 4% 4%
5 2% 2% 2%
0 Suicide Attempt by Employment
All Who American Asian Black Latino/a White Multiracial
Interacted Indian
with Police 100
90
Harassed by Police
80
Physically Assaulted by Police
Sexually Assaulted by Police 70
60%
60 55%
51%
50
40 37%

30
20
10
0
Employed Unemployed Lost Job Due to Bias Worked in
Underground
Economy
 EXECUTIVE SUMMARY 7

FAMILY ACCEPTANCE OF GREAT IMPORTANCE RESILIENCE

• Forty-three percent (43%) maintained most of their family Despite all of the harassment, mistreatment, discrimination
bonds, while 57% experienced signiicant family rejection. and violence faced by respondents, study participants also
• In the face of extensive institutional discrimination, family demonstrated determination, resourcefulness and perseverance:
acceptance had a protective afect against many threats • Although the survey identiied major structural
to well-being including health risks such as HIV infection barriers to obtaining health care, 76% of transgender
and suicide. Families were more likely to remain together respondents have been able to receive hormone
and provide support for transgender and gender non- therapy, indicating a determination to endure the
conforming family members than stereotypes suggest. abuse or search out sensitive medical providers.
• Despite high levels of harassment, bullying and violence in
Impact of Family Acceptance
school, many respondents were able to obtain an education
by returning to school. Although fewer 18 to 24-year-
Used drugs or alcohol to cope with 19%
mistreatment 32% olds were currently in school compared to the general
population, respondents returned to school in large numbers
Are current smokers 27%
32% at later ages, with 22% of those aged 25-44 currently in
32% school (compared to 7% of the general population).10
Had attempted suicide 51%
• Over three-fourths (78%) reported feeling more
Did sex work or other underground 11%
who for income 19% comfortable at work and their performance improving
after transitioning, despite reporting nearly the same
Had been incarcerated 11%
19% rates of harassment at work as the overall sample.

Experienced homelessness 9% • Of the 26% who reported losing a job due to bias, 58%
26%
reported being currently employed and of the 19% who
0 10 20 30 40 50 60 70 80
reported facing housing discrimination in the form of a denial
Families Who Accepted
Families Who Rejected
of a home/apartment, 94% reported being currently housed.

Status as a Student by Age9

50
45%
45
40 37%
35
30
25 22%
20
15
10 7%
5%
5 2% 3%
1%
0
18-24 25-44 45-54 55+
Overall Sample General Population
8 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

CUMULATIVE DISCRIMINATION CONCLUSION

Sixty-three percent (63%) of our participants had experienced It is part of social and legal convention in the United States to
a serious act of discrimination — events that would have a discriminate against, ridicule, and abuse transgender and gender
major impact on a person’s quality of life and ability to sustain non-conforming people within foundational institutions such
themselves inancially or emotionally. These events included the as the family, schools, the workplace and health care settings,
following: every day. Instead of recognizing that the moral failure lies in
society’s unwillingness to embrace diferent gender identities
• Lost job due to bias
and expressions, society blames transgender and gender non-
• Eviction due to bias conforming people for bringing the discrimination and violence
• School bullying/harassment so severe on themselves.
the respondent had to drop out
Nearly every system and institution in the United States, both
• Teacher bullying large and small, from local to national, is implicated by this data.
• Physical assault due to bias Medical providers and health systems, government agencies,
families, businesses and employers, schools and colleges, police
• Sexual assault due to bias
departments, jail and prison systems—each of these systems and
• Homelessness because of gender identity/expression institutions is failing daily in its obligation to serve transgender
• Lost relationship with partner or children and gender non-conforming people, instead subjecting them
due to gender identity/expression to mistreatment ranging from commonplace disrespect to
outright violence, abuse and the denial of human dignity. The
• Denial of medical service due to bias
consequences of these widespread injustices are human and real,
• Incarceration due to gender identity/expression ranging from unemployment and homelessness to illness and
death.
Almost a quarter (23%) of our respondents experienced a
catastrophic level of discrimination — having been impacted by at This report is a call to action for all of us, especially for those
least three of the above major life-disrupting events due to bias. who pass laws and set policies and practices, whose action or
These compounding acts of discrimination — due to the prejudice continued inaction will make a signiicant diference between
of others or lack of protective laws — exponentially increase the the current climate of discrimination and violence and a world of
diiculty of bouncing back and establishing a stable economic freedom and equality. And everyone else, from those who drive
and home life. buses or teach our children to those who sit on the judicial bench
or write prescriptions, must also take up the call for human rights
for transgender and gender non-conforming people, and confront
this pattern of abuse and injustice.

We must accept nothing less than a complete elimination of

this pervasive inhumanity; we must work continuously and
strenuously together for justice.
 EXECUTIVE SUMMARY 9

Endnotes
__________________________________________________________________________

1 U.S. Census Bureau, “Current Population Survey,” Annual Social and

Economic Supplement (Washington, DC: GPO, 2008).

2 “U.S.A. Suicide: 2002 Oicial Final Data,” prepared for the American
Association of Suicidology by John L. McIntosh, Ph.D. Oicial data source:
Kochanek, K.D., Murphy, S.L., Anderson, R.N., & Scott, C. (2004). Deaths:
Final data for 2002. National Vital Statistics Reports, 53 (5). Hyattsville, MD:
National Center for Health Statistics DHHS Publication No. (PHS) 2005-1120.
Population igures source: table I, p.108. of the National Center for Health
Statistics (Kochanek et al., 2004), see http://www.sprc.org/library/event_
kit/2002datapgv1.pdf.

3 General population data is from U.S. Census Bureau, “Current Population

Survey,” Annual Social and Economic Supplement (Washington, DC: GPO,
2008).

4 See note 3. “Mistreatment” includes harassment and bullying, physical or sexual

assault, discrimination, or expulsion from school at any level based on gender
identity/expression.

5 Seven percent (7%) was the rounded weighted average unemployment rate
for the general population during the six months the survey was in the ield,
based on which month questionnaires were completed. See seasonally
unadjusted monthly unemployment rates for September 2008 through
February 2009. U.S. Department of Labor, Bureau of Labor Statistics, “The
Employment Situation: September 2008,” (2008): http://www.bls.gov/news.
release/archives/empsit_10032008.htm.

6 1.7% were currently homeless in our sample compared to 1% in the general

population. National Coalition for the Homeless, “How Many People
Experience Homelessness?” (July 2009): http://www.nationalhomeless.org/
factsheets/How_Many.html.

7 U.S. Department of Housing and Urban Development, “U.S. Housing Market

Conditions, 2nd Quarter, 2009” (Washington, DC: GPO, 2009): http://www.
huduser.org/portal/periodicals/ushmc/summer09/nat_data.pdf.

8 The overall sample reported an HIV infection rate of 2.6% compared to

.6% in the general population. United Nations Programme on HIV/AIDS
(UNAIDS) and World Health Organization (WHO), “2007 AIDS Epidemic
Update” (2007): http://data.unaids.org/pub/EPISlides/2007/2007_
epiupdate_en.pdf. People of color in the sample reported substantially higher
rates: 24.9% of African-Americans, 10.9% of Latino/as, 7.0% of American
Indians, and 3.7% of Asian-Americans in the study reported being HIV
positive.

9 U.S. Census Bureau, “Current Population Survey: Enrollment Status of the

Population 3 Years Old and Over, by Sex, Age, Race, Hispanic Origin, Foreign
Born, and Foreign-Born” (Washington, DC: GPO, October 2008): Table 1.
http://www.census.gov/population/www/socdemo/school/cps2008.html.
The last category, over 55, was not rounded to its small size.

10 See note 9.
10 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

INJUSTICE AT EVERY TURN:

A REPORT OF THE NATIONAL
TRANSGENDER DISCRIMINATION SURVEY
Introduction Sixty-three percent (63%) of our participants experienced a
serious act of discrimination—events that would have a major
impact on a person’s quality of life and ability to sustain
E very day, transgender and gender non-conforming people
bear the brunt of social and economic marginalization
due to discrimination based on their gender identity or
themselves inancially or emotionally. Participants reported that
they had faced:
expression. Advocates confront this reality regularly working • Loss of job due to bias
with transgender people who have lost housing, been ired from
• Eviction due to bias
jobs, experienced mistreatment and violence, or been unable to
access the health care they need. Too often, policymakers, service • School bullying/harassment so bad the
providers, the media and society at large have dismissed or respondent had to drop out
discounted the needs of transgender and gender non-conforming • Teacher bullying
people, and a lack of hard data on the scope of anti-transgender
discrimination has hampered the work to make substantive policy • Physical assault due to bias

changes to address these needs. • Sexual assault due to bias

In 2008, The National Center for Transgender Equality and the • Homelessness because of gender identity/expression
National Gay and Lesbian Task Force formed a ground-breaking • Loss of relationship with partner or children
research partnership to address this problem, launching the due to gender identity/expression
irst comprehensive national transgender discrimination study.
• Denial of medical service due to bias
The data collected brings into clear focus the pervasiveness and
overwhelming collective weight of discrimination that transgender • Incarceration due to gender identity/expression
and gender non-conforming people endure.
Each of these can be devastating and have long-term
This report provides information on discrimination in every major consequences, as we will see in this report.
area of life — including housing, employment, health and health
Almost a quarter (23%) of our respondents experienced a
care, education, public accommodation, family life, criminal
catastrophic level of discrimination, having been impacted by
justice and government identity documents. In virtually every
at least three of the above major life-disrupting events due to
setting, the data underscores the urgent need for policymakers
bias. Imagine losing your home, your job and your children, or
and community leaders to change their business-as-usual
being bullied by a teacher, incarcerated because of your gender
approach and confront the devastating consequences of anti-
identity and sexually assaulted. These compounding acts of
transgender bias.
discrimination—due to the prejudice of others or unjust laws—
exponentially increase the diiculty of bouncing back and re-
establishing a stable economic and home life.
 INJUSTICE AT EVERY TURN: A REPORT OF THE NATIONAL TRANSGENDER DISCRIMINATION SURVEY 11

While these statistics are often devastating, it is our hope that Roadmap for this Report
they motivate people to take action, rather than simply despair.
The gravity of these indings compels each of us to confront anti- Immediately after this chapter is Methodology, then we provide
transgender bias in our communities and rebuild a foundation of chapters based on major areas of life:
health, social and economic security for transgender and gender
• Education
non-conforming people in our communities. We do believe that
the situation is improving and look forward to future studies that • Employment
will enable us to look at discrimination over time. • Health

All of us — whether we are human resources professionals, nurses • Family Life

or doctors, police oicers or judges, insurance company managers, • Housing and Homelessness
landlords or restaurant managers, clerks or EMTs, teachers
• Public Accommodations
or principals, friends or community advocates — must take
responsibility for the pervasive civil rights violations and callous • Identity Documents
disregard for basic humanity recorded and analyzed here. It is
• Police and Incarceration
through the choices that each of us make, and the institutional
policies we reject or uphold that either recreate or confront the Following these, we have shorter sections on two subjects: the
outrageous discrimination study participants endure. particular experiences of cross-dressers and the policy priorities
as deined by our respondents. We end with a Conclusion chapter.
We present our indings, having just scratched the surface of this
extensive data source. We encourage advocates and researchers There are three Appendices: Appendix A is a glossary of terms
to consider our indings with an eye toward much-needed future used in this report, Appendix B contains recommendations for
research. We expect these data to answer many questions about future researchers who seek to do similar studies or ask similar
the lives of transgender people and the needs of this community questions of respondents, and Appendix C is the original survey
and to provoke additional inquiry in years to come. To this end, instrument (paper version). We plan to provide the dataset to
we plan to provide the data set to additional researchers to additional researchers to perform deeper or diferent analysis.
perform deeper or diferent analysis.

“I was kicked out of my house and out of college when I was 18. I became
a street hooker, thief, drug abuser, and drug dealer. When I relect back,
it’s a miracle that I survived. I had so many close calls. I could have been
murdered, committed suicide, contracted AIDS, or fatally overdosed.”
12 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

METHODOLOGY
Our Respondents
T he National Transgender Discrimination Survey is the
most extensive survey of transgender discrimination ever
undertaken. Over eight months, a team of community-based At the outset, we had to determine if the population we sought
advocates, transgender leaders, researchers, lawyers and LGBT for the survey was transgender people only, or transgender and
policy experts came together to create an original survey gender non-conforming people. We ultimately chose to include
instrument. In the end, over 7,500 people responded to the both.
70-question survey. Over four months, our research team ielded
Both of our organizations deine “transgender” broadly to
its 70-question online survey through direct contacts with more
include those who transition from one gender to another
than 800 transgender-led or transgender-serving community-
(transsexuals), and those who may not, including genderqueer
based organizations in the U.S. We also contacted possible
people, cross-dressers, the androgynous, and those whose gender
participants through 150 active online community listserves. The
non-conformity is a part of their identity. Because the term
vast majority of respondents took the survey online, through a
“transgender” is understood in various ways that may or may not
URL established at Pennsylvania State University.
include these groups of people, we chose to use broader gender
Additionally, we distributed 2,000 paper surveys to organizations non-conforming language to ensure broad participation in the
serving hard-to-reach populations — including rural, homeless, survey.
and low-income transgender and gender non-conforming people,
Furthermore, gender non-conforming people, especially those
conducting phone follow-up for three months. With only $3,000
who are also lesbian, gay or bisexual, found themselves at the
in funding for outreach provided by the Network for LGBT Health
heart of the debate over the inclusion of transgender people and
Equity, formerly the Network for LGBT Tobacco Control, we
“gender identity” in the Employment Non-Discrimination Act in
decided to pay stipends to workers in homeless shelters, legal
2007. Information about their experiences of discrimination could
aid clinics, mobile health clinics and other service settings to
better shape debates like these and shed light on the relationship
host “survey parties” to encourage respondents whose economic
between gender identity/expression and discrimination.
vulnerability, housing insecurity, or literacy level might pose
particular barriers to participation. This efort resulted in the Consequently, we decided to invite the broader range of people to
inclusion of approximately 500 paper surveys in the inal sample. respond to the survey, and then, during cleaning, eliminate those
who were neither transgender nor gender non-conforming; this
Both the paper and online surveys were available in both English
process is described further in the “Cleaning the Data” section.
and Spanish. For additional information about the questionnaire
itself, please see the Survey Instrument chapter. In the Portrait chapter, and in our discussion of Questions 3 and
4 in Appendix B, we describe more about the results of the choice
The inal study sample includes 6,456 valid respondents from all
to survey both transgender and gender non-conforming people
50 states, the District of Columbia, Puerto Rico, Guam and the
(75% of our sample fell into the transgender category), as well as
U.S. Virgin Islands. Our geographic distribution generally mirrors
how we developed the categories of “transgender” and “gender
that of the general U.S. population. For more information, see the
non-conforming.” Throughout this report, we attempted to give
tables at the end of this chapter or the Portrait chapter.
both transgender and gender non-conforming results separately
so that those who are interested in one of the groups could use
more speciic data.
 METHODOLOGY 13

Developing the Survey Instrument Many questions we wanted to ask were deleted in the end so that
we could keep the survey at 70 questions. We understood length
Over eight months, a team of highly trained social science and to be a risk.1 We were hopeful that our two national organizations
health researchers, grassroots and national transgender rights maintained a level of credibility in the community that would
advocates, expert lawyers, statisticians, and LGBT movement generate a strong response and that our ailiation with an
leaders worked together to craft this questionnaire. The mix of academic institution, Pennsylvania State University, would also
trained researchers, movement advocates and end-users at the boost completion rates.
forefront of policy change was powerful.

We based survey questions — their inclusion, their framing, Distribution of Online

relevant terms, and literacy level — on the experiences of
transgender and gender non-conforming people in the room, and
and Paper Surveys
others in our lives, our families and our communities. By mining
Before starting survey ield work, we developed a list of about
the stories of discrimination we had already encountered as
800 active, transgender-speciic or trans-related organizations and
advocates, researchers, family members and grassroots organizers,
about 150 listserves in the United States. We attempted to reach
we helped design an instrument that was relevant and user-
every one by phone or e-mail, asking the organizations to e-mail
friendly, and ultimately yielded the largest sample of transgender
their constituents or members directly with the URL for the
experience ever gathered.
questionnaire upon release and to run articles and free ads about
There were a few places where wording of questions could have the survey in their newsletters.
been improved, which we realized during the data analysis phase
During our irst two weeks of ield work, study team members
of this project. Please see Appendix B, Survey Instrument—Issues
called hundreds of colleagues in LGBT organizations to ask
and Analysis, for guidance for future researchers who seek to
for their help in spreading the word about the survey, and
inquire about similar topics.
encouraging appropriate contacts to take the survey. We made
a sustained efort to focus on LGBT people of color, rural and
Length homeless/health service organizations so that our study would
not neglect the respondents most often left out of critical research
The survey contained 70 questions, although often a single on our communities.
“question” was in reality a combination of many questions (for During our six-month data gathering efort, we dedicated a
example, Question 4 asks for responses to 15 diferent terms). half-time staf person to do direct outreach to rural-focused
Reports from the ield varied widely about the time it took to organizations and listserves and those serving transgender people
complete the survey. Some reported taking the survey in 20 who access community resources via housing, health and legal
minutes on a personal computer; while others who accessed programs. In some cases, volunteers, some of whom were given
the survey through health or homeless services settings and a modest stipend, acted as survey assistants at clinics or small
took it with the assistance of outreach workers often took an “survey parties” through local programs, delivering and collecting
hour or longer. Before the survey data collection was started, paper surveys. We did not use incentives for respondents to
some experts expressed concern that respondents who had a complete the survey, although food was served at some group
high school diploma or less would be unable to complete such gatherings.
a lengthy questionnaire, but our inal sample included 806
respondents at that educational level. Our inal sample consisted of approximately 6,000 online surveys
and 500 paper surveys. More research or analysis would need
The team believes that the period in which we ielded the to be done on the sample to determine whether we may have
survey — about a year after the 2007 removal of gender identity avoided the typical online bias by collecting paper questionnaires
from proposed federal legislation that would have prohibited in addition to online data collection.2
discrimination based on sexual orientation in the workplace —
was a factor in the depth and breadth of our sample. This was a While we did our best to make the sample as representative as
historic moment when gender non-conforming and transgender possible of transgender and gender non-conforming people in the
people felt a particular urgency to tell their stories, and to have U.S., it is not appropriate to generalize the indings in this study
their experiences accounted for in the national conversation on to all transgender and gender non-conforming people because
workplace discrimination and employment. it not a random sample. A truly random sample of transgender
14 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

and gender non-conforming people is not currently possible, as higher literacy level than the remainder of the survey. Accordingly,
government actors that have the resources for random sampling we worried that this would prove to be an intimidating irst hurdle
have failed to include questions on transgender identity in their for some respondents. That instruction sheet is available in full in
population-based research. Appendix C: Survey Instrument.

Language and Translation Cleaning the Data

We attempted to make the language of the survey questionnaire The next step was to clean the data, which is the process of
accessible to as many participants as possible by maintaining an eliminating those questionnaires that did not belong in the
appropriately accessible literacy level without compromising the sample, as well as recoding written responses into categories
meaning of our questions. For example, we often omitted medical when appropriate.
terminology that is not commonly understood while putting
First, we eliminated respondents whose answers indicated that
technical terms in parentheses for those who were familiar with
they were not taking the survey in earnest or were answering
them.
questions illogically, such as by strongly agreeing with each term
Often, we also had to choose between words that were in Question 4.
clearer versus those that matched the sensitivities of the
Second, we eliminated from our data set those respondents who
various communities the survey was intended to speak to. For
indicated through their answers to Questions 1-4 that they were
example, we avoided using the terms “illegal,” “criminal,” and
not actually transgender or gender non-conforming. There were
“prostitution” in Question 29 because of implicit value judgments
a small group of people who were eliminated according to the
in those terms. Instead we opted for “street economy” and “sex
following rubric: If they were born as one gender (Question 2),
work,” which may have reassured some respondents but puzzled
and still identiied as that gender today (Question 3), we looked
others. We found striking the right balance on language use to be
to see if they identiied with the terms in Question 4. If they did
a challenge.
not identify with these terms and reported that people did not
Trained volunteers, including a company providing pro bono know they were gender non-conforming (Question 5) and they
services, translated the survey into Spanish; we did not have did not tell people (Question 6), we removed them from the
funding to translate into additional languages.3 Gendered terms sample.
posed a major challenge since they are often linguistically and
Third, throughout the survey there were open-ended questions,
culturally speciic and don’t always translate easily or precisely.
often “other, please specify ________,” to which respondents were
given the opportunity to write their own answer.5 Part of our
Hosting and Institutional Review cleaning process involved examining these written responses. In
some instances we were able to place more speciic responses into
The questionnaire was hosted online by Pennsylvania State the listed answer choices.
University through our partnership with Professor Susan (Sue) Fourth, we dealt with incompletes, duplicates, and those that did
Rankin. The technological aspects of administering the online not consent. There were 31 duplicates that we removed from the
survey were handled by Pennsylvania State University IT sample. We removed records if the respondent stopped before
professionals and her graduate students, who did an excellent answering Question 5, and we removed those who did not
job programming and safeguarding our data. Paper surveys were consent.
hand-entered into the system after the online survey closed.
Taken together, our cleaning process reduced our sample size
It was important to us that our data go through a university- from an initial set of 7,521 respondents to 6,456 respondents.
based Institutional Review Board (IRB) process, which ensures
conidentiality and humane treatment of survey participants, so
that our data could be published in and cited in peer-reviewed
journals. Although this did add extra steps and time to our
process, we believe it was well worth it.4

Going through institutional review also required that we start

the questionnaire with an instruction sheet that told participants
their rights and recourses as participants, as well as a variety of
other information. The language in the instruction sheet met
Pennsylvania State’s standards for IRB instructions and was at a
 METHODOLOGY 15

Data Analysis and Throughout this report, we occasionally use terms such as
“correlate,” “signiicant,” and “compare” that trained researchers
Presentation of Findings might interpret to mean that we ran statistical tests; we did not,
as explained above, and are using these terms in the way that a
After being cleaned, these data were analyzed to tabulate the
lay person uses such terminology.
sample’s responses to each question presented in the survey
instrument. Answers to individual survey questions were Throughout the report, we include quotes from respondents who
then broken down by various demographic characteristics to wrote about their experiences of acceptance and discrimination
explore diferences that may exist in the experiences of survey in response to an open-ended question. We have edited these
respondents based on such factors as race, income, gender and responses for grammar, spelling, brevity, and clarity, as well as to
educational attainment. Further analysis was completed to see preserve their conidentiality.
how some subgroups difered based on their answers to non-
demographic questions, such as questions about drug use, suicide
attempts and HIV status.

Not all respondents answered each question presented in the

survey, either because they skipped the question or because
the question did not apply to them. Tabulations of data were
completed for those who completed the question being analyzed,
with the further limitation that generally only those respondents
for whom the question was applicable were included in the
tabulation. For instance, when analyzing respondents’ experiences
while in jail or prison, the analysis was limited to those who
answered the questions and also reported they had been sent to
jail or prison.

Our indings are generally presented in the form of percentages,

with frequencies presented where relevant. Throughout this
report, we have rounded these percentages to whole numbers.
We did not round HIV rates, which are provided in two decimals
for more exact comparisons with existing research on the general
population, and did not round in a few other places where greater
precision was necessary due to small size.

When the respondents were segmented, occasionally the sample

size became either too small to report on or too small for reliable
analysis. When the n is under 15, we do not report the data and
when the n is over 15 but under 30, we report the data enclosed
in parentheses and make a note of it.

General population data are provided in the report as a way to

roughly gauge how our sample difers from the U.S. population
in terms of demographics and a variety of outcomes our survey
sought to measure.

We did not employ the use of statistical testing to establish the

statistical signiicance of the diferences we found between
various respondent subsets or between our sample and the
general population. Though our sample was not randomly
selected, future researchers may wish to conduct tests with this
sample as a way to crudely measure the statistical signiicance of
diferences and relationships among subsets in the sample.
16 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Demographic Composition of the Sample

(Some readers may be more interested in these data as it is presented in the next chapter:
A Portrait of Transgender and Gender Non-Conforming People.)

Question Response # %

Q1. Identify as Transgender Yes 6436 100

No 0 0
Total 6436 100

Q2. Sex Assigned at Birth Male 3870 60

Female 2566 40
Total 6436 100

Q3. Primary Gender Identity Today Male/Man 1687 26

Female/Woman 2608 41
Part time as one gender,
part time as another 1275 20
A gender not listed here,
please specify 864 13
Total 6434 100

Q4. Identify with the Word Transgender Not at all 618 10

Somewhat 1601 26
Strongly 4039 65
Total 6258 100

Q10. Region
(see Portrait chapter for the composition of the regions) New England 540 9
Mid-Atlantic 1314 21
South 1120 18
Mid-West 1292 21
West (Not California) 1035 17
California 906 15
Total 6207 100

Q47. Disability Yes 1972 31

No 4401 69
Total 6373 100

Q49. HIV Status HIV negative 5667 89

HIV positive 168 3
Don’t know 536 8
Total 6371 100
 METHODOLOGY 17

Question Response # %

Q11. Race (Multiple Answers Permitted) White 5372 83

Latino/a 402 6
Black 389 6
American Indian 368 6
Asian 213 3
Arab or Middle Eastern 45 1
Multiple responses were permitted
Total so % add to >100%

Q11. Race recoded American Indian only 75 1

Asian only 137 2
Black only 290 5
Hispanic only 294 5
White only 4872 76
Multiracial and other 736 11
Total 6404 100

Q12. Education Less than high school 53 1

Some high school 213 3
High school graduate 540 8
Some college <1 year 506 8
Technical school 310 5
>1 years of college, no degree 1263 20
Associate degree 506 8
Bachelor’s degree 1745 27
Master’s degree 859 13
Professional degree (e.g. MD, JD) 191 3
Doctorate degree 231 4
Total 6417 100

Q38. Did You Ever Attend School

as a Trans or GNC Person Yes 3114 49
No 3262 51
Total 6376 100

Q25. Work Status Full-time 2970 46

Part-time 1012 16
Multiple Jobs 490 8
Self-employed/Owner 541 8
Self-employed/ Contractor 282 4
Unemployed/Looking 700 11
Unemployed/Not looking 210 3
Disability 502 8
Student 1292 20
Retired 450 7
Homemaker 111 2
Other, specify 434 7
Multiple responses were permitted
Total so % add to >100%
18 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Question Response # %

Q13. Household Income Less than $10,000 944 15

$10,000 to $19,999 754 12
$20,000 to $29,999 731 12
$30,000 to $39,999 712 11
$40,000 to $49,999 539 9
$50,000 to $59,999 485 8
$60,000 to $69,999 394 6
$70,000 to $79,999 353 6
$80,000 to $89,999 252 4
$90,000 to $99,999 234 4
$100K to $149,999 539 9
$150Kto $ 199,999 163 3
$200K to $250,000 74 1
More than $250,000 84 1
Total 6258 100

Q16. Relationship Status Single 2286 36

Partnered 1706 27
Civil union 72 1
Married 1394 22
Separated 185 3
Divorced 690 11
Widowed 94 1
Total 6427 100

Q63. Citizenship U.S. citizen 6106 96

Documented non-citizen 156 2
Undocumented non-citizen 117 2
Total 6379 100

Q64. Voter Registration Registered 5695 89

Not Registered 689 11
Total 6384 100

Q65. Armed Service Yes 1261 20

No 4983 78
Denied Enlistment 133 2
Total 6377 100

Q66. Sexual Orientation Gay/Lesbian/Same-gender 1326 21

Bisexual 1473 23
Queer 1270 20
Heterosexual 1341 21
Asexual 260 4
Other, specify 698 11
Total 6368 100
 METHODOLOGY 19

Endnotes
__________________________________________________________________________

1 In general, we suggest that future researchers not replicate the length of this
survey, unless they have the resources to process the results and are sure that
respondents will complete the questionnaire.

2 According to Don Dillman, “The lack of Internet service for 29% of the
population and high-speed service for 53% of the population is complicated
by diferences between those who have and do not have these services. Non-
Whites, people 65+ years old, people with lower incomes, and those with
less education have lower internet access rates than their counterparts, and,
therefore, are more likely to be left out of Internet surveys.” Don Dillman,
Jolene Smyth, and Leah Melani Christian, Internet, Mail, and Mixed-Mode
Surveys: The Tailored Design Method (New York: Wiley, 2008). Therefore,
online samples often have higher educational attainment and higher
household income. Our sample had considerably lower household income,
which would lead one to speculate that we have avoided this bias. However,
our educational attainment is much higher than the general population,
which could lead to the opposite conclusion. Even more interestingly, one
would expect the sample to demonstrate higher levels than the general
population of being in school between 18-24, if it were privileged, yet, as
discussed in the Education chapter later, our sample is in school less than
the general population in that age range. For more information about
online bias, see David Solomon, “Conducting web-based surveys,” Practical
Assessment, Research & Evaluation, 7 no.19, (2001): http://PAREonline.net/
getvn.asp?v=7&n=19. See also Lee Rainie et al., “The Ever-Shifting Internet
Population: A new look at Internet access and the digital divide,” Pew Internet
& American Life Project (2003): http://www.pewinternet.org/Reports/2003/
The-EverShifting-Internet-Population-A-new-look-at-Internet-access-and-
the-digital-divide/02-Who-is-not-online/03-Several-demographic-factors-
are-strong-predictors-of-Internet-use.aspx.

3 We would recommend that future studies budget funding for translation. We

also recommend working with members of the transgender community who
speak the language you are translating to to be sure that the terms used are
current and appropriate.

4 We urge other researchers to follow the IRB process to continue building

peer-reviewed research and articles that document the overwhelming
problems of discrimination against transgender and gender non-conforming
people. However, the additional time and expense involved may make
institutional review impractical for some community-based surveys that are
not intended for publication in peer-reviewed academic or research journals.

5 In every case where writing in answers was an option, coding and tabulating
the data was extremely time-consuming. For organizations conducting
a survey such as this with fewer resources to process results, it may be
advantageous to avoid or limit this type of question.
20 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

A PORTRAIT OF TRANSGENDER AND

GENDER NON-CONFORMING PEOPLE
Our sample provides a new and complex look at transgender and gender non-conforming people
and the ways they deine themselves. In this chapter, we will explore information about who
responded to our survey and present some of the more detailed indings about gender identity
and expression. It is our hope that these additional data about our respondents will provide a
fuller picture of their lives.
Transgender and gender non-conforming people form a diverse group and, while they shared
many common experiences that are outlined in this report, our participants also came from many
demographic and sociographic groups. We will begin by exploring some broader demographic
characteristics and then focus more speciically on the concepts of gender, gender identity and
sexual orientation.

Race of Respondents
Race
Black Asian American Indian
Respondents were given the following options: 2% 1%
5%
Latino/a
• White 5%

• Black or African American Multiracial

11%
• American Indian or Alaska Native
(enrolled or principal tribe)
• Hispanic or Latino/a White
76%
• Asian or Paciic Islander

• Arab or Middle Eastern

• Multiracial or mixed race

Throughout the report, when we report data on race, those who

checked more than one racial identity are included within the
multiracial category. This includes all respondents who identiied
as Arab/Middle Eastern because all Arab/Middle Eastern
respondents in this study also selected a second racial identity
option. Accordingly, reports about race, other than about the
multiracial category, provide information on those who chose that
racial/ethnic identity alone.

Our sample size of American Indian/Alaska Native respondents

was the smallest of the inal categories. While this group was
small, we did include American Indian/Alaska Native separately
in all data analyses that involved race.
 A PORTRAIT OF TRANSGENDER AND GENDER NON-CONFORMING PEOPLE 21

The National Transgender Discrimination Survey Sample

Age
The sample included participants from 18 to 89 years of age. Our
sample has a larger percentage of young people than the U.S.
population as a whole. Further research is needed to know whether
the diference in age between our respondents and the population
as a whole is a result of our research methods or relects difering
understandings and social acceptance of gender identity/expression
among diferent generations. We suspect that a combination of
the two factors may have been involved. When more studies are
undertaken of transgender and gender non-conforming experience,
we will be better able to answer this question.

Age of Respondents 1

100
90
1 dot = 1 respondent
80
70
60
52%
50 Population Density in the United States
40 36%
30
19% 17%19%
20 13% 15% 15%
11%
10
2%
0
18-24 25-44 45-54 55-64 65+
Our Sample American Community Survey, 2009

Location
The sample included respondents from all 50 states, the District
of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands. Our
geographic distribution approximately mirrors that of the general
U.S. population. The regional breakdown we used is: New England
(ME, NH, VT, MA, RI, CT), Mid-Atlantic (NY, NJ, DE, PA, MD, DC, VA,
1 dot = 100,000 people
WV), South (NC, SC, GA, FL, AL, MS, LA, TX, OK, AR, TN, KY) Midwest
(OH, MI, IN, IL, WI, MN, IA, MO, KS, NE, SD, ND), West (NM, AZ, CO, WY,
UT, NV, MT, ID, WA, OR, AK, HI), California (CA).

Respondents by Region2

50
45
40
35 32%
30
25
21% 21% 22%
19% 18%
20 17%
15%
15 12%
11%
9%
10
5%
5
0
New England Mid-Atlantic South Midwest West California
Our Sample General Population
22 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Household Income Employment Status

Our respondents reported much lower household incomes than When asked about employment (with the option of selecting
the population as a whole, with many living in dire poverty. as many responses as were applicable), respondents noted the
Fifteen percent (15%) of our respondents reported making following:
under $10,000/year, nearly four times the rate of this household
income category for the general population.3 Twelve percent Employment Status of Respondents
(12%) said they made between $10,000 and $20,000/year.
Fourteen percent (14%) said they made $100,000/year or more, Full-time 46%
compared to 25% making 100,000/year or more for the general Part-time 16%
population. More than one job 8%
Self-employed, own your business 8%
Self-employed, contract worker 4%
Household Incomes of Respondents 4

Unemployed but looking 11%

Unemployed and stopped looking 3%
50
On disability 8%
45
Student 20%
40
Retired 7%
35 32% 33%
Homemaker or full-time parent 2%
30 28% 27%
25% Other, please specify 7%
25
0 5 10 15 20 25 30 35 40 45 50
20
15% 14%
15 12%
9%
10 Based on these responses, we determined that of all our
4%
5
respondents, 70% were currently employed, 11% were currently
0
Under $10K $10K-under $20K-under $50K-under $100K+ unemployed,6 and 19% were out of the workforce (generally as
$20K $50K $100K students, retirees, or homemakers).
Our Sample General Population
When calculating the unemployment rate, the U.S. Department
of Labor excludes those who are out of the workforce;
Given that household income does vary between men and applying the same standard to our sample provides a generally
women in the United States,5 it is notable that the current gender comparable unemployment rate of 14%. The weighted
of our participants did not impact their income much. unemployment rate for the general population during the time
the questionnaires were collected was 7%.7
Household Income by Gender Identity/Expression
SEX WORK AND WORK IN THE UNDERGROUND ECONOMY
50
45 It has been well documented that economic circumstances have
40 caused many transgender people to enter the underground
35% 34%
35 31% 32% economy for survival, as sex workers or by selling drugs. Yet,
30 27% despite the stereotypes that a majority do so, the vast majority
25% 26% 26%
25
(84%) of participants have never done so. Sixteen percent (16%)
20
15%16%16% 16% 15% 14% of respondents said they had engaged in sex work, drug sales, or
15 12% 13%11% 12% 12%
9% other underground activities for income.
10
5 Sex workers made up the largest portion of those who
0
Under $10K $10K-under $20K-under $50K-under $100K+
had worked in the underground economy with 11% of all
$20K $50K $100K respondents reporting having done sex work for income. Eight
MTF FTM All Trans GNC percent (8%) engaged in drug sales.

In comparison, the Prostitutes’ Education Network estimates that

1% of women in the U.S. have engaged in sex work.8
Additional analysis related to household income is contained in
the Education and Employment chapters.
 A PORTRAIT OF TRANSGENDER AND GENDER NON-CONFORMING PEOPLE 23

Educational Attainment Disability

In terms of educational attainment: 4% reported having no Thirty percent (30%) of respondents reported having a physical
high school diploma, 8% have a high school diploma, 40% have disability or mental health condition that substantially afects a
attended college without receiving a four-year degree, 27% major life activity. By contrast, the overall U.S. population reports
have attained a college degree, and 20% have gone to graduate a disability at a rate of 20%.10 However, the way we asked the
school or received a professional degree. In contrast to the other question about disability may difer from the deinition used by
measures of economic security, health, and other indicators we the Centers for Disease Control.
examined in the study, where our respondents often fare much
worse than the general population, our sample has a higher level
of educational attainment than the general population. Study Citizenship
indings of higher levels of poverty, incarceration, homelessness,
Ninety-six percent (96%) of our sample respondents were U.S.
and poor health outcomes among respondents speak to the power
citizens. Two percent (2%) were undocumented non-citizens. Two
of anti-transgender bias to “trump” educational attainment. The
percent (2%) were documented non-citizens.
Education chapter provides additional breakdown and analysis of
these igures. In the U.S., generally 7.1% of the population are non-citizens and
among those, generally 45% are undocumented.11
Educational Attainment of the Sample and the General Population9
Citizenship Status of Respondents
50
45 Documented Undocumented
40% non-citizen non-citizen
40 2% 2%
35 31%
30 28% 27%
25
20%
20 18%
14%
15
8% 9%
10
4%
5
U.S. citizen
0 96%
No HS Degree High School Some College College Degree Graduate
Diploma Degree

Our Sample General Population

24 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Gender Identity/Expression ANALYTIC GENDER IDENTITY/EXPRESSION CATEGORIES

Gender identity and expression are complex and layered

IDENTITY characteristics, with almost as many variations as there
are individuals. However, for the purposes of this study, the
As with any community, language around identity in transgender
researchers created aggregate categories presented here so that we
communities is constantly changing. Class, race, culture,
might have useful “containers” in which to organize and analyze
region, education and age all shape the language respondents
respondents’ experiences of anti-transgender bias and its impacts.
use to describe their gender identity and expression, as well
as individual preferences. We ofered participants a variety of Based on the terms that people identiied with, as well as their
choices that we understood to be commonly used, and they chose sex assigned at birth and current gender identity, we created
“Strongly,” “Somewhat,” and “Not at all” for each. several gender identity/expression categories that, though limited,
provide a framework from which to analyze strengths, resiliencies
Percentages of respondents who selected that and exposure to prejudice and abuse.
they “strongly” indentiied with term We identiied two groups of transgender respondents: those who
are male-to-female (MTF) and those who are female-to-male
Transgender 65%
(FTM), also referred to as transgender women and transgender
MTF (male to female) 46%
men respectively. These respondents generally identiied strongly
Transsexual 46%
Gender non-conforming or 32%
with the terms transgender, transsexual, MTF, or FTM. Fully 75%
FTM (female to male) 26%
of all respondents fell into one of the transgender categories, with
Genderqueer 22% 47% of the sample identifying as MTF and 28% as FTM. For more
Two-spirit 15% information on how we formed these categories, consult Appendix
Cross-dresser 15% B: Survey Instrument — Issues and Analysis.
Androgynous 14%
We also created a “gender non-conforming” category. Fourteen
Third gender 10%
percent (14%) of the sample identiied as gender non-conforming,
Feminine male 10%
which generally included those who strongly identiied as
Masculine female or butch 8%
genderqueer, two-spirit, and third gender, among others. Three
Intersex 6%
percent (3%) of the sample self-reported identifying as gender
Drag performer (King/Queen) 3%
non-conforming along a male-to-female spectrum of gender
AG or Aggressive 2%
Other 17%
identity/expression and 9% of the sample described themselves
as gender non-conforming along a female-to-male spectrum of
0 20 40 60 80 100
gender identity/expression. Of the gender non-conforming people
Note: respondents could select all terms that applied so percentages do not
in the sample, therefore, 78% identify on the female-to-male
add to 100%. Deinitions of these terms are provided in Appendix A.
spectrum, with 22% on the male-to-female spectrum.

Additionally, we created two cross-dresser categories, generally

Over 500 respondents wrote in a range of additional gender
including those that identiied strongly with the term cross-dresser.
identities including: “transdyke,” “mahuwahine,”12 “FTX,”13 “boi,”
Eleven percent (11%) of our sample identiied as male-to-female
“questioning,” “stud,” “both-neither,” “princess” and “bender,”
cross-dressers, while another 3% identiied as female-to-male
among others. This remarkable descriptive variety speaks to
cross-dressers. The existence of those who are best described
the dynamic, evolving diversity of gender expression within
as female-to-male cross-dressers is notable. The experiences of
transgender and gender non-conforming communities.
cross-dressers, when remarkably diferent than that of the rest of
the sample, are noted throughout this report. However, we also
provided a separate chapter that provides results about male-born
cross-dressers because of their unique experience.
 A PORTRAIT OF TRANSGENDER AND GENDER NON-CONFORMING PEOPLE 25

Although both of our organizations irmly deine “transgender” Sex Assigned at Birth of Respondents
to include gender non-conforming people and cross-dressers,
to better understand and report on the experiences of diferent What sex What is your Current Gender?
types of transgender people, we needed these analytic categories. were you
Therefore, in this report, when we refer to transgender assigned at
respondents, we do not include cross-dressers and gender non- birth, on your Overall Part-time/
Male Female
conforming respondents. original birth Sample Other
certiicate?
Analytic Gender Identity/Expression Categories Male 60% 20% 87% 61%

Feale 40% 80% 13% 39%

Cross-dresser Male-assigned-at-birth
female to male Gender Non-Conforming
3% 3%
Female-assigned-at-birth
Gender Non-Conforming GENDER IDENTITY/EXPRESSION AND CURRENT AGE
9%
The most dramatic demographic diferences in gender identity/
Cross-dresser,
male-to-female
expression were among age groups. Our older respondents are
MTF
11% Transgender much more likely to have been assigned male at birth and to be
47%
living as women, while younger respondents are more likely to
have been assigned female at birth and living as male. In addition,
FTM
Transgender gender non-conforming respondents were also in the younger age
28% categories.

Respondents’ Gender Identity/Expression and Current Age

70
ASSIGNMENT AT BIRTH AND CURRENT IDENTITY 65%
60 59%
Sixty percent (60%) of respondents were assigned male at birth,
52%
while 40% were assigned female. We gave respondents a choice 50

of indicating whether their current gender identity was male, 40 44%

female or if they lived a part-time or gender non-conforming 34%
30 24%
identity. Twenty-nine percent (29%) of respondents said their 25% 18%
current gender identity was male. Forty-two percent (42%) said 20
18%
16%
they were currently female. Twenty-nine percent (29%) said they 10 8% 12%
11% 2% 3%
identiied as something other than male or female, or that they 5% 2%
2%
0 1%
identiied/lived part time as one gender and part-time as another. 0%
18-24 25-44 45-54 55-64 65+

Out of those who are transgender, 63% were assigned male MTF FTM All Trans GNC

at birth and 37% were assigned female. Out of those who are
gender non-conforming, 22% were assigned male and 78% were
assigned female.
26 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Transition MEDICAL TRANSITION

Two terms that we used to deine the medical aspects of

Transition is a process that some — but certainly not all —
transition are “medical transition” and “surgical transition.”
transgender and gender non-conforming people undertake to live
Medical transition includes respondents who have had any type
in a gender diferent from the one they were assigned at birth.
of surgery or hormonal treatment. Surgical transition identiies
For some, the journey traveled from birth sex to current gender
only those respondents who have had some type of transition-
may involve primarily a social change but no medical component;
related surgical procedure.
for others, medical procedures are an essential step toward
embodying their gender. Sixty-one percent (61%) of our respondents reported having
medically transitioned,14 while 33% said that they had surgically
For many gender non-conforming people, transition as a
transitioned. The percentage of respondents who we label
framework has no meaning in expressing their gender — there
“medically transitioned” is higher than the percent of those who
may be no transition process at all, but rather a recognition of a
we consider “transitioned” because a sizable percent of those who
gender identity that deies convention or conventional categories.
have had hormone therapy are not yet living full-time. Detailed
For yet other gender non-conforming people, transition is a
information about speciic treatments and procedures is contained
meaningful concept that applies to their journey from birth
in the Health chapter.
sex to their current identity, which may not be male or female.
Respondents in our sample were asked questions that helped us It is important to keep in mind that almost all transition-
identify whether they had embarked on a transition process or related care is paid for out of pocket, without any insurance
if they desired to do so in the future. This was important to us reimbursement. Thus, appropriate medical treatment is highly
and, hopefully, to future researchers in considering the role of dependent on an individual’s ability to pay for it. The desire to
transition in (among other things) transgender health, economic medically transition and the ability to aford to do so are entirely
security, experience of bias and family life. diferent and should not be conlated or confused.

FULL-TIME STATUS AND TRANSITION AGE OF TRANSITION

Fifty-ive percent (55%) of our sample reported that they lived For those who had transitioned, we calculated the age that they
full-time in a gender diferent from their birth sex. We considered transitioned (when they began to live full time in a gender diferent
a respondent to have transitioned if that person reported living than their sex at birth). Most transitioned between the ages of 18
full time in a diferent gender than that assigned at birth. and 44.

Twenty-seven percent (27%) said they were not living full-time in Generally, transgender men in our sample transitioned at earlier
their desired gender yet but wanted to someday. Eighteen percent ages than transgender women.
(18%) said they did not want to live full time in a gender other
than that assigned at birth. Age of Transition by Gender Identity

50
Transition Status of Respondents 46%
45
40% 41%
40
35
Do not want 30
to live full time 25%
25
in a gender other
than that assigned 20 18%
at birth. 15 12%
18%
10 8%
5% 5%
Not living full-time 5
1%
in their desired Living full-time
0
gender yet but in a gender different Under 18 18-24 25-44 45-54 55+
want to someday from their birth sex
MTF FTM
55%
27%
 A PORTRAIT OF TRANSGENDER AND GENDER NON-CONFORMING PEOPLE 27

People can tell I’m transgender/GNC even if I don’t tell them:

Gender Identity and the Public Sphere

VISUAL NON-CONFORMITY Always 6%

At the outset of our study, the research team hypothesized (based

Most of the time 16%
on anecdotal experience) that those respondents whom others
visually identify as not conforming to society’s expectations of
Sometimes 27%
gender might be at higher risk for discrimination and violence.
Thus, we determined whether respondents believed their gender
Occasionally 29%
presentation matched their gender identity by asking whether:
“People can tell I’m transgender even if I don’t tell them.” The
term we developed for the study participants who are perceived15 Never 21%

by strangers or in casual circumstances to be transgender or

0 5 10 15 20 25 30 35 40 45 50
gender non-conforming is visual non-conformers. This is a similar
to the concept of “passing,” a more colloquial term used by some
We also collapsed these categories further for our analysis.16
to describe the same perception.

Throughout the report, we will note the signiicance of visual Visual Conformity Analytic Categories
non-conformity as a risk factor in eliciting anti-transgender bias
and its attendant social and economic burdens.
Visual Conformers 21%

Somewhat Visually Conforming 56%

Visual Non-Conformers 22%

0 10 20 30 40 50 60 70

People can tell I’m transgender even if I don’t tell them:

50

45

40 38%
37%
35 34% 34%
31% 32%
29% 29% 29% 30%
30
27% 26% 25%
25
21%
20 18%
16% 16% 16% 17%
15% 15% 14%
15
12%
10
6% 6% 7% 7% 7%
5%
5 3%

0
MTF FTM Cross-dresser (MTF) Cross-dresser (FTM) GNC (MTF Spectrum) GNC (FTM Spectrum)
Always Most of the time Sometimes Occasionally Never
28 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Outness Sexuality and Relationships

Along with visual conformity, the research team wondered about
“outness” in the lives of the respondents. Our question was: SEXUAL ORIENTATION
does being open that one is transgender or expressing gender The sexual orientation of the sample demonstrates a diverse
non-conformity have any positive or protective efect (i.e. in the spectrum of sexual orientations among transgender and gender
workplace, at the doctor’s oice, or in social situations) or does non-conforming people. Among respondents, 23% reported
it simply increase risk for discrimination? In LGBT communities, a lesbian or gay sexual orientation (or attraction to the same
the process of coming out is widely seen as a path to self- gender); 24% identiied as bisexual; 23% reported a queer
empowerment and public understanding. A number of studies orientation; 23% reported a heterosexual or opposite-gender
among lesbian, gay and bisexual people have shown positive sexual orientation, 4% describe themselves as asexual and 2%
efects of being out on social and economic outcomes.17 However, wrote in other answers.
the speciic impact of outness on transgender people has not been
examined. The wide distribution of responses speaks to the complexity of
sexual orientation for those whose gender identity/expression
Multiple questions on levels of outness helped us establish two may have changed over the course of their lives.
basic categories, “generally out” and “generally not out,” in order
to ascertain whether outness has a positive or negative efect in
Sexual Orientation of Respondents
the lives of transgender and gender non-conforming respondents.
Asexual Other
2%
4%
Outness of Respondents with Collapsed Categories

Gay/Lesbian/
Same-gender
23%
Heterosexual
23%

Generally not out

41% Bisexual
Generally out Queer 25%
59% 23%

Those who assume all transgender people are straight after

transition are as incorrect as those who assume them all to be gay,
lesbian or bisexual.
Outness in speciic contexts, such as the workplace, with family
members, and in seeking medical care is reported on in the The common assumption that gender identity and sexual
relevant chapters. orientation form the basis for two distinct communities obscures
the reality, documented here, that the majority of transgender
I tell people that I’m transgender/gender non-conforming people — at least in our sample — are lesbian, gay, bisexual or
(Mark all that apply) queer-identiied. While debate in the LGBT community often
draws clear lines of demarcation between the LGB and the T, our
100
indings suggest that there is considerable overlap.18
90
80
70 68%

60
50
42%
40
30 26%
22%
20 15%
12%
10
0
Never Close Friends Family Casual Work Everyone
Friends Colleagues
 A PORTRAIT OF TRANSGENDER AND GENDER NON-CONFORMING PEOPLE 29

Sexual Orientation of MTF Respondents

Relationship Status
Other
Asexual 2%
7% Our sample was split evenly among those who reported being
currently in a relationship and those who reported being single,
separated, divorced or widowed.
Gay/Lesbian/ Thirty-six percent (36%) of survey respondents said they were
Same-gender
29% single. Twenty-seven percent (27%) said they were partnered.
Heterosexual
23% Twenty-three percent (23%) indicated they were in a civil union
or were married. Three percent (3%) said they were separated.
Eleven percent (11%) said they were divorced. One percent (1%)
Queer said they were widowed. In the general population, 51% are
Bisexual
7%
31%
married.18 Note that many respondents may not have the ability to
legally marry depending on the gender of their partner.

Relationship Status of Respondents

Sexual Orientation of FTM Respondents

Asexual Other Widowed
Divorced
2% 2% 1%
11%
Separated
Gay/Lesbian/ 3%
Same-gender Civil union
13% 1%

Bisexual Single
Heterosexual
13% 35%
25%

Married
22%

Queer
46% Partnered
27%

Sexual Orientation of GNC Respondents

Asexual Other
Heterosexual 3% 3%
4%

Gay/Lesbian/
Same-gender
33%

Queer
45%

Bisexual
13%
30 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Civic Participation Endnotes

__________________________________________________________________________

VOTER REGISTRATION 1 U.S. Census Bureau, “American Community Survey (ACS): 1-year Public
Use Microdata Sample: 2009 (2010): http://factinder.census.gov/home/
Our sample had high rates of voter

89%
en/acs_pums_2009_1yr.html. The ACS has more age categories than our
registration. Eight-nine percent survey instrument; for the purposes of analysis, the ACS categories have
(89%) of respondents said they been combined here to match our survey categories to enable comparisons
were registered to vote while 11% were registered and limited to the adult U.S. population (age 18 and over).

said they were not. The U.S. Census to vote. 2 U.S. Census Bureau, “Annual Estimates of the Resident Population for the
reports that in the 2008 election United States, Regions, States, and Puerto Rico: April 1, 2000 to July 1,
2009” (Washington, DC: GPO, 2009): http://www.census.gov/popest/
cycle, the closest Presidential election year to our survey, 71% of the
states/tables/NST-EST2009-01.csv.
voting-eligible population was registered to vote.19
3 U.S. Census Bureau, “Current Population Survey,” Annual Social and
Economic Supplement (Washington, DC: GPO, 2008).
MILITARY SERVICE
4 General population data is from U.S. Census Bureau, “Current Population
Our sample was very highly engaged in military service to the Survey,” Annual Social and Economic Supplement (Washington, DC: GPO,
nation. Twenty percent (20%) of respondents said they are or 2008).
had been a member of the armed forces. Seventy-eight percent 5 The Institute for Women’s Policy Research, “Fact Sheet: The Gender Wage
(78%) said they had not, while 2% said they were denied entry. Gap: 2009” (2009): http://www.iwpr.org/pdf/C350.pdf.
According to the American Community Survey for the same year
6 Note that in the report we use two deinitions of “unemployed.” Here, we
as this survey, 10% of the adult United States population had have approximated the deinition the U.S. Department of Labor uses, in
served in the military.20 which “unemployed and stopped looking” are considered to be outside
of the workforce, and thus not part of the equation when calculating
the unemployment rate. However, when measuring discrimination and
Military Service of Respondents
harassment against people who are “unemployed,” those who chose
Denied entry “unemployed and stopped looking” are included.
2%
7 7% is the rounded weighted average unemployment rate for the general
population during the six months the survey was in the ield, based on
which month questionnaires were completed. See seasonally unadjusted
Yes monthly unemployment rates for September 2008 through February 2009.
20% U.S. Department of Labor, Bureau of Labor Statistics, “The Employment
Situation: september 2008,” (2008): http://www.bls.gov/news.release/
archives/empsit_10032008.htm.

8 Prostitutes’ Education Network, “Prostitution in The United States -

No The Statistics,” (2007): http://prostitution.procon.org/view.source.
78%
php?sourceID=000240.

9 U.S. Census Bureau, “Current Population Survey,” Annual Social and

Economic Supplement (Washington, DC: GPO, 2009).

10 U.S. Department of Health and Human Services, Centers for Disease

Control, “Press Release: Number of U.S. Adults Reporting Disabilities is
Increasing,” (Washington, DC: GPO, 2009): http://www.cdc.gov/media/
pressrel/2009/r090430.htm.

11 7.1% of the U.S. population are foreign-born, non-U.S. citizens according

to the U.S. Census Bureau, “Nativity Status and Citizenship in the
United States: 2009,” American Community Survey Briefs, ACSBR/09-16,
(Washington, DC: GPO, 2010): www.census.gov/prod/2010pubs/p20-562.
pdf. For the proportion of documented or undocumented non-citizens
(the Pew Hispanic Center uses the term “unauthorized”) see Table 3 of
the following report: Jefery Passel and D’Vera Cohn, “U.S. Unauthorized
Immigration Flows Are Down Sharply Since Mid-Decade,” (2010): http://
pewhispanic.org/iles/reports/126.pdf.
 A PORTRAIT OF TRANSGENDER AND GENDER NON-CONFORMING PEOPLE 31

12 A relatively new Hawaiian term for transgender women of Hawaiian and

Polynesian ancestry. Mahu denotes someone who is homosexual, intersex,
or has a cross-gendered identity, while wahine means both woman and
feminine.

13 FTX generally refers to females assigned at birth who no longer identify as

female, but also not male.

14 The percentage of respondents whom we categorize as “medically

transitioned” is higher than the percent of those who we consider
“transitioned” because a sizable proportion of those who have had
hormone therapy are not living full-time yet.

15 This perception is often based on a person’s physical features, the sound

of their voice, mannerisms and other stereotypes of how men/women are
supposed to appear and present.

16 “Always” and “most of the time” were categorized as visual conforming,

“sometimes” and “occasionally” became somewhat visually conforming,
and “never” became visual non-conforming.

17 Some researchers have found that coming out to family members and
others may have some positive inluence on identity formation and social
and intimate relationships for lesbians and gay men. R. Savin-Williams,
“Coming Out to Parents and Self-Esteem Among Gay and Lesbian Youths,”
Journal of Homosexuality 18, no.1-2 (1989); Ilan Meyer, “Prejudice, Social
Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations:
Conceptual Issues and Research Evidence,” Psychol Bull 129, no.5 (2003);
M. Eliason, “Identity Formation for Lesbian, Bisexual, and Gay Persons,”
Journal of Homosexuality 30, no.3 (1996).

18 U.S. Census Bureau, “Family Status and Household Relationship of People

15 Years and Over, by Marital Status, Age, and Sex: 2009,” Current
Population Survey, 2009 Annual Social and Economic Supplement, Table
A2, (Washington, DC: GPO, 2009): http://www.census.gov/population/
www/socdemo/hh-fam/cps2009.html.

19 U.S. Census Bureau, “Voting and Registration in the Election of 2008”

(2010): http://www.census.gov/prod/2010pubs/p20-562.pdf.

20 Kelly Ann Holder, U.S. Census Bureau, Housing and Household Economics
Statistics Division, “Comparison of ACS And ASEC Data on Veteran Status
and Period of Military Service: 2007” (Washington, DC: GPO, 2007): http://
www.census.gov/hhes/www/laborfor/veterans/comparison_report.pdf.
32 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

EDUCATION
Education is a fundamental human right. It can expand our horizons, “People are sufering in
help us learn about ourselves and our world and build foundational my school, there are so
skills for our working lives. In the United States, there is a strong many trans kids that just
connection between one’s level of educational attainment and income. can’t come out because
In addition, individuals who have higher education levels are less likely they are afraid.”
to be dependent on public safety-net programs, to be incarcerated,
or to experience extreme poverty. They are also more likely to have
“I ind these constant
positive health outcomes, such as lower rates of smoking, and high
whispers, this constant
rates of civic participation.1
staring, it terriies me
Unfortunately, not all students have the opportunity to pursue education in the same way all the
in a safe environment. Our data shows that transgender and gender high school bullies did.
non-conforming people are currently unable to access equal educational When they followed me
opportunities because of harassment, discrimination and even violence. and screamed at me
Our data also shows the way this discrimination impacts educational and threw my things
attainment, which in turn afects other outcomes such as income, around the room.”
incarceration, health and suicidality, over respondents’ life spans.
 EDUCATION 33

KEY FINDINGS IN EDUCATION

What emerges clearly from the following data is that in education, as in other areas of life, survey participants faced high
levels of harassment and violence. For participants in the study, this mistreatment is highly correlated with lower levels of
educational attainment, lower income and a variety of other negative outcomes from homelessness to suicide.

• Those who expressed a transgender identity or gender non-conformity while in grades K-12 reported alarming rates of
harassment (78%), physical assault (35%) and sexual violence (12%).

• The harassment was so severe that it led nearly one-sixth (15%) to leave school in grades K-12 or in higher
education settings.

• Six percent (6%) of respondents were expelled in grades K-12 for their gender identity/expression.

• Teachers and staff members, whose job in part includes ensuring student safety, were too often the perpetrators of
harassment and violence in K-12. Thirty-one percent (31%) of the sample reported harassment by teachers or staff,
5% reported physical assault by teachers or staff and 3% reported sexual assault by teachers or staff.

• Negative experiences at school varied by gender and race. Students of color experienced higher rates of harassment
and violence across the board. In terms of gender, MTF students reported higher rates of violence, while FTM and
gender non-conforming students reported higher rates of harassment and bullying.

• Nineteen percent (19%) of respondents expressing a transgender identity or gender non-conformity in higher education
reported being denied access to gender-appropriate housing. Five percent (5%) were denied campus housing
altogether. Eleven percent (11%) lost or could not get inancial aid or scholarships because of gender identity/
expression.

• Despite mistreatment in school, respondents reported considerably higher rates of educational attainment than the
general population, with 47% receiving a college or graduate degree, compared with only 27% of the general population.
These high levels of achievement appear to be largely due to respondents returning to school later in life.

• Educational attainment did not provide respondents the protection against poverty that is common in the United
States. At each level of educational attainment, our respondents had considerably lower incomes than the general
population. Our sample was 4-5 times more likely to have a household income of less than $10,000/year at each
educational category, including college graduates.

• Experiences of mistreatment in school correlated with lower income levels. Those who reported mistreatment in
school were 50% less likely to earn $50,000/year than the general population.

• Those respondents who said they were physically assaulted at school due to gender identity/expression were
twice as likely to have done sex work and other work in the underground economy and were 50% more likely to be
incarcerated.

• For those who had to leave school due to harassment, nearly half (48%) reported having experienced homelessness.

• Those who were mistreated in school had higher rates of drug and alcohol abuse and smoking to cope with the
mistreatment. For those who were physically assaulted or had to leave school due to harassment, rates of misuse of
alcohol and drugs doubled.

• Respondents who reported having to leave school due to harassment were HIV-positive at a rate of 5.14%, more
than eight times the HIV rate of the general population, 0.6%.2

• More than half (51%) of respondents who were harassed, physically or sexually assaulted, or expelled because
of their gender identity/expression reported having attempted suicide. Of those who were physically assaulted by
teachers/staff or students, 64% reported having attempted suicide. And three-quarters (76%) of those who were
assaulted by teachers or staff reported having attempted suicide.
34 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Expression of Transgender Identity and Gender

Expressing a Transgender Identity or
Non-Conformity at School by Region
Gender Non-Conformity at School
100
We asked respondents a series of questions to explore their
90
experience of the educational system when they “attended school
80
as a transgender/gender non-conforming person.” Participants
70
who answered these questions may have done so because they
60 56% 57%
openly identiied as transgender or gender non-conforming at 53%
49% 48%
school or in some other way expressed gender non-conformity. 50
We did not ask whether they expressed a transgender identity or 40 38%

gender non-conforming presentation at school; so when we report 30

results based on gender identity/expression, those who identify as 20
transgender today may have expressed gender non-conformity at
10
school but not a transgender identity.
0
Forty-nine percent (49%) of study participants reported engaging New England Mid-Atlantic South Midwest West California

in educational pursuits as a transgender/gender non-conforming

person at any level, with 29% reporting such attendance in K-12
educational settings, and 40% reporting a transgender or gender Notably, lower current household income was strongly associated
non-conforming presentation or identity in college, technical with expressing a transgender identity or gender non-conformity
school or graduate school. in school. Those who most frequently expressed a transgender
identity or gender non-conformity at school were those in the
lowest income categories.
Expression of Transgender Identity and Gender
Non-Conformity at School by Age
Expression of Transgender Identity and Gender Non-
100 Conformity at School by Current Household Income
90
80 73% 100
70 90
60 55% 80
49%
50 70 63
60
40 60
30% 50
30 23% 50
41
20 13% 40 36
10 30
0 20
Overall 18-24 25-44 45-54 55-64 65+
Sample 10
0
Under $10K $10K-under $20K-under $50k-under $100k+
$20K $50K $100k
Among study participants, “I am afraid in school
people of color were more
and I am slowly coming Respondents who identify as “Not being out at school
likely to report expressing
a transgender identity or out. I came out to transgender today reported
has sheltered me from
expressing transgender
gender non-conformity at one of my teachers many of the challenges
school (Black 52%, Latino/a identities or gender non-
and I have never felt conformity at school at a other transgender/
57%, Asian 59%, American
Indian 56%, Multiracial so good in my life.” frequency of 50% while those
gender non-conforming
63%), than whites (46%). who are gender non-conforming
today reported 68%. Female- people face.”
Transgender and gender non-conforming people from New
England (56%), California (57%), and other West Coast to-male respondents who
respondents (excluding CA) (53%), answered airmatively more identify as transgender today expressed transgender identities
often than those from other regions of the country. or gender non-conformity at school at particularly high rates
(72%), compared to only 37% of male-to-female transgender
respondents.
 EDUCATION 35

Any Mistreatment at School by Region

Experiences of Harassment and
(includes harassment, assault, and expulsion)
Discrimination at School
100
Fully 61% of respondents who 61% reported 90
expressed a transgender identity
harassment, 80
or gender non-conformity at
school reported considerable assault or expulsion 70
61%
65%
61% 63% 61%
60 58%
abuse because of their identity/ because they
expression. From elementary 50
were transgender
through graduate school, the 40
survey showed high levels of or gender 30
harassment and bullying, physical non-conforming 20
assault, sexual assault, and
at school. 10
expulsion from school.
0
The following data reports on the experiences of those New England Mid-Atlantic South Midwest West California

respondents who expressed a transgender identity or gender

non-conformity in school. Throughout, we report on negative
experiences that respondents attributed to bias based on their Respondents who identity as female-to-male transgender people
transgender identity or gender non-conformity. today reported a higher rate of these abuses (65%) than male-to-
female respondents (53%) and those who identify as gender non-
Fifty-nine percent (59%) of respondents said they were harassed
conforming experienced abuse at a higher frequency (70%) than
or bullied in school at any level. Twenty-three percent (23%)
transgender-identiied respondents (59%).
said they were physically assaulted in school at any level. Eight
percent (8%) were sexually assaulted at school at any level. Five
percent (5%) were expelled at any level. Any Mistreatment at School by Gender Identity/Expression
(includes harassment, assault, and expulsion)
Race and geography compounded these efects. Multiracial
respondents reported these abuses at 71%. Those living in the 100
South reported 65%.
90

80
Any Mistreatment at School by Race 70%
70 65%
(includes harassment, assault, and expulsion) 59%
60
53%
100 50

90 40

80 30
71%
70 65% 20
61% 61% 60%
60 56% 10
50 48%
0
MTF FTM All Trans GNC
40
30
20
Respondents in all educational settings also reported denial
10
of access to essential gender-appropriate facilities, such as
0
Overall American Asian Black Latino/a White Multiracial bathrooms (26%) and housing (19%).
Sample Indian

“I am not allowed to use the facilities

I would like and have been denied
requests for unisex bathrooms.”
36 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Harassment, Assault and Discrimination in K-12 Settings

K-12 Settings
100
Kindergarten through twelfth grade is a formative period, both
educationally and socially. Alarmingly, our study showed both 90
78%
physical and emotional damage done to students in these grades. 80
In this section, we irst examine experiences of harassment and 70
assault in general. Later we look more closely at harassment and 60
assault committed by other students versus that committed by 50
teachers. Within each of these sets, we will further subdivide our
40 35%
indings by 1) harassment and bullying, 2) physical assault, and
30
3) sexual assault. Throughout we will report on these experiences
through the lenses of race, gender identity, and region. 20
12%
10 6%

MISTREATMENT IN K-12 SCHOOLS 0

Harassed Physical Assaulted Sexual Assaulted Expelled
Seventy-eight percent (78%) of the 1,876 respondents who
expressed a transgender identity or gender non-conformity in
grades K-12 reported harassment by students, teachers or staf.
Many of the students experienced violence in the form of physical Harassment and Assault in K-12 Settings by Race
assault by either a peer or teacher/staf member (35%) or sexual
100
assault (12%). Six percent (6%) reported expulsion due to their
90 85%
gender identity/expression. 78% 80%
80 72% 72%
70
Harassment 60
58%
49%
50 45%
There were regional variations; “Shortly after I came 38%
40 35% 34%
students in the South noted 33%
29%
higher levels of harassment
out in high school, I 30 24%
28%
17% 18%
15%
and violence. Gender began receiving threats 20 12%
8% 10%
10
identity/expression was also in my locker. The usual 0
clearly a factor; those who Overall American Asian Black Latino/a White Multiracial
are transgender men today
sort of idiocy: ‘Damn Sample Indian
reported a considerably higher dyke, no one wants you Harassed Physical Assaulted Sexual Assaulted
frequency of harassment and here’ or ‘Fucking fag.’”
bullying than those who are
transgender women today.
Gender non-conforming students citing harassment at higher
rates than their transgender counterparts. Harassment and Assault in K-12 Settings by Region

100
Physical Assault
90 83%
81% 79% 81%
Multiracial students (45%) reported a higher incidence of 80 74% 74%
physical assault than students of other races, and those in the 70
South (40%) and West (40%) reported higher incidences than 60
those in other regions. Male-to-female transgender participants 50
40% 40%
experienced higher rates of assault (43%) than female-to-male 40 34% 37%
31% 31%
respondents (34%). 30
20 13% 12% 13%
10% 11% 11%
Sexual Assault 10

American Indian (24%), multiracial (18%), Asian (17%) and 0

New England Mid-Atlantic South Midwest West California
Black (15%) respondents experienced sexual assault at higher
rates than students of other races. MTF respondents experienced Harassed Physical Assaulted Sexual Assaulted
sexual assault more often (15%) than their FTM peers (10%).
 EDUCATION 37

Harassment and Assault in K-12 Settings by Gender Identity/Expression Harassment and Assault by Students in K-12 Settings by Race

100 100
90 84% 83% 90 83%
77% 76% 78%
80 80 72%
69% 68%
70 70
58%
60
60
50 44% 45%
50 43% 38%
38% 40 35% 34%
40 34% 31% 28%
27% 30 26%
30 21%
15% 17%
20 11% 12%
20 15% 7% 9%
10% 12% 10% 10
10
0
0 Overall American Asian Black Latino/a White Multiracial
MTF FTM All Trans GNC Sample Indian

Harassed Physical Assaulted Sexual Assaulted Harassed Physical Assaulted Sexual Assaulted

HARASSMENT AND ASSAULT BY OTHER STUDENTS IN K-12 Harassment and Assault by Students in K-12 Settings by Region

Examining harassment perpetrated by other students in the K-12 100

setting, respondents reported high levels of harassment and 90
bullying (76%) and physical assault (35%). 78% 80% 78% 80%
80 73%
72%
Multiracial students reported the highest levels of harassment 70

and bullying (83%) and physical assault (45%); American 60

Indian students showed particularly high levels of sexual assault 50

39% 40%
(21%). Respondents who are female-to-male transgender today 40 34% 36%
30% 31%
reported higher rates of harassment and bullying (82%) while 30
MTFs reported higher rates of physical (42%) and sexual assault 20 13% 12%
11% 9% 9% 11%
(14%).3 10
0
New England Mid-Atlantic South Midwest West California
Harassment and Assault in K-12 Settings by Students
Harassed Physical Assaulted Sexual Assaulted

100

90

80 76%

70 Harassment and Assault by Students in K-12

60
Settings by Gender Identity/Expression

50
100
40 35%
90
82% 81%
30 80 75%
20 70 66%
11%
10 60
0 50
42%
Harassed Physical Assaulted Sexual Assaulted 37%
40 33%
30 26%
20 14%
11% 9%
8%
10
0
MTF FTM All Trans GNC
Harassed Physical Assaulted Sexual Assaulted
38 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

HARASSMENT AND ASSAULT BY “My sister has faced more outright

TEACHERS AND STAFF IN K-12
discrimination for her support of me than I
Mistreatment by teachers and staf in K-12 was also severe and
have. I transitioned in her last year in high
had an even greater negative impact than mistreatment by
peers. Respondents experienced considerable abuse, including school, the students verbally harassed her
harassment and bullying (31%), physical assault (5%) and sexual regularly to the point that she considered
assault (3%) at the hands of teachers and staf. Students and
dropping out and just getting her GED. Teachers
their parents have every right to expect that teachers and staf
will keep children safe, and not endanger the students through would also verbally harass her, saying things
violence or harassmen. This trust was violated for far too many. like “You will go to hell for your support of
Latino/a and multiracial respondents reported the highest levels that abomination” and generally treating
of harassment and bullying by their teachers, at 35% and 42% her unequally compared to other students.”
respectively. Multiracial and American Indian students experienced
the highest levels of physical assault by teachers and staf at 6%.
African American students experienced much higher rates of sexual Harassment and Assault by Teachers/Staff in K-12 Settings by Region4
assult by teachers (7%) relative to their peers of any race.
50
Respondents who today identify as female-to-male transgender
45
people experienced teacher harassment and bullying by teachers
40 38%
and staf at higher rates (35%) than male-to-female transgender
study participants (30%), but MTFs were at nearly double the risk 35 32%
31% 31%
for physical (7%) and sexual (3%) assault than their FTM peers 30 27% 27%
(4% physical, 2% sexual). 25
20
15
K-12 Overall Abuse by Teachers/Staff
10
6% 5% 5% 5%
4% 3% 4%
50 5 2% 1% 2% 2%
1%
45 0
New England Mid-Atlantic South Midwest West California
40
Harassed Physical Assaulted Sexual Assaulted
35
31%
30

25
Harassment and Assault by Teachers/Staff in K-12 Settings
20
by Gender Identity/Expression
15

10 50
5%
5 3% 45

0 40
Harassed Physical Assaulted Sexual Assaulted 35%
35 33%
30%
30
26%
25
Harassment and Assault by Teachers/Staff in K-12 Settings by Race
20
15
50
45 10 7%
42% 5%
4% 3% 3%
40 5 3% 2% 1%
35%
35 0
31% MTF FTM All Trans GNC
29%
30
23% Harassed Physical Assaulted Sexual Assaulted
25
19%
20 17%
15
10 6% 7% 6%
5% 4% 4% 4%
5 3% 3% 3% 3% 4%
2% 2%
0
Overall American Asian Black Latino/a White Multiracial
Sample Indian

Harassed Physical Assaulted Sexual Assaulted

 EDUCATION 39

College, Graduate School, Educational Attainment

Professional School and Despite the mistreatment that “I have chosen
Technical School respondents have faced, they reported
to attend
high levels of educational attainment.
In examining higher education speciically, those attending Almost half of our sample had a college online
college, graduate school, professional school or technical school college degree (27%) or a graduate to avoid
reported high rates of abuse by students, teachers and staf, degree (20%); this compares to a
including harassment and bullying (35%) as well as physical combined total of 27% of the general
harassment.”
5
(5%) and sexual assault (3%). Two percent (2%) reported population with these degrees. This
expulsion due to their gender identity/expression. At this level, above average educational attainment appears to be related to
the variation in frequency of harassment and assault did not vary many older students returning to school after facing job loss or
considerably among racial groups, between regions, or by gender other diiculties; we explore this further in the section, “School
identity/expression. Attendance by Age.”
Those students identifying as transgender or expressing gender
non-conformity while attending college, graduate school or Educational Attainment of Our Sample and the General Population
technical school also reported other barriers to full participation
including denial of campus housing (5%) denial of gender- 50
appropriate housing (20%), and deanial of appropriate bathroom 45
facilities. 40%
40
35 31%
30 28% 27%
25
20%
20 18%
14%
15
8% 9%
10
4%
5
0
No HS Diploma High School Some College College Degree Graduate
Diploma Degree
Overall Sample General Population

“I am in a Ph.D. program and have been censured by the faculty for coming out as a trans
woman. I have been denied classes and otherwise harassed by some teachers. One male
psychologist verbally attacked me in class and used transphobic and misogynist language.”

“I am not able to pass as male to the students who live in the same
residence hall that I do because I have a female roommate, which
automatically shows to them that I [was born] female as well.”
40 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Female-to-male respondents reported higher levels of educational FORCED TO LEAVE SCHOOL

attainment than their male-to-female peers. Fifty-two percent
In addition to the previously Harassment was so
(52%) of transgender men had college or graduate degrees
discussed problem of expulsion
compared to 41% of transgender women. Gender non-conforming
due to bias, we found many
severe that it led
people reported college and graduate degree attainment at 60%. nearly one-sixth (15%)
study participants experienced
In the general population, men and women have the same rate of
other barriers to attendance to leave school.
holding a college or graduate degree.7
so severe that they were also
forced to leave school (in grades K-12 or in higher education).
Educational Attainment by Gender Identity/Expression Fifteen percent (15%) reported having to leave school “because the
harassment was so bad.” Fifteen percent (15%) reported leaving
50 school due to inancial reasons related to transition. Eleven percent
44%
45 42% (11%) said they lost or could not get inancial aid or scholarships
40 38%
34%
because they were transgender or gender non-conforming.
35 31% 32%
30 26% 26%
American Indian, Black, Latino/a and multiracial respondents
25 23%
21%
reported these diiculties at higher rates than students of other
18% 19% races, and transgender women respondents experienced these
20
15 barriers at higher rates than transgender men.
10% 9%
10 7%
5% 4% 5%
5 3% 3%
Impediments to Staying in School by Race
0
MTF FTM All Trans GNC
50
No HS Diploma High School Diploma Some College
College Degree Graduate Degree 45
(40%)
40
35 (33%)
Black and Latino/a respondents were the least likely to obtain a 30 (28%) 28%
high school diploma. 25 21% 21% 22% 22%
18%
20 18% 17%
15%15%
15 11% 13% 12%13%
11% 10% 10% 9%
10
5
0
Overall American Asian Black Latino/a White Multiracial
Sample Indian
Left Due to Harassment
Left Due to Financial Reasons Due to Transition
Financial Aid/Scholarship Discrimination

( ) Sample size too low for reliable data

Educational Attainment by Race

50
47% 46%
45
40% 41%
40 39% 39%
37%
35
32%
30 29%
27%
25%
25
22%
20% 20% 20% 19% 19%
20 18%
16% 17%
15% 15% 15%
15
12%
10% 9% 9%
10 8% 8% 7%
4% 5% 4%
5 3%
2%
0
Overall Sample American Indian Asian Black Latino/a White Multiracial
No high school degree High school only Some college College degree Graduate degree (any)
 EDUCATION 41

“Prior to being out at school, I received about “I was kicked out of school by my principal
$18,000 in inancial aid, several awards, and because he hated who I was; I was also harassed
scholarships. The year that I decided to be “out” by students and even called a slut by a one of
on my applications, I received one scholarship my Special Ed teachers because she didn’t like
out of 18 that I applied for despite having a the way I dressed. I was sent to a correctional
4.0 and an excellent application package.” facility for boys because I used to act out when I
was very young, not having the guidance I wish
Impediments to Staying in School by Gender Identity/Expression I had. There at the correctional facility, I was
harassed, attacked, spit on, verbally abused by
50
other youth and staf, and sexually abused.”
45
40
35
Status as a Student by Age10
30
25 23% 50
20% 45%
20 16% 17% 17% 45
14%
15 12% 12% 40
10% 9% 37%
10 6% 35
4%
5
30
0
MTF FTM Trans GNC 25 22%
Left Due to Harassment 20
Left Due to Financial Reasons Due to Transition 15
Financial Aid/Scholarship Discrimination
10 7%
5%
5 2% 3%
1%
0
SCHOOL ATTENDANCE BY AGE 18-24 25-44 45-54 55+
Overall Sample General Population
The age breakdown of those who reported that they were
currently in school was very diferent than the general
population.8 For 18-24 year olds in the general population, 45%
were currently in school. However, in our sample, only 37% were Because of these indings related to the percentage of people in
in school. For older age categories, our respondents were in school school at diferent ages, we do not believe online bias11 is the only
at rates two to three times higher than the general population. reason our sample has such high educational attainment igures.
For 25-44 year olds, 7% of the general population was in school, Had these attainment igures been due solely to online bias, we
whereas 22% of our sample were in school. For 45-54 year olds, would have expected a higher rate of students in the 18-24 age
the general population igure was 2% compared to 5% of our category exceeding that (or at least matching that) of the general
respondents.9 population. Thus, we believe that transgender people reported
higher rates of formal education than the general population
This pattern indicates that many transgender and gender non- largely due to returning to school at later ages (ages 25 and
conforming people are experiencing interruptions in their above).
education compared to the general population. It also shows a
pattern for some of returning to school later in life to inish or
acquire diplomas or degrees, perhaps as an attempt to increase “Regarding employment status, I lost my job of 10
employment opportunities in the face of discrimination. years as a result of transition. I was unemployed
for several months, then underemployed in a temp
“I am an older re-entry student at a university job. Eventually, I returned to school to get an
in California. I was surprised and pleased Associate’s degree in nursing which I paid for with
to ind that among my younger friends home equity loans, and became a registered nurse.”
(who are typically college-aged), gender and
sexuality seems almost to be a non-issue.
This gives me great hope for the future.”
42 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

FINANCIAL BARRIERS TO EDUCATIONAL ATTAINMENT Household Income Levels of Respondents Mistreated in School13

As previously mentioned, 15% of the sample reported leaving

40
school for inancial reasons related to transition. Respondents
35 33% 33%
who left school for inancial reasons experienced lower levels 31% 30%
of educational attainment overall. This is most notable in the 30 28%
25%
percentage of respondents who reported their highest education 25
21% 21%
level was some college. Sixty-one percent (61%) of those who 20
had to leave school due to inancial reasons related to transition 15% 16%
15 12%
started college but did not inish it. This contrasts with the rest of 11%
10 9% 9%
our sample (who did not leave school for inancial reasons) for
4%
which 39% started but did not inish college. This is also relected 5
in the percentages of people who achieved college and graduate 0
Under $10K $10K-under $20K-under $50k-under $100k+
degrees. A combined 30% of people who left school for inancial
$20K $50K $100k
reasons ultimately received a college (19%) or graduate degree General Population No School Mistreatment Mistreated in School
(11%) as opposed to a combined total of 49% of those who did
not have to leave school for inancial reasons.

Educational Attainment of Those Who Left School for Financial Reasons We also found that mistreatment in school correlated with lower
levels of educational attainment. Those who had to leave school
70 due to harassment were less likely to graduate from high school,
61%
60 college or graduate school. Forty-nine percent (49%) of those who
50
did not have to leave school due to harassment went on to receive
39% a college or graduate degree, whereas 30% of those who did have
40
to leave school achieved the same (either returning to school later
30 28%
21%
or switching to a new school in order to graduate). Those who had
19%
20 to leave school due to harassment were twice as likely (9%) to not
11%
10 6% 8% graduate from high school as opposed to those who did not (4%).
3% 4%
0
No HS Diploma High School Some College College Degree Graduate Educational Attainment of Those Who Left School Due to Harassment
Diploma Degree
Had to leave school due to nancial reasons related to transition
50
Did not have to leave school due to nancial reasons related to transition 49%
45
40%
40
35
MISTREATMENT, EDUCATIONAL ATTAINMENT, AND INCOME 30 28%
25
In our sample, mistreatment in school, educational attainment 19%
21%
20
and present household income of our respondents were
15 11% 11%
connected. We found that negative experiences in school were 9%
10 8%
tied to income disparities later in life. Sixty-seven percent (67%) 4%
5
of those making under $10,000 per year at the time of the survey
0
had been harassed, physically assaulted, sexually assaulted or No HS Diploma High School Some College College Degree Graduate
expelled from school. Comparatively, a smaller number (55%) Diploma Degree
Left School Due to Harassment Did Not Leave
of those with high incomes, making $100,000 per year or more,
experienced this mistreatment.
We also compared current income for those who reported no
problems in school (either because they did not experience bias or
because they did not express a transgender identity or gender non-
conformity at school) with those who did experience mistreatment
at school. Forty-six percent (46%) of those who reported no
mistreatment at school reported making over $50,000/year at
the time of the survey, whereas 30% of those who experienced
mistreatment in school were in the same income range. Fifty-eight
percent (58%) of the general population makes $50,000/year or
more, meaning our respondents who were mistreated in school are
about half as likely to be in that range than the general population.12
 EDUCATION 43

EDUCATIONAL ATTAINMENT AND INCOME Income of Those With Only a High School Diploma
COMPARED TO THE GENERAL POPULATION Compared to the General Population
50
Below we compare the income of our respondents to that of the
45
general U.S. population14 at four levels of educational attainment:
40
no high school diploma, only high school diploma, some college 35% 34% 34%
35
and college degree or higher.
30 26%
Shockingly, our sample is 4-5 times more likely than the general 25
population to have a household income of less than $10,000/ 20 18%
15% 15%
year at each level.15 For example, 8% of those who achieved a 15
10%
bachelor’s degree or higher in our sample still made less than 10 6% 5%
$10,000/year as compared to only 2% of the general population, 5

and 42% of our respondents who did not have a high school 0
Under $10K $10K-under $20K-under $50K-under $100K+
diploma made less than $10,000/year as compared with 9% of $20K $50K $100K
the general population without a high school diploma.
Our Sample General Population
Our respondents were 2-3 times less likely than the general
population to be making $100,000/year or more at the same
Income of Those With Some College
levels of educational attainment. For example, 5% of our
Compared to the General Population
respondents who had a high school diploma make $100,000/year
or more as compared to 15% of the general population, and 20% 50
of our respondents who had a college degree make $100,000 or 45

more as compared to 46% of the general population. 40 37%

34%
35
30 27%
Income of Those Without a High School Diploma 25% 25%
25
Compared to the General Population16 19%
20
15%
50 15
45 42% 10 7% 8%
40 4%
5
35%
35 0
30 27% Under $10K $10K-under $20K-under $50K-under $100K+
25% $20K $50K $100K
25
20 Our Sample General Population
15% 15% 14%
15
9% 10%
10 7%
5
0 Income of Those With a College Degree
Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K Compared to the General Population
Our Sample General Population 50 46%
45
40
35 33% 33%
30%
30
25
20%
20 16%
15
8% 9%
10
5 2% 3%
0
Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K

Our Sample General Population

44 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Making the Connections: Experiences in MISTREATMENT IN SCHOOL AND INCARCERATION

School, Economic Security, and Health We found an association between being assaulted at school and
being incarcerated. Fifteen percent (15%) of our sample reported
In this section, we examine the connections between negative having been incarcerated at some point in their lives, but 22% of
experiences in school and employment access, incarceration, those who were physically assaulted in school were incarcerated
homelessness and health outcomes. at some point in their lives. Further, 24% of those who were
sexually assaulted in school were incarcerated at some point in
MISTREATMENT IN SCHOOL AND their lives.
ACCESS TO EMPLOYMENT
MISTREATMENT IN SCHOOL AND HOMELESSNESS
We found that being mistreated in school aligned with various
negative outcomes later in life. There was an alarming
relationship between Nearly half of those
We found that those who were mistreated in school were more mistreatment in school and who left school due to
likely than others to report doing sex work or other work in the whether respondents reported
underground economy such as drug sales. For example, 32%
harassment, experienced
having ever experienced
of those who were physically assaulted at school also reported homelessness. For those homelessness.
doing sex work or other work in the underground economy as who were verbally harassed,
compared to 14% of those who were not assaulted. Thirty-nine physically or sexually assaulted, or expelled because they were
percent (39%) of those who had to leave school “because the transgender or gender non-conforming, 25% reported having
harassment was so bad” reported doing sex work or other work in experienced homelessness as compared to 14% of those who
the underground economy. did not experience this mistreatment at school. For the subset
Having to leave school because harassment was intolerable was who were physically assaulted at school, 38% reported having
also associated with unemployment. Nineteen percent (19%) of experienced homelessness, and for those who had to leave school
those who had to leave school because of harassment reported due to harassment, nearly half (48%) were currently or formerly
being unemployed as compared with 11% of those who did not. homelessness.

We also found that being Those physically MISTREATMENT IN SCHOOL AND HEALTH
physically attacked in school
was linked to later actions assaulted at school We examined four health indicators — smoking, drug and
in the workplace that were were more than twice alcohol abuse, HIV rates, and suicide attempts — as they related
presumably taken to avoid to mistreatment in school. In all cases, those who experienced
as likely to report
further discrimination. Those mistreatment in school had worse outcomes.
who were physically attacked doing sex work or
in school were considerably other work in the Smoking
more likely to stay in a job underground economy. Thirty-seven percent (37%) of those who were physically
they would prefer to leave
assaulted at school reported being current daily or occasional
(64%) compared to those
smokers compared to 29% of those who were not. Forty-
who were not (42%). Similarly, 47% of those who were physically
ive percent (45%) of those who had to leave school due to
assaulted in school “did not seek a promotion or raise” in order to
harassment reported being current daily or occasional smokers.
avoid discrimination as opposed to 27% of those who were not.
Thus, it appears that appropriate treatment in school impacts later
job success. Drugs and Alcohol

Thirty-ive percent (35%) of those who were verbally harassed,

physically or sexually assaulted, or expelled because they were
transgender or gender non-conforming, reported using drugs
or alcohol to cope with mistreatment they faced for being
transgender or gender non-conforming. This compared to 21%
of those who did not face these forms of mistreatment in school.
This number rose to 44% for those who were physically assaulted
and 48% of those who had to leave school due to harassment.
 EDUCATION 45

HIV

Respondents who reported having to leave school due to

harassment were HIV-positive at a rate of 5.14%, compared to
1.87% of respondents who did not. This rate, 5.14%, is more than
eight times the HIV rate of the general population, 0.6%.17

Suicide

Fifty-one percent (51%) of Three-quarters of

those who were verbally
harassed, physically or
those who were
sexually assaulted, or assaulted by teachers
expelled because they were or staf reported having
transgender or gender
non-conforming reported
attempted suicide.
having attempted suicide.
Of those who were physically assaulted, 64% attempted suicide,
and of those who were sexually assaulted 68% attempted suicide.
Of those who had to leave school because of harassment, 68%
reported having attempted suicide.
Notably, suicide attempt rates rose dramatically when teachers
were the reported perpetrators: 59% for those harassed or bullied
by teachers in K-12 or higher education, 76% among those who
were physically assaulted by teachers and 69% among those who
were sexually assaulted by teachers.
46 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

CONCLUSIONS FOR EDUCATION

Harassment and discrimination against transgender and gender non-conforming students People of color
is severe and pervasive in school. In grades K-12, over three-quarters of students reported were especially
experiencing harassment or assault. Almost one-third were harassed by their teachers. In higher
vulnerable to
education, students are too often denied gender-appropriate housing or housing altogether and
lower educational
experienced bias in inancial aid and scholarship opportunities.
attainment and
Given these devastating circumstances, the number of those who stayed in school, or returned
lower income.
despite mistreatment, demonstrates a remarkable resiliency and commitment to obtaining an
education. The level of educational attainment in this sample is notable given the extreme levels
of discrimination and abuse in educational settings reported.

The fact that so many are going back to school later in life likely speaks both to persistence as well as the desperate
economic state people ind themselves in because of severe employment discrimination. Respondents appear to be
experiencing a revolving door of between the classroom and the job market driven by educational and workplace abuses.

Clearly, despite these high levels of educational attainment, our respondents are not fully beneitting from their efforts as
relected by current household income. Whereas most who obtain high school diplomas, college degrees, or professional
degrees see a corresponding increase in income, our sample too often does not.

People of color were especially vulnerable to lower educational attainment and lower income, which may be in part due to
the fact that people of color were more likely to report having expressed their gender identity or gender non-conformity at
school and because of the compounding effects of racism.

In terms of gender, MTF students reported higher rates of violence, while FTM and gender non-conforming students reported
higher rates of harassment and bullying. We speculate that the difference here is that MTF students were under-reporting
verbal harassment that occurred when they were also experiencing violence.

We found that mistreatment in school had a lasting effect on our respondents’ lives and correlated with a number of negative
outcomes including higher rates of sex work, incarceration, homelessness, smoking, drug and alcohol abuse, HIV and
attempted suicide.

All of the experiences documented here as well as the related negative outcomes later in life speak to an urgent need for
reform of the nation’s education system and an end to the abuse of transgender and gender non-conforming students. Like
all other students, transgender and gender non-conforming people have a right to equal opportunity in school, free from
harassment and violence.

“Overall, my experience at school was night and day diferent when they didn’t know I am trans.”

“In school I was harassed and bulled for being diferent. I was forced to wear
dresses to school until 8th grade when the dress code was changed.”
 EDUCATION 47

RECOMMENDATIONS FOR EDUCATION

• Provide a safe learning environment for transgender and gender non-conforming students

• Enact and enforce anti-harassment policies that cover gender identity/expression as well as race and other personal
characteristics within educational settings at all levels and provide training so that faculty, staff and students are aware
of and comply with the policies.

• Actively and promptly investigate all complaints of harassment or violence perpetrated by students, faculty or staff
and ensure that appropriate disciplinary actions are taken. have a zero-tolerance policy for violence and harassment
initiated by faculty and staff members.

• Pass and ensure compliance with all local, state and federal laws relating to harassment, discrimination and assault.

• Create a supportive environment for transgender and gender non-conforming students

• Develop curricular and extra-curricular programming to create a school environment that afirms transgender and
gender non-conforming people and students, including but not limited to inclusive Gay-Straight Alliances.

• Ensure that transgender and gender non-conforming students of color are fully included and supported in these
efforts.

• Help transgender and gender non-conforming students remain in school

• Develop policies to ensure that transgender and gender non-conforming students are not expelled because of their
gender identity or expression or because of something triggered by their gender identity or expression (such as a
physical alteration when the student was simply acting in self-defense).

• Intervene with transgender and gender non-conforming students who are at high risk of dropping out, especially
students of color who face additional risk factors.

• Ensure that higher education is accessible to transgender and gender non-conforming students

• Ensure that inancial aid and scholarship opportunities are open to and non-discriminatory toward transgender and
gender non-conforming applicants.

• Enact policies to ensure transgender and gender non-conforming students have access to gender-appropriate housing
and facilities.

• Develop trans-inclusive support systems for older students returning to school.

• Bridge the gap between education and employment

• Ensure that campus resources such as career counseling and job placement services are accessible to transgender
students and are able to provide culturally competent resources that help students become employed in their ields.

• Provide meaningful internship opportunities for those students to make career contacts and to show the contribution
that they can make to the workplace.

• Ensure GED programs, vocational training programs, and other workforce development programs are accessible to
transgender and gender non-conforming people.
48 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Endnotes 11 According to Don Dillman, “The lack of Internet service for 29% of
__________________________________________________________________________
the population and high-speed service for 53% of the population is
complicated by diferences between those who have and do not have these
services. Non-Whites, people 65+ years old, people with lower incomes,
1 Sandy Baum and Jennifer Ma, “Education Pays 2007: The Beneits of
and those with less education have lower internet access rates than their
Higher Education for Individuals and Society,” Trends in Higher Education
counterparts, and, therefore, are more likely to be left out of Internet
Series, (2007): http://www.collegeboard.com/prod_downloads/about/
surveys.” Don Dillman, Jolene Smyth, and Leah Melani Christian, Internet,
news_info/trends/ed_pays_2007.pdf.
Mail, and Mixed-Mode Surveys: The Tailored Design Method (New York:
2 HIV rates have not been rounded for better comparison to national rates. Wiley, 2008). Therefore, online samples often have higher educational
attainment and higher household income. Our sample had considerably
3 In a similar survey reaching LGBT students in 2007, the Gay, Lesbian, and lower household income, which would lead one to speculate that we have
Straight Education Network found that 86.2% of respondents reported avoided this bias. However, our educational attainment is much higher
being verbally harassed in the last year — 44.1% said they were physically than the general population, which could lead to the opposite conclusion.
harassed, and 22.1% reported physical assault. The transgender-speciic Even more interestingly, one would expect the sample to demonstrate
break out from that sample reported much higher rates, including verbal higher levels than the general population of being in school between 18-
harassment because of sexual orientation at 89%, verbal harassment 24, if it were privileged, yet, as discussed in the Education chapter later,
because of gender expression at 87%, physical harassment because our sample is in school less than the general population in that age range.
of sexual orientation at 55%, physical harassment due to gender For more information about online bias, see David Solomon, “Conducting
expression at 53%, physical assault due to sexual orientation at 28%, web-based surveys,” Practical Assessment, Research & Evaluation,7 no.19,
and physical assault due to gender expression at 26%. Gay, Lesbian, and (2001):http://PAREonline.net/getvn.asp?v=7&n=19 . See also Lee Rainie
Straight Education Network, “2007 National School Climate Survey” et al., “The Ever-Shifting Internet Population: A new look at Internet
(2008): http://www.glsen.org/binary-data/GLSEN_ATTACHMENTS/ access and the digital divide,” Pew Internet & American Life Project (2003):
ile/000/001/1290-1.pdf; Gay, Lesbian, and Straight Education Network, http://www.pewinternet.org/Reports/2003/The-EverShifting-Internet-
“Harsh Realities” (2009): http://www.glsen.org/binary-data/GLSEN_ Population-A-new-look-at-Internet-access-and-the-digital-divide/02-Who-
ATTACHMENTS/ile/000/001/1290-1.pdf. is-not-online/03-Several-demographic-factors-are-strong-predictors-of-
4 Physical and sexual assault igures have not been rounded due to their Internet-use.aspx.
small size. 12 U.S. Census Bureau, “Current Population Survey,” Annual Social and
5 U.S. Census Bureau, “Educational Attainment in the United States: 2009 - Economic Supplement (Washington, DC: GPO, 2009).
Detailed Tables, Current Population Survey” (Washington, DC: GPO, 2009): 13 Ibid.
http://www.census.gov/hhes/socdemo/education/data/cps/2009/tables.
html. 14 Ibid.

6 U.S. Census Bureau, “Current Population Survey,” Annual Social and 15 Given that overall, our respondents have only nearly four times the rate
Economic Supplement (2009). of having a household income lower than $10,000 per year reported
elsewhere, a reader might be confused that these data (that states for
7 U.S. Census Bureau, “Current Population Survey: Enrollment Status of each educational attainment level, respondents have 4-5 times the rate
the Population 3 Years Old and Over, by Sex, Age, Race, Hispanic Origin, of being in the lowest income category) is incorrect. It is correct. The
Foreign Born, and Foreign-Born” (Washington, DC: GPO, October 2008): reason our overall rate of those with $10,000 per year or less is only nearly
Table 1. http://www.census.gov/population/www/socdemo/school/ four times larger than the general population is that our sample has a
cps2008.html. large number of who are in the lowest income category and yet have the
8 Ibid. highest educational attainment (24% of those making $10,000 or lower
in our sample had a bachelor’s degree or higher). The highest educational
9 Ibid. category has the lowest percentage of people in our sample receiving
$10,000 annually or less, so the large presence of highly educated people
10 Some numbers have not been rounded due to their size.
in the sample’s lowest income category drags the overall percentage down
closer to the general population percentage in that income category.

16 U.S. Census Bureau, “Current Population Survey,” Annual Social and

Economic Supplement (Washington, DC: GPO, 2009).

17 HIV rates have not been rounded for better comparison to national rates.
50 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

EMPLOYMENT
Employment is fundamental to people’s ability to support themselves and their families. Paid
work is not only essential to livelihood; it also contributes greatly to a sense of dignity and
accomplishment over a lifetime. The Universal Declaration of Human Rights asserts the rights
of individuals to work at the job of their choice, receiving equal pay for equal work, without
discrimination. Yet far too often, transgender people are denied these basic human rights.
There are also serious social consequences associated with unemployment and under-
employment. The loss of a job and unemployment are linked to depression and other mental
health challenges.1 Given the high rates of unemployment seen in our sample and the high rates
of suicide attempts noted in the Health chapter of this document, employment issues are of
particular concern to transgender and gender non-conforming people.
Field work for this study was done from September 2008 through February 2009, with a large
majority completing questionnaires during September. Accordingly, the employment statistics
here largely precede the widespread layofs and double digit unemployment that the nation as a
whole experienced as the economy moved into a major recession. The data that follow show that
due to discrimination, study participants were experiencing very high rates of unemployment
and extremely poor employment conditions. Given that respondents were faring worse than
the nation as a whole before the recession led to large-scale layofs, the data suggests that in
the current crisis, transgender and gender non-conforming people are likely facing even higher
unemployment than their gender-conforming peers.
The data show not only the rampant discrimination against transgender and gender non-
conforming people, but also show that large numbers have turned to the underground economy
for income, such as sex work or drug sales, in order to survive. Throughout this chapter, we refer
to this as “underground employment.”
 EMPLOYMENT 51

KEY FINDINGS IN EMPLOYMENT

• Double the rate of unemployment: Survey respondents experienced unemployment at twice the rate of the general
population, with rates for people of color up to four times the national unemployment rate.

• Near universal harassment on the job: Ninety percent (90%) of those surveyed reported experiencing harassment or
mistreatment on the job or took actions to avoid it.

• Considerable loss of jobs and careers: Forty-seven percent (47%) said they had experienced an adverse job outcome,
such as being ired, not hired or denied a promotion because of being transgender/gender non-conforming; 26% of
respondents said that they had lost a job due to being transgender or gender non-conforming.

• Race multiplies the effect of discrimination: For Black, Latino/a, American Indian and multiracial respondents,
discrimination in the workplace was even more pervasive, sometimes resulting in up to twice or three times the rates of
various negative outcomes.

• Living in dire poverty: Fifteen percent (15%) of our respondents reported a household income under $10,000/year, nearly
four times the rate of this category for the general population. Those who lost a job due to bias lived at this level of
poverty at six times the rate of the general population. More information about income can be found in the Portrait and
Education chapters.

• Rampant under-employment: Forty-four percent (44%) reported experiencing under-employment.

• Large majorities attempted to avoid discrimination by hiding their gender or gender transition (71%) or delaying their
gender transition (57%).

• The vast majority (78%) of those who transitioned from one gender to the other reported that they felt more
comfortable at work and their job performance improved.

• Eighty-six percent (86%) of those who have not lost a job due to bias reported that they were able to access
restrooms at work appropriate for their gender identity, meaning that 14% of those who kept their jobs were denied
access.

• People who had lost a job due to bias or were currently unemployed reported much higher involvement in
underground employment such as sex work or drug sales, had much higher levels of incarceration and homelessness,
and negative health outcomes.

• Sixteen percent (16%) said they had been compelled to engage in underground employment for income. Eleven percent
(11%) turned to sex work.

• Many respondents demonstrated resilience: Of the 26% who reported losing a job due to bias, 58% reported being
currently employed.
52 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Outness at Work by Age

Outness at Work
50
We asked about outness at work in two diferent ways, only
45 43%
examining those who were currently employed. First, we 41%
40 39%
asked respondents whether they tell work colleagues they are 36% 37%

transgender or gender non-conforming. Second, we asked 35

whether or not people at work knew that the respondent was 30

transgender or gender non-conforming 25

20
In the irst measure, 38% reported that they tell work colleagues
15
that they are transgender or gender non-conforming.2
10

5
Outness at Work by Gender Identity/Expression
0
18-24 25-44 45-54 55-64 65+
50 48%

45 44%
41%
40 38% In the second measure, whether “The only positive
35 33% or not people at work knew that
30 the respondent was transgender or
beneit of being
25 gender non-conforming, we found on Disability is
20 that over one third (35%) reported that I do not have
15 that “most” or “all” coworkers knew to worry about
10 they were transgender or gender non-
employment
5 conforming. Another third (37%) said
“some” or “a few” coworkers knew, discrimination.”
0
Overall Sample MTF FTM All Trans GNC and 28% said no one knew.

Among those who had transitioned, “For years, I

Outness did not vary much by race or age. we see slightly elevated rates of
lived ‘in the
coworkers being aware of their
transgender or gender non- closet’ in order to
Outness at Work by Race
conforming status. Half (50%) support myself
50 reported “most” or “all” coworkers in my career.”
44%
45 knew, 34% said “some” or “a few”
39%
40 38% 38% 37% 37% knew, and 16% said no one knew.
35%
35
30
25
20
15
10
5
0
Overall American Asian Black Latino/a White Multiracial
Sample Indian
 EMPLOYMENT 53

Employment Discrimination Male-to-female transgender respondents reported job loss due

to bias at a frequency of 36% while female-to-male transgender
Forty-seven percent (47%) of “I went from making respondents reported 19%. Twenty-nine percent (29%) of
survey respondents said they transgender respondents experienced job loss due to bias while
40K, to nothing; I gender non-conforming participants reported 15%.
had experienced an adverse
job action—they did not get a can barely get a part
job, were denied a promotion time job at a fast Loss of Job by Gender
or were ired—because they food restaurant.”
are transgender or gender non- 50

conforming. 45

40
36%
Adverse Job Actions 35

30 29%

50 47% 25
44% 19%
45 20
40 15%
15
35
10
30
26% 5
25 23%
0
20
MTF FTM All Trans GNC
15
10
5
Respondents who reported having lost a job due to bias reported
0
I did not get a job I I lost my job I was denied a Did not get a job, being currently unemployed (26%), many times the general
applied for promotion denied a promotion, population rate at the time of the survey (7%), which suggests
or red
that they have been unable to ind new employment after a
discriminatory termination. Twenty-eight percent (28%) of those
who have lost a job due to bias have also reported work in the
JOB LOSS DUE TO DISCRIMINATION
underground economy. Those who were living in the South were
An alarming number of the people surveyed, 26%, reported more likely to have lost a job due to bias (30%) than those living
losing their jobs directly due to their gender identity/ in other regions of the country. Undocumented non-citizens
expression. Particularly hard hit were those who were Black (39%) reported lost jobs due to bias more often than U.S. citizens
(32%), multiracial (36%), and American Indian (36%). (26%). Those with no high school diploma (37%) and those with
only a high school diploma (33%) also experienced particularly
Loss of Job by Race high rates of job loss due to bias.

50
45
40
“I was highly regarded at my new workplace
36% 36%
35 32% until one of my old co-workers came in for
30%
30
26% an interview there and saw me. During his
25 24%
interview he told them all about me. He
20
15 14% didn’t get the job, but I soon lost mine.”
10
5
0
Overall American Asian Black Latino/a White Multiracial
Sample Indian
54 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

DISCRIMINATION IN HIRING “It was absolutely impossible to ind any work

Forty-four percent (44%) of survey respondents reported they at all during transition. I was unemployed
did not get a job they applied for because of being transgender for four years. I went from comfortably upper
or gender non-conforming. Eighty-one percent (81%) of those
middle class to the brink of destitution; I
who had lost their job due to bias also reported discrimination in
hiring as did 71% of those currently unemployed. Also particularly have spent all my retirement savings.”
hard hit were multiracial respondents (56%), American Indians
(55%) and those making under $10,000/year (60%).
DENIED PROMOTION

Discrimination in Hiring by Race

Twenty-three percent (23%) of respondents reported that they
100
were denied a promotion because of being transgender or gender
90
non-conforming. Thirty-three percent (33%) of those with no
80
high school diploma reported denial of a promotion due to bias
70
along with 31% of those who made under $10,000/year. Also
60 55% 56% hard hit were Latino/a (29%), multiracial (31%) and American
50
48% 47% Indian (31%) respondents.
44% 42%
40%
40
30 Denied Promotion by Race
20
50
10
45
0
Overall American Asian Black Latino/a White Multiracial 40
Sample Indian
35
31% 31%
29%
30 27%
25 23%
Sixty-one percent (61%) of those who reported doing sex work, 21%
20
drug sales or other underground work also say that they had
15 13%
experienced discrimination in hiring in the traditional workforce.
10
Male-to-female respondents experienced discrimination in 5
hiring at 55%, compared to 40% of female-to-male respondents. 0
Overall American Asian Black Latino/a White Multiracial
Gender non-conforming respondents experienced this form of Sample Indian
discrimination at 32%.

Discrimination in Hiring by Gender Twenty-nine percent (29%) of male-to-female respondents

reported denial of promotion due to bias, while female-to-
60 male respondents reported an 18% rate. Twenty percent (20%)
55%

49% of gender non-conforming respondents reported denial of

50
promotions due to bias.
40%
40
32%
30

20

10

0
MTF FTM All Trans GNC
 EMPLOYMENT 55

Denied Promotion by Gender Identity/Expression

Under-employment
50
We asked respondents whether they were currently or previously
45
under-employed due to their gender identity/expression; that is
40
“working in the ield I should not be in or a position for which I
35 am over-qualiied.”
30 29%
25% Forty-four percent (44%) of our respondents reported that
25
20% they considered themselves under-employed. Seventy-seven
20 18%
percent (77%) of those who lost a job due to bias also reported
15
experiencing under-employment at some point as well. Sixty-
10
four percent (64%) of those currently unemployed also reported
5
under-employment. Those who made less than $10,000/year
0
MTF FTM All Trans GNC reported current or previous under-employment at a rate of 56%.
Also highly impacted were multiracial respondents (56%).

Underemployment Including by Race

UNEMPLOYMENT

Transgender and gender non-conforming people are

unemployed at alarming rates. Overall, the unemployment
rate for respondents was 14%; double the weighted national
average at the time of the survey.3 Nineteen percent (19%)
of respondents were out of the workforce and “not looking.”
Black, American Indian, Latino/a and multiracial respondents
experienced unemployment at considerably higher rates than
their white counterparts. Black respondents were unemployed
at 28%, four times the rate among the general population;
American Indian/Alaska Native respondents were unemployed
at over three times the general population rate at 24%,
Latino/a and multiracial respondents were unemployed over
twice the general population rate at 18%

Unemployment Rates including by Race Underemployment by Gender Identity/Expression Chart

50 100
45
90
40
80
35
70
30 28%
24% 60
25 50%
50 47%
20 18% 18% 42%
40 38%
15 14%
12%
10% 30
10 7%
20
5
0 10
General Overall American Asian Black Latino/a White Multiracial
0
Population Sample Indian MTF FTM All Trans GNC

“I was a very respected lawyer before all of this, but lost my practice and clients,
and have not been able to attract any new clients or get referrals or even get a job in my ield
for the past 8 years. Very frustrating because I don’t feel any less intelligent or less qualiied,
but others, both the public and lawyers, perceive me that way.”
56 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Workplace Abuse — DIRECT MISTREATMENT AND DISCRIMINATION

A Near-Universal Experience Respondents reported on a wide range of workplace abuses,

including direct discrimination and mistreatment by coworkers
Harassment and mistreatment at work is a near universal and supervisors. Seventy-eight (78%) of respondents said they
experience for transgender and gender non-conforming people experienced some type of direct mistreatment or discrimination.
and its manifestations and consequences are many. Not only
do many face mistreatment and discrimination directly from Direct Mistreatment and Discrimination in the Workplace
coworkers and supervisors; others feel distressed and intimidated
when they see others discriminated against, and decide they must I was harassed by someone at work 50%
hide who they are or give up certain career aspirations in order to Supervisors/coworkers shared information
48%
stay protected. about me inappropriately
I was referred to by the wrong pronoun,
Ninety percent (90%) of respondents said they had directly 45%
repeatedly and on purpose
experienced harassment or mistreatment at work or felt forced to
I did not get a job I applied for 44%
take protective actions that negatively impacted their careers or
their well-being, such as hiding who they were, in order to avoid I was asked inappropriate questions about
41%
my transgender or surgical status
workplace repercussions.
I was forced to present in the wrong
32%
Mistreatment ranged from verbal harassment and breaches of gender to keep my job

conidentiality to physical and sexual assault, while bias-avoidant I lost my job 26%
behaviors included hiding one’s gender, delaying transition, or
staying in a job one would have preferred to leave. Given the I was denied a promotion 23%

broad spectrum of workplace abuse experienced by our study I was denied access to appropriate
22%
participants, their persistent engagement in the workforce speaks bathrooms
to a determination and resilience that goes largely unheralded I was not able to work out a suitable
21%
bathroom situation
in statistics and discourse about transgender and gender non-
I was removed from direct contact with
conforming people in the workplace. 20%
clients
I was the victim of physical violence at
7%
work

“The obstacles currently facing trans people in I was the victim of sexual assault at work 6%

regards to employment are the most insidious.

At least one of these 78%
Without an income, one has absolutely NO
0 10 20 30 40 50 60 70 80 90 100
voice, politically, economically or socially.
Elimination of employment discrimination, In answering each negative work experience question,
above all else, is the keystone to fundamental transgender respondents reported higher levels of abuse than
transgender equality in America.” their gender non-conforming counterparts, often with a gap
of 10 percentage points or more. Male-to-female respondents
experienced harassment and mistreatment slightly more often
than female-to-male respondents, though MTF experience of job
loss, denial of promotion and discrimination in hiring was much
higher than for FTM respondents.

People of color in the sample generally reported higher levels of

abuse than the sample as a whole. Other respondents reporting
higher vulnerability to mistreatment at work were those who had
lost jobs due to discrimination; the unemployed; respondents who
had done sex work, drug sales, or other underground work for
income; and those earning under $10,000 annually.
 EMPLOYMENT 57

Direct Mistreatment at Work for MTF and FTM Respondents Direct Mistreatment at Work for Transgender and
Gender Non-Conforming Respondents

54% 52%
I was harassed by someone at work 50% I was harassed by someone at work 47%

Supervisors/coworkers shared information 53% Supervisors/coworkers shared information 52%

about me inappropriately 51% about me inappropriately 32%

I was referred to be the wrong pronoun, 51% I was referred to by the wrong pronoun, 51%
repeatedly and on purpose 51% repeatedly and on purpose 26%

55% 49%
I did not get a job I applied for 40% I did not get a job I applied for 32%

I was asked inappropriate questions about 43% I was asked inappropriate questions about 46%
my transgender or surgical status 50% my transgender or surgical status 23%

I was forced to present in the wrong 37% I was forced to present in the wrong 33%
gender to keep my job 27% gender to keep my job 23%

36% 29%
I lost my job 19% I lost my job 15%

29% 25%
I was denied a promotion 18% I was denied a promotion 20%

I was denied access to appropriate 28% I was denied access to appropriate 25%
bathrooms 21% bathrooms 8%

I was not able to work out a suitable 23% I was not able to work out a suitable 23%
bathroom situation 23% bathroom situation 10%

I was removed from direct contact with 27% I was removed from direct contact with 22%
clients 15% clients 14%

I was the victim of physical violence at 9% I was the victim of physical violence at 7%
work 4% work 6%

8% 6%
I was the victim of sexual assault at work 3% I was the victim of sexual assault at work 5%

82% 81%
At least one of these 80% At least one of these 71%

0 10 20 30 40 50 60 70 80 90 100 0 10 20 30 40 50 60 70 80 90 100
MTF FTM All Trans GNC

“I was ired from my job after 18 years of loyal employment after a fellow
employee saw me dressed while attending counseling and reported me
to the boss. I was forced on to public assistance to survive.”
58 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

HARASSMENT Harassment by Other Factors

Fifty percent (50%) of respondents reported experiencing 100

harassment in the workplace. This was the most common 90
negative experience at work. Risk of harassment was higher for 80 76%
those earning lower incomes. High numbers of those who were 70 66%
currently unemployed also reported that they had been harassed 60%
60
when they were working. Similarly, a large number of those who 50
reported having lost jobs due to bias also reported having been 40
harassed at work. Last, those that had done underground work 30
such as sex work, drug sales, or other underground activities for 20
income also frequently reported that they had been harassed at 10
work. 0
Those who lost job due to Unemployed Those who participated in
bias underground employment
Harassment by Race

100
90 PHYSICAL ASSAULT AT WORK
80
Seven percent (7%) of our sample reported being physically
70
62% assaulted at work because of being transgender or gender non-
60 55%
50%
53% conforming. Undocumented noncitizens in our sample reported
50 48%
43% 44% the highest rates of physical assault at 25%, over three times the
40
rate of the overall sample.
30
20
Physical Assault at Work by Race
10
0 50
Overall American Asian Black Latino/a White Multiracial
Sample Indian 45
40
35
30
Harassment by Income
25
20%
100 20
15 14%
90 12% 12%
80 10 7%
5% 5%
70 5

60 58% 0
55%
51% Overall American Asian Black Latino/a White Multiracial
50 47% Sample Indian
42%
40
30
20
10
0
Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K
 EMPLOYMENT 59

Physical Assault at Work by Educational Attainment SEXUAL ASSAULT AT WORK

50
Six percent (6%) of respondents reported being sexually
45
assaulted by someone at work because of being transgender or
40
gender non-conforming. Undocumented noncitizens reported the
35 particularly high rates of sexual assault at 19%, over three times
30 the rate of the overall sample.
25 23%

20 Sexual Assault at Work by Race

15 12%
50
10 8%
4% 5% 45
5
40
0
No HS Diploma HS Diploma Some College College Degree Graduate 35
Degree
30
25
20 17%
Physical Assault at Work, by Others at High Risk 15 14%
11%
10 9%
6% 7%
50 5 4%

45 0
Overall American Asian Black Latino/a White Multiracial
40
Sample Indian
35

30

25
Sexual Assault at Work by Household Income
20 18% 17%
15 50
10 45
5 40
0 35
Lost Job Due to Bias Participated in Underground Economy
30
25
20
15
10%
10 7% 6%
5 4% 3%

0
Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K
60 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Sexual Assault at Work by Educational Attainment FORCED TO PRESENT IN THE WRONG GENDER

50
Thirty-two percent (32%) of respondents reported being forced
45
to present in the wrong gender to keep their jobs. Our question
40
did not specify whether they were required to do so by their
35 employer, or they felt forced to because of fear of discrimination.
30 Undocumented noncitizens reported this experience at a
25 particularly high rate (45%).
20%
20
15 Forced to Present in the Wrong Gender by Race
10%
10 7%
4% 4% 50
5
45
0 40%
No HS Diploma HS Diploma Some College College Degree Graduate 39%
40
Degree 34%
35 32% 31%
30 28%

25 23%
Sexual Assault at Work, Others at High Risk 20
15
50 10
45 5
40 0
Overall American Asian Black Latino/a White Multiracial
35 Sample Indian
30

25

20
15% Forced to Present in the Wrong Gender by Household Income
15 13%

10 100
5 90
0 80
Lost Job Due to Bias Participated in Underground Economy
70
60
50
42% 40%
40 34%
30 26% 24%
20
10
0
Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K

“When one of my colleagues found out I was born female, I was forced to use the
bathroom in another part of the building where I worked, because he said that
I made the ‘real’ men uncomfortable with my presence. Now, I look like a bio-
male, and the only reason they knew about my status is because a supervisor
found out, and spread my business to the other supervisors and friends. I had
to walk 5 minutes to another building, which impeded my break times.”
 EMPLOYMENT 61

RESTROOMS AT WORK INAPPROPRIATE QUESTIONS

Eighty-six percent (86%) of those who have not lost a job due Forty-one percent (41%) Forty-ive (45%) of our
to bias reported that they were able to access restrooms at work of respondents reported sample reported having
appropriate for their gender identity, meaning that 14% of those having been asked
been referred to by the
who kept their jobs were denied access. Looking at the full inappropriate questions
sample, regardless of whether they were able to keep or they had about their transgender wrong pronouns “repeatedly
lost a job, 78% were given access to restrooms appropriate for or surgical status. and on purpose” at work.
their gender identity and 22% were denied access.

Denied Access to Gender-Appropriate Restrooms by Race Was Asked Inappropriate Questions by Race

50 100
45 90
40 80
35 32% 70
30%
30 27% 60 54%
50%
25 22% 22% 50 43%
20% 41% 39%
18% 40 38%
20
30 28%
15
10 20
5 10
0 0
Overall American Asian Black Latino/a White Multiracial Overall American Asian Black Latino/a White Multiracial
Sample Indian Sample Indian

Denied Access to Gender-Appropriate Restrooms by Household Income Was Asked Inappropriate Questions by Household Income

50 100
45 90
40 80
34% 70
35
30 60 53%
24% 49%
25 22% 50 43%
20 18% 40 34%
16% 30%
15 30
10 20
5 10
0 0
Under $10K $10K-under $20K-under $50K-under $100K+ Under $10K $10K-under $20K-under $50k-under 100K+
$20K $50K $100K $20K $50K $100k

“At the job I came out at, most were ok and accepting; but the HR
manager blocked any attempts for me to arrange a bathroom, even after I
pointed to a local law allowing me to use the correct bathroom.”
62 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

DELIBERATE MISUSE OF PRONOUNS BREACHES OF CONFIDENTIALITY

Forty-ive (45%) of our sample reported having been referred to Forty-eight percent (48%)
“My former employer outs
by the wrong pronouns “repeatedly and on purpose” at work. reported that supervisors or
coworkers shared information
me anytime a prospective
about the respondent that employer calls.”
they should not have had.
Deliberate Misuse of Pronouns by Race
100 Breaches of Conidentiality by Race
90
80 100

70 90
63%
60 57% 80
49% 70
50 45% 43%
37% 39% 60 56%
40 51% 53%
50 48% 47% 46%
30
20 40 33%
10 30

0 20
Overall American Asian Black Latino/a White Multiracial 10
Sample Indian
0
Overall American Asian Black Latino/a White Multiracial
Sample Indian
Deliberate Misuse of Pronouns by Household Income
100
90
80
Breaches of Conidentiality by Household Income

70
100
60 57% 56%
90
50 47%
38% 80
40
32% 70
30
60 57%
20 52%
49%
50
10 42% 41%
40
0
Under 10K $10K-under $20K-under $50K-under $100K+ 30
$20K $50K $100K
20
10

Deliberate Misuse of Pronouns by Educational Attainment 0

Under $10K $10K-under $20K-under $50K-under $100K+
100 $20K $50K $100K
90
80
70
60 54%
50% 52%
50
40 38% 38%

30
20
10
0
No HS Diploma High School Some College College Degree Graduate
Diploma Degree
 EMPLOYMENT 63

Discrimination-Avoidant Behaviors by Gender Identity/Expression

Attempts to Avoid Discrimination
100
In order to avoid discriminatory actions and workplace abuse,
90
many study respondents reported having “delayed my gender 80 72%
69%71%
transition” (57%) or “hid my gender or gender transition” (71%). 70 65%
62%
Given the importance of transition for many people, it is striking 60 50% 59%
50% 47%
50 46%48% 44% 45%
that well over half of our respondents delayed this life-airming,
36% 38% 38% 32%
40 34%
and often live-saving step. Even more alarming is that nearly 30%
30 25%
three-quarters of respondents reported they felt they had to hide 20
who they are on a daily basis for job security. 10
0
Many respondents stayed in jobs they would have preferred to Hid my gender Delayed Stayed in a job Changed jobs Didn’t seek
or transition transition I’d prefer to promotion/raise
leave (45%) or didn’t seek promotions or raises (30%) in order to leave
avoid discrimination. Others (42%) said they had changed jobs to MTF FTM All Trans GNC
escape discrimination.

Discrimination-Avoidant Behaviors, Overall Sample

100
90
Employment Bias by Association
80
71% We asked respondents whether their spouses/partners or
70
60 57% children experienced job discrimination due to the respondent
50 45% being transgender or gender non-conforming.4 Fourteen
42%
40 percent (14%) of respondents reported that due to their gender
30%
30 identity, their spouse or partner experienced job discrimination.
20 Respondents who reported having lost a job due to bias reported
10 discrimination against their partners at twice that rate (28%).
0
Hid my gender Delayed Stayed in a job Changed jobs Didn’t seek Respondents also reported that their children were subject to job
or transition transition I’d prefer to promotion/raise
leave discrimination due to associational bias at 11%. For those who lost
jobs due to bias, discrimination against their children was reported
at 25%.
The discrimination avoidant behaviors described in this section all
Undocumented non-citizens reported high levels of associational
have implications for career achievement and secure livelihood.
discrimination for both spouses/partners (20%) and children (20%).
Those who have lost a job due to discrimination display the
highest levels of discrimination avoidant behavior.
Employment Bias by Association by Race

Discrimination-Avoidant Behavior Among Those 50

Who Have Lost a Job Due to Bias 45
40
100 35
90 30
79% 24% 24%
80 76% 25 23%
68% 20% 19% 19%
70 66% 20 17%
14% 15%
60 15 13% 12%
50% 11% 10% 9%
50 10
40 5
30 0
Overall American Asian Black Latino/a White Multiracial
20 Sample Indian
10 Children Spouse/Partner
0
Hid my gender Delayed Stayed in a job Changed jobs Didn’t seek
or transition transition I’d prefer to promotion/raise
leave
64 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Improved Job Situation For Sex Work, Drug Sales, and Other
Those Who Transition Underground Work for Income
Of respondents who are living full-time in accordance with Given that transgender and gender non-conforming people are
their gender identity, 78% said they felt more comfortable often denied access to, forced out of or grossly mistreated in
and their performance improved at work. Respondents in the traditional employment markets, it follows that underground
higher income categories more often reported an increase in work can be an essential survival strategy.
feeling comfortable and performing better after transitioning.
Sixteen percent (16%) of our sample has had some experience in sex
Transgender men (78%) and transgender women (79%) who
work, drug sales, and other underground work. Those at high risk
have transitioned reported nearly identical rates of improved job
for underground work were those who had lost jobs due to bias
situation.
(28%), compared to those who had not lost a job (13%), and the
These respondents who felt their performance improved unemployed (29%), compared to 14% of those who were employed.
experienced similar rates of harassment and other forms of
Black (53%) and Latino/a (34%) respondents had extremely high
mistreatment in the workplace as other transgender and gender
rates of underground work, likely related in part to barriers and
non-conforming people. For example, of those who transitioned
abuse within educational systems and dramatically higher rates of
who said their job performance improved, 51% also reported
employment discrimination.
being harassed at work, compared 50% of the overall sample.
Male-to-female (19%) respondents had slightly higher rates
Improved Job Performance by Income of underground work than female-to-male (15%) respondents,
and transgender (18%) and gender non-conforming (16%)
respondents were involved at almost equal frequency.
100
90 Participation in the Underground Economy by Race
81% 82%
80 78% 78%
69%
70 60
53%
60
50 47%
50
40 40
34%
30 30% 29% 30%
30
20
21% 20%
10 20 18%
16% 16% 16%
11% 11% 11%
0 10% 11%
10 8%
Under $10K $10K-under $20K-under $50K-under $100K+ 6% 6% 6%
$20K $50K $100K
0
Overall American Asian Black Latino/a White Multiracial
Sample Indian

“When I started my transition, the place that Any Underground Economy Sex Work Drug Sales

I was working was very supportive. My boss

had a family member who is transgender. I was Participation in the Underground Economy
treated with respect by everyone. I had worked by Gender Identity/Expression

there for many years and everyone assumed that 50

45
I was gay until then and they knew my partner.
40
I guess they just igured I would still be me. 35
Except for growing facial hair and going bald, 30

I am the same, only better and more free.” 25

19%
20 18%
15% 15% 16%
15 12%
10% 9% 10% 9%
10 8% 7%
5
0
MTF FTM All Trans GNC
Any Underground Economy Sex Work Drug Sales
 EMPLOYMENT 65

Participation in the Underground Economy by Employment attainment remained elevated, including 6% of those with
graduate degrees.
50
45 Sex Work by Educational Attainment
40
50
35
28% 29% 45
30
25 40
20% 21%
35 33%
20
14% 14% 30
15
10 25

5 20
16%
0 15 12%
Lost Job Unemployed
10 7%
Any Underground Economy Sex Work Drug Sales 6%
5
0
No HS Diploma High School Some College College Degree Graduate
Diploma Degree
SEX WORK

Eleven percent (11%) of respondents did sex work for income.

Here we take a closer look at the demographics of sex workers Homelessness
in our sample and then examine their rates of incarceration, Respondents reporting sex work were far more likely to also
homelessness, and health outcomes. report experiencing homelessness due to bias than the full
MTF respondents were more likely to report sex work (15%) than sample; anecdotal evidence indicates that many who face
FTM respondents (7%); these data unearths the reality that some homelessness do sex work to pay rent or to stay in a hotel.
transgender men have also done sex work at some point in their Forty-eight percent (48%) of those who had done sex work also
lives. Transgender respondents, overall, reported sex work at 12%, reported experiencing homelessness due to bias. This compares
only slightly higher than gender non-conforming respondents (10%). to 19% of the sample overall and 7.4% for the general population
overall.5
Respondents of color were more likely to have reported having
done sex work; African-American respondents reporting the Incarceration
highest rate at 44%. Latino/a respondents had the next highest
rate at 28%. These data aligns with extremely high rates of Participants who did sex work were almost four times as likely
unemployment and workplace abuse experienced by respondents to have been incarcerated for any reason (48%) than the overall
of color in the study. sample (16%).

Sex Work by Race HIV

Those who had did sex work were over 25 times more likely to be
50
HIV-positive (15.32%) than the general population (0.6%).6
45 44%

40
Smoking
35
30 28% The rate of smoking among those who had done sex work was
25 much higher (49%) than the overall sample (30%).
20 19%
17%
15 Drinking and Drugs
11% 11%
10
6% Respondents who had done sex work were twice as likely to
5
misuse drugs or alcohol to cope with the mistreatment (18%) as
0
Overall American Asian Black Latino/a White Multiracial the overall sample (8%).
Sample Indian

Suicide Attempts
Those with higher educational attainment were less likely to
The rate of attempted suicide among those who had done sex
report sex work. Those with no high school diploma reported a
work was mucg higher (60%) than the overall sample (41%) and
33% rate of sex work, compared to those with college degrees
more than 37 times higher than the general population (1.6%).
at 7%. However, sex work among those with high levels of
66 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Making the Connections: Homelessness

Employment Discrimination, Respondents who had lost a job due to bias were four times more
likely to have experienced homelessness due to bias (40%) than
Economic Security, and Health those who did not lose a job due to bias (10%).

In this section, we examine the connections between employment

Incarceration
discrimination and present income, incarceration, homelessness
and health outcomes. Respondents who had lost a job due to bias were 85% more likely
to have been incarcerated for any reason (24%) than those who
RESPONDENTS WHO HAVE LOST JOBS did not lose a job.
DUE TO DISCRIMINATION
HIV
We looked at present household income of the more than one
quarter (26%) of our sample who said they had lost jobs because Respondents who had lost a job due to bias reported an HIV rate
they were transgender or gender non-conforming and found the (4.59%) over seven times higher than the general population
apparent efects to be severe. Respondents who had lost a job due (.6%),8 and more than double the rate of those who did not lose a
to bias were six times as likely to be living on a household income job (2.06%).
under $10,000/year (24%) as the general U.S. population (4%). 7
They were nearly twice as likely to be living on between $10,000 Smoking
and $20,000/year (17%) as the general population (9%).
Respondents who had lost a job due to bias were more likely to
be smokers (38%) than the overall sample (30%).
Income of the General Population, Our Sample,
and Those Who Lost a Job Due to Bias
Drinking & Drugs

50 Respondents who had lost a job due to bias were 70% more likely
45
to misuse drugs or alcohol to cope with the mistreatment they
40
34% 33% face (12%) than those who had not lost a job (7%).
35 32% 32%
30%
30 28% 27%
24% 25%
25 Suicide Attempts
19%
20 17%
15% 14% 14% Respondents who had lost a job due to bias were much more
15 11% 12% 11%
9% 8% likely to have attempted suicide (55%) than those respondents
10
4%
5 who had not lost a job due to bias (38%), and both igures are
0 striking in contrast to the general population igure of 1.6%.
Under $10K $10K-under $20K-under $50K- under $100K+
$20K $50K $100K
General population Lost A Job Due to Bias
Overall Sample Did Not Lose a Job Due to Bias

“I was ired for being transgender. I was on the brink of homelessness

and starvation until a friend (who is also transgender) invited me
to stay with her in a diferent state, over 15 hours away.”
 EMPLOYMENT 67

UNEMPLOYED RESPONDENTS “I was ired from a good job because I tried to

Here we take a closer look at those respondents who reported transition on the job. I then lived on menial
being currently unemployed and describe the higher incidence employment for over 3 years before inally
of negative outcomes they experienced. These respondents may
landing another good one that was full-time job
be unemployed because they lost a job due to bias, because they
experienced discrimination in hiring, or for other reasons. and had beneits. At one point, I had an ofer
of employment withdrawn after the would-
Homelessness be employer found out I was transgender.”
Respondents who were unemployed were more than twice as
likely to have experienced homelessness due to bias (38%) than
those who were employed (14%).

Incarceration

Respondents who were unemployed were 85% more likely to

have been incarcerated for any reason (24%) than those who
were employed (13%).

HIV

Respondents who were unemployed reported an HIV rate

(4.67%) over seven times higher than the general population
(.6%),9 and more than double the rate of those who were
employed (1.81%).

Smoking

Respondents who were unemployed were more likely to be

smokers (38%) than the overall sample (30%), and almost twice
as likely to be smokers than those who were working (20%).

Drinking & Drugs

Respondents who were unemployed were almost two times as

likely to misuse drugs or alcohol to cope with the mistreatment
they face (13%) than those who were working (7%).

Suicide Attempts

Respondents who were unemployed were much more likely to

have attempted suicide (51%) than those respondents who were
working (37%), and both igures are striking in contrast to the
general population igure of 1.6%.
68 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

CONCLUSIONS FOR EMPLOYMENT

Transgender and gender non-conforming people face staggering rates of harassment mistreatment, and discrimination at
work. In this chapter we have shown that many of those who faced this discrimination also experienced multiple, devastating
outcomes across many areas of life.

The most obvious sign of this discrimination was the extremely high unemployment igures, double the rate of the general
population at the time of study. Underemployment and low household income were also widely reported.

Encouragingly, most of those who have transitioned reported feeling more comfortable at work and that their job
performance had improved. However, many of our respondents are unable to reap that beneit because they delayed their
gender transition in order to avoid discrimination. The data appears to indicate that transition is not only pivotal to the
individual’s well-being, but also that employers would be wise to support and facilitate gender transition of their employees
to increase productivity.

Many report changing jobs to avoid discrimination or the risk of discrimination. Again, employers should be aware how
environments hostile to transgender workers negatively affect their bottom line, as they lose experienced employees and
face the added expense of hiring and training replacements.

High rates of workplace abuse and unemployment among respondents, and resulting poverty, indicate that anti-transgender
discrimination has left many in a position where sex work and drug sales are necessary for survival. Respondents of color
were particularly vulnerable to being pushed into underground work, with a combination of discrimination based on gender,
race and citizenship forcing them farthest to the margins.

The data show that there is a high price to pay for those who must do sex work and other underground work, including
homelessness, incarceration and catastrophic health outcomes.

This survey is a call to action; employment discrimination has devastating effects on transgender and gender non-conforming
people and must be confronted and eradicated. Not only must individual employers be held accountable, but society as a
whole must be held accountable for widespread violations of a basic human right.

RECOMMENDATIONS FOR EMPLOYMENT

Respondents in this study faced overwhelming bias and mistreatment in the workplace due to gender identity and
expression. In the absence of workplace protections, employers and coworkers are free to engage in a broad range of
abuses from arbitrary irings to demeaning and even violent treatment. The solution to this problem requires the attention of
the legislative and executive branches of government, corporations and other employers, labor organizations and non-proit
organizations.

• Federal, state, and local laws should be enacted to prohibit discrimination on the basis of gender identity or expression.

• Federal employment non-discrimination legislation should be enacted with transgender/gender non-conforming

protections intact.

• States and local governments should prioritize enactment of non-discrimination laws.

• Government agencies should implement laws through regulations, compliance guidelines, training, and publicized
decisions by enforcement agencies.

• Only a handful of the states/localities that currently have legal protections have written regulations or guidelines
showing employers how to properly treat transgender and gender non-conforming employees. Without these speciics,
employers are not sure what the law requires of them and employees cannot engage in effective self-advocacy when
being mistreated or discriminated against.
 EMPLOYMENT 69

• Enforcement agency staff should undergo training to better understand the speciic issues that transgender and
gender non-conforming employees experience in the workplace and should learn how to respectfully deal with
transgender and gender non-conforming complainants.

• Decisions, investigations, and settlements related to discrimination on the basis of gender identity/expression should
be publicized as much as possible to increase awareness of what constitutes illegal discriminatory actions.

• Enforcement agencies should develop and offer trainings for employers on how to comply with the law. If this is not
done, non-proit organizations should develop and provide these trainings.

• Enforcement agencies and non-proit groups should develop “Know Your Rights” materials and trainings for
transgender and gender non-conforming people.

• Corporations should enact and enforce their own gender identity/expression non-discrimination policies.

• All employees should be trained on how to comply with the policy. Hiring oficers must be instructed to ensure they are
not consciously or unconsciously discriminating in hiring and should also be educated about how to recognize when
an applicant has a poor work record due to discrimination.

• Written policies should be developed concerning gender transition in the workplace so that all employees understand
proper, respectful protocol. This policy should address conidentiality, access to gender-segregated facilities, dress
standards (if relevant), medical leave policies, pronouns and forms of address, harassment, change of employee
records and badges, and any other topic necessary for a smooth gender transition in the workplace.

• Companies should actively recruit transgender and gender non-conforming applicants.

• Government agencies at all levels should develop transgender-speciic workforce development programs, or modify
existing programs, to train and match transgender and gender non-conforming people to the best jobs available.

• Staff running these programs should be properly trained to address and work with transgender and gender non-
conforming participants respectfully.

• Special attention in such programs should be paid to devising ways to expunge criminal records of persons who have
been incarcerated for survival behaviors, and/or ind employers who are willing to hire applicants with criminal records.

• These programs should train cooperating employers on how to avoid discrimination in hiring transgender and
gender non-conforming employees and require that staff of cooperating employers have received training on how to
respectfully treat these coworkers.

• Government agencies should work with transgender organizations to develop such programs, ideally providing grants
to these organizations for their assistance.

• Labor organizations should ensure that contracts include gender identity/expression nondiscrimination clauses, train
union oficers and rank-and-ile on the importance of nondiscrimination in the workplace, and how to process grievances
related to discriminatory treatment.

• Governments should focus their resources on providing meaningful pathways out of poverty, such as by increasing
employment opportunities for transgender and gender non-conforming people, rather than expending signiicant
resources on arresting, prosecuting, and incarcerating those doing sex work.
70 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Endnotes
__________________________________________________________________________

1 U.S. National Library of Health and the National Institutes of Health,

Medline Plus, “Out of Work May Mean Out of Sorts: Mental health takes a
beating with economic downturn, http://www.nlm.nih.gov/medlineplus/
news/fullstory_102374.html

2 This includes people who said they tell “everyone.”

3 Seven percent (7%) was the rounded weighted average unemployment

rate for the general population during the six months the survey was in
the ield, based on which month questionnaires were completed. See
seasonally unadjusted monthly unemployment rates for September
2008 through February 2009. For information on how we calculated
the unemployment rate for respondents, see the Portrait chapter. U.S.
Department of Labor, Bureau of Labor Statistics, “The Employment
Situation: September 2008,” (2008): http://www.bls.gov/news.release/
archives/empsit_10032008.htm

4 See Appendix B: Survey Instrument – Issues and Analysis for more

discussion of this question.

5 Bruce G. Link, PhD, et al., “Lifetime and Five-Year Prevalence of

Homelessness in the United States,” American Journal of Public
Health 84, (December 1994): http://ajph.aphapublications.org/cgi/
reprint/84/12/1907.

6 HIV rates are reported without rounding in order to make a more precise
comparison with general population data.

7 4.15% of the population had a household income below $10,000 per year.
U. S. Department of Commerce, U.S. Census Bureau and U.S. Department
of Labor, Bureau of Labor Statistics, “Current Population Survey: Annual
Social and Economic Supplement” (2008).

8 HIV rates reported without rounding in order to make a more precise

comparison with general population data.

9 HIV rates reported without rounding in order to make a more precise

comparison with general population data.
72 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

HEALTH
Access to health care is a fundamental human right that is regularly denied to transgender and
gender non-conforming people.

Transgender and gender non-conforming people frequently experience discrimination when

accessing health care, from disrespect and harassment to violence and outright denial of service.
Participants in our study reported barriers to care whether seeking preventive medicine, routine
and emergency care, or transgender-related services. These realities, combined with widespread
provider ignorance about the health needs of transgender and gender non-conforming people,
deter them from seeking and receiving quality health care.

Our data consistently show that racial bias presents a sizable additional risk of discrimination
for transgender and gender non-conforming people of color in virtually every major area of the
study, making their health care access and outcomes dramatically worse.

KEY FINDINGS IN HEALTH

• Survey participants reported that when they were sick or injured, they postponed medical care due to discrimination
(28%) or inability to afford it (48%).

• Respondents faced serious hurdles to accessing health care, including:

• Refusal of care: 19% of our sample reported being refused care due to their transgender or gender non-conforming
status, with even higher numbers among people of color in the survey.

• Harassment and violence in medical settings: 28% of respondents were subjected to harassment in medical
settings and 2% were victims of violence in doctor’s ofice.

• Lack of provider knowledge: 50% of the sample reported having to teach their medical providers about
transgender care.

• The majority of survey participants have accessed some form of transition-related medical care despite the
barriers; the majority reported wanting to have some type of surgery but have not had any surgeries yet.

• If medical providers were aware of the patient’s transgender status, the likelihood of that person experiencing
discrimination increased.

• Respondents reported over four times the national average of HIV infection, 2.64% in our sample compared to .6% in
the general population, with rates for transgender women at 4.28%, and with those who are unemployed (4.67%) or who
have done sex work (15.32%) even higher.1

• Over a quarter of the respondents misused drugs or alcohol speciically to cope with the mistreatment they faced
due to their gender identity or expression.

• A staggering 41% of respondents reported attempting suicide compared to 1.6% of the general population, with
unemployment, bullying in school, low household income and sexual and physical associated with even higher rates.
 HEALTH 73

Access to Healthcare Health Care Experiences

HEALTH CARE SETTINGS DISCRIMINATION BY MEDICAL PROVIDERS

A majority of study participants sought care (“when you are Denial of health care and 19% of our sample
sick or need advice about your health”) through a doctor’s multiple barriers to care are
reported being refused
oice (60%); however a sizable minority used health centers commonplace in the lives
and clinics (28%). Four percent (4%) of respondents primarily of transgender and gender care altogether, due to
used emergency rooms for care. Several studies have shown non-conforming people. their gender identity
that individuals who use emergency rooms for primary care Respondents in our study or expression, with
experience more adverse health outcomes than those who seeking health care were
even higher numbers
regularly see a primary physician.2 Factors that correlated with denied equal treatment in
increased use of emergency rooms (ERs) among our respondents doctor’s oices and hospitals
among people of
were: (24%), emergency rooms color in the survey.
(13%), mental health clinics
• Race—17% of African-Americans used ERs for
(11%), by EMTs (5%) and in drug treatment programs (3%).3
primary care, as did 8% of Latino/a respondents;
Female-to-male respondents reported higher rates of unequal
• Household income—8% of respondents earning under treatment than male-to-female respondents. Latino/a respondents
$10,000 per year used ERs for primary care; reported the highest rate of unequal treatment of any racial
• Employment status—10% of unemployed respondents category (32% by a doctor or hospital and 19% in both emergency
and 7% of those who said they had lost their rooms and mental health clinics).
jobs due to bias used ERs for primary care;
We also asked whether respondents had been denied service
• Education—13% of those with less than a high altogether by doctors and other providers.4 Nineteen percent
school diploma used ERs for primary care. (19%) had been refused treatment by a doctor or other provider
because of their transgender or gender non-conforming status.
Visual conformers and those who had identity documents that
matched their presentation had high rates of using doctor’s oices Twenty-four percent (24%) of transgender women reported
for their care. having been refused treatment altogether and 20% of transgender
men did. Respondents who reported they had lost jobs due to
Primary Source of Medical Care for Respondents bias (36%); American Indians (36%); those who worked in the
underground economy (30%); those on public insurance (28%);
100
and those who transitioned (25%) experienced high occurrence
90
of refusal to treat.
80
70
60%
60
50
40
30
20 17%

10 7%
4% 4% 2%
0
ER Doctor's Health center Free clinic VA Alternative
of ce provider

“After an accident on ice, I was left untreated in the ER for two hours when they
found my breasts under my bra while I was dressed outwardly as male.”

“I have been refused emergency room treatment even when delivered to the
hospital by ambulance with numerous broken bones and wounds.”
74 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Refusal to Provide Medical Care by Race VIOLENCE AND HARASSMENT WHEN

SEEKING MEDICAL TREATMENT
50
Doctors’ oices, hospitals, and
45 2% of respondents
40 other sources of care were
36%
often unsafe spaces for study
reported being
35
30 participants. Over one-quarter physically attacked
27%
25 22%
of respondents (28%) reported in a doctor’s oice.
20 19% 19%
17%
verbal harassment in a doctor’s
15%
15 oice, emergency room or other
28% reported being
10 medical setting and 2% of the
5 respondents reported being verbally harassed in
0 physically attacked in a doctor’s a medical setting.
Overall American Asian Black Latino/a White Multiracial
Sample Indian
oice.

Those particularly vulnerable to physical attack in doctors’

oices and hospitals include those who have lost their jobs
Refusal to Provide Care by Gender Identity/Expression
(6%); African-Americans (6%); those who done sex work, drug
sales or other work in the underground economy (6%); those
50 who transitioned before they were 18 (5%); and those who are
45 undocumented non-citizens (4%).
40 In emergency rooms, 1% reported attack. Those more vulnerable
35 to attack include those who are undocumented (6%); those who
30 have worked in the underground economy (5%); those who
24%
25 22% lost their jobs (4%); and Asian respondents (4%). Obviously,
20%
20 harassment and physical attacks have a deterrent efect on
15 patients seeking additional care and impact the wider community
10 as information about such abuses circulates.
6%
5

0
MTF FTM All Trans GNC
“My experiences in dealing with hospital
personnel after my rape was not pleasant and
lacked a lot of sensitivity to trans issues.”
“I have had general practitioners refuse to
accept me as a patient on the basis of having “When I tried to kill myself and was
a history of gender identity disorder.” taken to a suicide center, I was made
fun of by staf and treated roughly.”

“I was forced to have a pelvic exam by a doctor

when I went in for a sore throat. The doctor
invited others to look at me while he examined
me and talked to them about my genitals.”
 HEALTH 75

OUTNESS AND DISCRIMINATION “I have been harassed and physically assaulted on

Twenty-eight percent (28%) of respondents said they were out to the street. One time, I didn’t go the hospital until I
all their medical providers. Eighteen percent (18%) said they were went home, changed [out of feminine] clothes, and
out to most, 33% said some or a few, and 21% were out to none. then went to the emergency room in male mode. I
had a broken collar bone as a result of that attack.”
When Seeking Medical Care, How Many People Know or
Believe You Are Transgender or Gender Non-Conforming?

“I rarely tell doctors of my gender identity. It just

seems so hard to explain what “genderqueer”
means in a short doctor’s appointment. I also
Most
am reluctant to take the risk of discrimination;
18%
Some I need to be healthy more than I need to
33%
be out to my doctors. I hate making this
None
compromise. But I’m not quite that brave yet.”
21%

All “Denial of health care by doctors is the most

28%
pressing problem for me. Finding doctors that
will treat, will prescribe, and will even look at
you like a human being rather than a thing
Doctors can provide more efective care when they have
has been problematic. Have been denied care
all medically relevant information about their patients. by doctors and major hospitals so much that I
Unfortunately, our data shows that doctors’ knowledge of now use only urgent care physician assistants,
a patient’s transgender status increases the likelihood of and I never reveal my gender history.”
discrimination and abuse. Medical professionals’ awareness
of their patient’s transgender status increased experiences of
discrimination among study participants up to eight percentage
points depending on the setting:
• Denied service altogether: 23% of those who were
out or mostly out to medical providers compared to
15% of those who were not out or partly out
• Harassment in ambulance or by EMT: 8% of those who
were out or mostly out to medical providers compared
with 5% of those who were not out or partly out
• Physically attacked or assaulted in a hospital: 2% of
those who were out or mostly out to medical providers
compared with 1% of those who were not out or partly out
76 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

MEDICAL PROVIDERS’ LACK OF KNOWLEDGE male transgender respondents reported postponing care due to
discrimination and disrespect at a much higher frequency (42%,
When respondents saw 50% of the sample sick/injured; 48% preventive) than male-to-female transgender
medical providers, including
reported having to teach respondents (24%, sick/injured; 27% preventive). Those with the
doctors, they often
encountered ignorance about their medical providers highest rates of postponing care when sick/injured included those
who have lost a job due to bias (45%) and those who have done
basic aspects of transgender about transgender care.
sex work, sold drugs, or done other work in the underground
health and found themselves
economy for income (45%). Twenty-nine percent (29%) of
required to “teach my provider” to obtain appropriate care. Fully
respondents who were “out” or “mostly out” to medical providers
50% of study respondents reported having to teach providers
reported they had delayed care when ill and 33% postponed or
about some aspect of their health needs; those who reported
avoided preventive care because of discrimination by providers.
“teaching” most often include transgender men (62%), those who
have transitioned (61%) and those on public insurance (56%).
“The transition and health care has been expensive,
“I have several health issues and have been all at a time where my main source of income
refused care by one doctor who ‘suggested’ (my law practice) deteriorated. I have exhausted
that I go someplace else because she could my savings and the equity from selling my home
not treat me since she ‘did not know just to pay medical and living expenses.”
anything about transgender people.’ “
Postponement Due to Discrimination by Providers

POSTPONEMENT OF NECESSARY AND 50 48%

PREVENTIVE MEDICAL CARE 45 42%

We asked respondents whether 40

One fourth of study 35 33%
they postponed or did not try
to get two types of health care:
participants reported 30 27%
24%
preventive care “like checkups” delaying needed care
25 23%
20 17% 18%
and necessary care “when sick because of disrespect
15
or injured.” We found that and discrimination from 10
many postponed care because
medical providers. 5
they could not afford it and
0
many postponed care because MTF FTM GNC (MTF GNC (FTM
Spectrum) Spectrum)
of discrimination and disrespect from providers.
Needed Care Preventive Care
A large number of study participants postponed necessary
medical care due to inability to aford it, whether seeking care
when sick or injured (48%), or pursuing preventive care (50%). ACCESS TO INSURANCE
Transgender men reported postponing any care due to inability to
Study participants were less likely than the general population
aford it at higher rates (55%) than transgender women (49%).
to have health insurance, more likely to be covered by public
Insurance was a real factor in delayed care: those who have programs such as Medicare or Medicaid, and less likely to be
private insurance were much less likely to postpone care because insured by an employer.
of inability to aford it when sick or injured (37%) than those
Nineteen percent (19%) of the sample lacked any health
with public (46%) or no insurance who postponed care (86%).
insurance compared to 17% of the general population.5 Fifty-one
In terms of preventive care, those without insurance reported percent (51%) had employer-based coverage compared to 58% of
delaying care due to inability to aford it much more frequently the general population.6
(88%) than those with private insurance (39%) or public
African-American respondents had the worst health insurance
insurance (44%). Failing to obtain preventive care is known to
coverage of any racial category: 39% reported private coverage
lead to poor long-term health outcomes.
and 30% public. Thirty-one percent (31%) of Black respondents
Due to discrimination and disrespect, 28% postponed or avoided reported being uninsured; by contrast 66% of white respondents
medical treatment when they were sick or injured and 33% reported private insurance, 17% public insurance and 17%
delayed or did not try to get preventive health care. Female-to-
 HEALTH 77

uninsured. In the general population, 68% have private insurance Source of Insurance
and 28% have public insurance.7
No Insurance 19%
Health Insurance by Race Current or Former Employer 40%

Someone Else's Employer 11%

100 Medicare 7%
90 Purchased 7%
80 42% 39%
52% Military Health Care 5%
70 55%
62% 66%
69% Other Public Health Care 4%
60
50 Student Insurance 4%
30%
40 33% Medicaid 3%
20%
22%
30 19% Other 1%
9% 17%
20
31% 28% 0 5 10 15 20 25 30 35 40 45 50
10 25% 22% 23%
19% 17%
0
Overall American Asian Black Latino/a White Multiracial
Sample Indian
Uninsured Public Insurance Private Insurance
Transition-related Care
Undocumented non-citizens had very low rates of coverage: 26% Most survey respondents had
The majority of
reported private insurance, 37% public insurance, and 36% no sought or accessed some form
insurance. The South was the worst region for coverage where of transition-related care.
survey participants
59% of respondents reported private insurance, 17% public Counseling and hormone have accessed some
insurance and 25% no insurance. treatment were notably more form of transition-
utilized than any surgical related medical care
Transgender women reported private insurance at 54%, public
procedures, although the
insurance at 24% and 22% were uninsured. Transgender men despite the barriers.
majority reported wanting
reported private insurance at 68%, public insurance at 13%
to “someday” be able to have
and 19% with no insurance. Transgender respondents, overall,
surgery. The high costs of gender-related surgeries and their
reported private insurance at 60%, public insurance at 20% and
exclusion from most health insurance plans render these life-
20% had no insurance. Gender non-conforming respondents were
changing (in some cases, life-saving) and medically necessary
insured at higher rates than their transgender counterparts, with
procedures inaccessible to most transgender people.
73% reporting private insurance, 11% public insurance, and 17%
uninsured. Throughout this section, we focus primarily on transgender
people rather than on gender non-conforming people, though
“I have been living with excruciating they too may also desire and sometimes use various forms of
gender-related medical care.
pain in my ovaries because I can’t ind a
doctor who will examine my reproductive The World Professional Association for Transgender Health
(WPATH) publishes Standards of Care8 which are guidelines
organs.” (from a transgender man)
for mental health, medical and surgical professionals on the
current consensus for providing assistance to patients who
seek transition-related care. They are intended to be lexible
to assist professionals and their patients in determining what
is appropriate for each individual. The Standards of Care are a
useful resource in understanding the commonly experienced
pathways through transition-related care.

“My choices for health coverage at my

employer all exclude any treatment for
transgender issues, even though they cover
things like hormones for other people.”
78 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

COUNSELING HORMONE THERAPY

Counseling often plays an important role in transition. Because of Sixty-two percent (62%) of respondents have had hormone
the WPATH Standards of Care, medical providers often require a therapy, with the likelihood increasing with age; an additional
letter from a qualiied counselor stating that the patient is ready 23% hope to have it in the future. Transgender-identiied
for transition-related medical care; transgender people may seek respondents accessed hormonal therapy (76%) at much higher
out counseling for that purpose. Counseling may also play a role rates than their gender non-conforming peers, with transgender
in assisting with the social aspects of transition, especially in women more likely to have accessed hormone therapy (80%)
dealing with discrimination and family rejection. than transgender men (69%). Almost all respondents who
reported undertaking transition-related surgeries also reported
Seventy-ive percent (75%) of respondents received counseling
receiving hormone therapy (93%).
related to their gender identity and an additional 14% hoped to
receive it someday. Only 11% of the overall sample did not want
Hormone Therapy by Age of Respondent
it. Those who identiied as transgender were much more likely
to have had counseling (84%) than those who are gender non-
100
conforming (48%). Eighty-nine percent (89%) of those who 90
82%
medically transitioned have received counseling, as have 91% of 80
78% 76%
those who had some type of surgery. 70 64%
60
Part of counseling can involve receiving a gender-related mental
50 47%
health diagnosis such as “Gender Identity Disorder.” Many
40 33%
doctors require this diagnosis before providing hormones or
30 23%
surgical treatment, but the diagnosis itself is widely criticized for 21%
18%
20 13% 15%
categorizing naturally occurring gender variance as pathological.9 7%
11%
8%
10 6%
Fifty-percent (50%) of study participants have received a gender-
0
related mental health diagnosis. Transgender women reported 18-24 25-44 45-54 55-64 65+
a higher rate of diagnosis (68%) than transgender men (56%); Have had it Want it someday Do not want it

and transgender-identiied participants had a substantially higher

rate of diagnosis (63%) than gender non-conforming respondents
(11%).

“I can no longer aford health care of any kind. I am fully transitioned and thus
reliant upon estradiol as my body produces neither estrogens nor androgens in
suicient quantity. I am unable to go to the doctor for my prescriptions, and thus
have been unable to buy my hormones for over one year. Thus I watch my hair falling
out, my nails dissolve and am weak and tired like a far older lady than I am.”
 HEALTH 79

SURGERY—MALE-TO-FEMALE SURGERY—FEMALE-TO-MALE

Transgender women may elect to undertake a variety of surgeries, Transgender men may elect to undertake a variety of surgeries,
including breast augmentation, orchiectomy (removal of testes), including chest reconstruction, hysterectomy, metoidioplasty and
vaginoplasty (creation of a vagina and/or removal of the penis), other genital surgeries. We asked respondents to report on chest
and facial feminization surgeries. We asked respondents to report surgery; hysterectomy; metoidioplasty, which releases the clitoris;
on whether they had, or wanted, breast augmentation surgery, surgeries that create testes; and phalloplasty, which surgically
orchiectomies and vaginoplasties. As the charts below show, most creates a penis and testes. The majority of FTM transgender-
transgender women reported wanting or having these surgeries. identiied respondents wanted to have, or have already had,
In addition, 17% reported having had facial surgery.10 However, chest surgery and a hysterectomy. However, when it came to
it is impossible to know how many others would desire or utilize genital surgeries, very few reported having such surgeries; a slim
surgery if it was more inancially accessible. majority (53%) reported desiring other genital surgery such as
metoidioplasty in addition to the 3% that have had it; and one-
MTF Breast Augmentation Surgery MTF Orchiectomy quarter (27%) wanted to have a phalloplasty in addition to the
1% who have had it. It is impossible to know how these rates
would change if these surgeries were more inancially accessible.

Don't Want
Have Had 14% Have Had FTM Chest Surgery FTM Hysterectomy
Don't Want 21% 25%
26%

Don't Want
Want Want 7% Have Had
Don't Want
Someday Someday 21% 21%
53% 61% Have Had
43%
Want
Someday
50% Want
MTF Vaginoplasty Someday
58%

Don't Want
14% Have Had FTM Metoidioplasty/
23%
Creation of Testes FTM Phalloplasty

Want Have Had Have Had

Someday 4% 2%
64% Want
Someday
Don't Want 27%
44% Want
Someday Don't Want
53% 72%

“I cannot aford gender reassignment surgery

which is crucial to my mental well being and
thoughts of suicide are always present.”
“I have also have had several bouts with depression
and anxiety disorders and once ended up in the
emergency room for depression. I still bounce
in and out of depression due to not being able
to get the appropriate surgical procedures.”
80 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Health Vulnerabilities Doing sex work for income clearly was a major risk factor, with
61% of respondents who were HIV positive reporting they had
Survey participants reported poorer health outcomes than the done sex work for income. To consider this from a diferent angle,
general population in a variety of critical health areas. of all the people in our sample who had done sex work, 15.32%
reported being HIV positive.
PHYSICAL VIOLENCE AND SEXUAL ASSAULT
Among survey participants, 88% of those who reported being HIV
In questions related to “As a child because I positive identiied as either MTF or gender non-conforming on
experiences in educational the male-to-female spectrum. The reported rate of HIV infection
settings, at work, in
acted “girly,” I was a for the MTF transgender respondents was 4.28%. The reported
interactions with police and victim of severe child rate of HIV infection for FTM respondents was .51%, lower than
with family members, at abuse, and was sexually the national average.
homeless shelters, accessing assaulted. I avoided Other categories that reported substantially higher HIV rates than
public accommodations,
transitioning until I came the sample as a whole were:
and in jails and prisons,
respondents were asked to the point of suicide.” • Those without a high-school diploma (13.49%)
about physical violence or • Those who had been sexually assaulted due to bias (10.13%)
sexual violence, or both, committed against them because of
• Those with household income below $10,000 a year (6.40%)
their gender identity/expression. There was no general question
asked about whether respondents had ever experienced any bias- • Those who had lost a job due to bias (4.59%) or reported
motivated violence, and further, there was no question that asked being unemployed (4.67%)
to report on violence that was not speciically motivated by anti- Eight percent (8%) of our sample reported that they did not
transgender bias. know their HIV status. Transgender women and transgender
Twenty-six percent (26%) of respondents had been physically men had equal rates of not knowing, both 8%, with transgender
assaulted in at least one of these contexts because they were respondents also at 8% and gender non-conforming respondents
transgender or gender non-conforming. Ten percent (10%) of at 9%. Those most likely not to know their HIV status include
respondents were sexually assaulted due to this bias. undocumented non-citizens (17%), those with household incomes
under $10,000/year (14%), and those with lower educational
Having been physically or sexually assaulted aligned with a range
attainment (those with no high school diploma and high
of other negative outcomes, as described below in each relevant
school diploma only, both at 13%).With regard to race, Asian
section.
respondents were least likely to know their status (13%).

HIV
HIV Infection By Race, Compared to U.S. General Population
Respondents reported an HIV infection rate of 2.64%,11 over
four times the rate of HIV 25
24.90%
Respondents reported
infection in the general
United States adult population over four times the 20

(0.6%) as reported by the national average of

15
United Nations Programme HIV infection.
on HIV/AIDS and the World 10.92%
10
Health Organization.12 People of color reported HIV infection
7.04%
at substantially higher rates: 24.90% of African-Americans,
5 3.70% 3.52%
10.92% of Latino/as, 7.04% of American Indians, and 3.70% of 2.64%
Asian-Americans in the study reported being HIV positive. This 0.60% 0.78%
0
compares with national rates of 2.4% for African Americans, .08% Overall Survey American Asian Black Latino/a White Multiracial
Latino/as, and .01% Asian Americans.13 Non-U.S. citizens in our Sample Total Indian

sample reported more than twice the rate of HIV infection of U.S.
citizens (2.41%), with documented non-citizens at 7.84% and
undocumented at 6.96%.
 HEALTH 81

HIV Status Unknown By Race risk were those who had lost a job due to discrimination; 12%
reported currently using drugs and alcohol, while 28% have done
25
so in the past.

20 Alcohol and drug use decreased by age among our participants,

as they did in studies of the general population,15 with those 65
15 years and above reporting less than half the rate of use (4%)
13%
of those who are the 18-44 age range (9%). This contrasts with
10% 10%
10 9% studies of LGBT populations that show a less dramatic decrease
8% 8%
6% in use over the life cycle;16 however, because our study only asked
5 about use connected to mistreatment, the comparisons with both
the general population and LGBT studies are not precise.
0
Overall American Asian Black Latino/a White Multiracial
Sample Indian
SMOKING

Thirty percent (30%) of our sample reported smoking daily or

occasionally, compared to 20.6% of U.S. adults.17 Studies of LGBT
DRUG AND ALCOHOL USE adults show similar rates to those in our study, with elevated
rates of 1.1-2.4 times that of the general population,18 and a 2004
The National Institutes of
26% use or have used California study found a 30.7% smoking rate for transgender
Health (NIH) estimate that
alcohol and drugs to people.19 In the general population, men smoke at higher rates
7.3% of the general public
than women, but in LGBT studies, women smoke at higher
abuses or is dependent on cope with the impacts
rates than men. Our sample resembled the LGBT data regarding
alcohol, while 1.7% abuses of discrimination. elevated smoking levels but difered in that more men than
or is dependent on non-
women in our sample smoke, a pattern that is closer to that of the
prescription drugs.14 Eight percent (8%) of study participants
general population. When asked if they would “like to quit,” 70%
reported currently using alcohol or drugs speciically to cope
of smokers in the study selected yes.
with the mistreatment that they received as a result of being
transgender or gender non-conforming, while 18% said they
Comparative Smoking Rates from Other Studies,20
had done so in the past but do not currently. We did not ask
Compared to Our Study
about general use of alcohol and drugs, only usage which the
respondents described as a coping strategy for dealing with the
mistreatment they face as transgender or gender non-conforming General Lesbian
Bisexual Our Sample
Population and Gay
persons.

Doing sex work, drug “I do not use drugs Men 23.1% 26.5-30.9% 29.5-38.1% 33%
sales, and other work in
but my drinking has
the underground economy
for income more than increased over the past Women 18.3% 22.3-26% 30.9-39.1% 29%

doubles the risk of alcohol 3 years due to stress

or drug use because of and loneliness.” Visual conformers were less likely to be current smokers (27%)
mistreatment, with 19% of than visual non-conformers (37%), suggesting that the stress
these respondents currently caused by the additional mistreatment that visual non-conformers
using alcohol and/or drugs “When I started coming face may be involved in the development of an addiction to
while 36% reported that out, I stopped the nicotine. Similarly, those who have been physically assaulted due
they had done so in the to bias (40%) and sexually assaulted due to bias (45%) have
past. Those who have been
drinking and stopped the
higher smoking rates than their peers who were not assaulted.
the physically attacked due depression medicines.
to bias also had a higher When I started living
rate of current alcohol full time in my real
and drug misuse (15%) as
gender, I blossomed into
did those who have been
sexually assaulted due to an outgoing, loving,
bias (16%). Also at elevated giving person.”
82 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

SUICIDE ATTEMPTS Suicide Attempt by Employment

When asked “have you ever

41% of respondents 100
attempted suicide?” 41% of 90
respondents answered yes. reported attempting 80
According to government suicide. 70
60%
health estimates, ive million, 60
51%
55%

or 1.6% of currently living 50

40 37%
Americans have attempted suicide in the course of their lives.21
30
Our study asked if respondents had ever attempted suicide while
20
most federal studies refer to suicide attempts within the last year;
10
accordingly it is diicult to compare our numbers with other
0
studies. Regardless, our indings show a shockingly high rate of Employed Unemployed Lost Job Due to Bias Worked in
Underground
suicidality. Economy

The National Institute for Mental Health (NIMH) reports that

most suicide attempts are signs of extreme distress, with risk
factors including precipitating events such as job loss, economic In terms of age group risk, the highest rates of suicide attempts
crises, and loss of functioning.22 Given that respondents in in this study were reported among those in the 18-24 age group
this study reported loss in nearly every major life area, from (45%) and 25-44 age group (45%), with only 16% of those over
employment to housing to family life, the suicide statistics 65 reporting a suicide attempt. These rates are inverse to the
reported here cry out for further research on the connection general population, which shows a higher incidence of attempts
between the consequences of bias in the lives of transgender and among older Americans than youth.24
gender non-conforming people and suicide attempts.23
Suicide Attempts by Age
NIMH also reports that generally African-Americans, Latino/
as and Asians have much lower suicide rates than whites and 100
American Indians; our sample showed a diferent pattern of risk 90
for suicide by race, with Black and Latino/a respondents showing 80
dramatically elevated rates in comparison to their rates in the 70
general population. 60

50 45% 45%
Suicide Attempt by Race 40
39%
33%
30
100
20 16%
90
80 10

70 0
18-24 25-44 45-54 55-64 65+
60 56% 54%
50 45% 44%
41% 39%
40 38%
Our questionnaire did not ask
30
at what age the respondents Over half of those
20
made suicide attempts and bullied, harassed,
10
therefore it is diicult to draw assaulted, or expelled
0
conclusions about the risk of
Overall American Asian Black Latino/a White Multiracial due to bias in school
Sample Indian suicide over their life spans.
However, there are a number
attempt suicide.
of attributes that align with
Respondents’ work status and experiences of discrimination in an increased rate of attempted suicide. High risk groups include
employment also had a sizable impact on their likelihood of visual non-conformers (44%) and those who are generally out
having attempted suicide. about their transgender status (44%). Those who have medically
transitioned (45%) and surgically transitioned (43%) have higher
rates of attempted suicide than those who have not (34% and
39% respectively).
 HEALTH 83

Those who were bullied, harassed, assaulted, or expelled because “My suicide attempt had a lot to do with
they were transgender or gender non-conforming in school (at
the fact that I felt hopeless and alone
any school level) reported elevated levels of suicide attempts
(51% compared with 41% of our sample as a whole). Most
in regards to my gender identity.”
notably, suicide attempt rates rise dramatically when teachers
were the reported perpetrators: 59% for those harassed or bullied
by teachers, 76% among those who were physically assaulted by
teachers and 69% among those who were sexually assaulted by
teachers. These numbers speak to the urgency of ending violence
and harassment of transgender students by both their peers and
their teachers.

Education and household income both align with suicide rates,

with those earning $10,000 annually or less at extremely high
risk (54%), while those making more than $100,000 are at
comparatively lower risk (26%), while still tremendously higher
than the general population. Those who have not completed
college attempted suicide at higher rates (48% among those
with no high school diploma, 49% for those with a high school
diploma only, and 48% for those with some college education)
while those have completed college (33%) or graduate school
(31%) have lower rates.

Those who had survived violence perpetrated against them

because they were transgender or gender non-conforming were at
very high risk; 61% of physical assault survivors reported a suicide
attempt, while sexual assault survivors reported an attempt rate
of 64%.
84 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

CONCLUSIONS FOR HEALTH

Respondents reported serious barriers to health care and outrageous frequencies of anti-transgender bias in care, from
disrespect to refusal of care, from verbal harassment to physical and sexual abuse. Transgender people of color and low-
income respondents faced substantially elevated risk of abuse, refusal of care, and poor health outcomes than the sample as
a whole.

The data gathered here speak to a compelling need to examine the connection between multiple incidences of
discrimination, harassment and abuse faced by our respondents in the health care system and the high risk for poor health
outcomes. Additionally, our data suggest that discriminatory events are commonplace in the daily lives of transgender people
and that this has a cumulative impact—from losing a job because of bias to losing health insurance; from experiencing
health provider abuse to avoiding health care; from long-term unemployment to turning to work on the streets. The collective
impact of these events exposed our respondents to increased risk for HIV infection, smoking, drug/alcohol use, and suicide
attempts.

It is important to note that the traumatic impact of discrimination also has health care implications. Transgender people face
violence in daily life; when this risk is compounded by the high rates of physical and sexual assault they face while accessing
medical care, health care costs increase, both to treat the immediate trauma as well as ongoing physical and psychological
issues that may be created.

As we have seen across a number of categories in the survey, the ability to work substantially impacts transgender health. In
particular, those who have been ired due to anti-transgender bias and those who have done sex work, drug sales, or other
work in the underground economy are much more likely to experience health risks that are shown to lead to poorer health
outcomes.

Discrimination in the health care system presents major barriers to care for transgender people and yet a majority of our
survey participants were able to access some transition-related care, with 75% receiving counseling and 62% obtaining
hormones. Genital surgery, on the other hand, remains out of reach for a large majority, despite being desired by most
respondents. This is one important reason why legal rights for transgender people must never be determined by surgical
status.

“I saw a doctor in New York and told her how I wanted [chest surgery]. She looked at
me sternly and said, ‘I can’t believe you are wasting my time. Do you know what your
problem is? You just want to be a boy. You want to be a boy and that’s never gonna happen
so just do yourself a favor and get over it.’ Then she left the room abruptly. I grabbed my
things and bolted down the street, feeling like the biggest freak in the world.”
 HEALTH 85

RECOMMENDATIONS FOR HEALTH

• Anti-transgender bias in the medical profession and U.S. health care system has catastrophic consequences for
transgender and gender non-conforming people. This study is a call to action for the medical profession:

• The medical establishment should fully integrate transgender-sensitive care into its professional standards, and this
must be part of a broader commitment to cultural competency around race, class, and age;

• Doctors and other health care providers who harass, assault, or discriminate against transgender and gender non-
conforming patients should be disciplined and held accountable according to the standards of their professions.

• Public and private insurance systems should cover transgender-related care; it is urgently needed and is essential to
basic health care for transgender people.

• Ending violence against transgender people should be a public health priority, because of the direct and indirect negative
effect it has on both victims and on the health care system that must treat them.

• Medical providers and policy makers should never base equal and respectful treatment and the attainment of appropriate
government-issued identity documents on:

• Whether an individual has obtained surgery, given that surgeries are inancially inaccessible for large majorities of
transgender people because they are rarely covered by either public or private insurance;

• Whether an individual is able to afford or attain proof of citizenship or legal residency.

• Rates of HIV infection, attempted suicide, drug and alcohol abuse, and smoking among transgender and gender non-
conforming people speak to the overwhelming need for:

• Transgender-sensitive health education, health care, and recovery programs;

• Transgender-speciic prevention programs.

• Additional data about the health outcomes of transgender and gender non-conforming people is urgently needed:

• Health studies and other surveys need to include gender identity as a demographic category;

• Information about health risks, outcomes and needs must be sought speciically about transgender populations;

• Transgender people should not be put in categories such as “men who have sex with men” (MSM) as transgender
women consistently are and transgender men sometimes are. Separate categories should be created for transgender
women and transgender men so HIV rates and other sexual health issues can be accurately tracked and researched.
86 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Endnotes 13 Henry J. Kaiser Family Foundation, “The HIV-AIDS Epidemic in the United
__________________________________________________________________________
States” (2007): http://www.kf.org/hivaids/upload/3029-071.pdf

14 U.S. Department of Health and Human Services, Substance Abuse and

1 HIV rates are presented with two decimal places for more accurate Mental Health Services Administration, “Results from the 2008 National
comparison with general population igures. Survey on Drug Use and Health: National Findings” (2009): http://www.
oas.samhsa.gov/nsduh/2k8nsduh/2k8Results.pdf
2 See for example P. Foraselli, C. DeAngelis, and A. Kaszuba, “Compliance
with follow-up appointments generated in a pediatric emergency room, ” 15 U.S. Department of Health and Human Services, Substance Abuse and
American Journal of Preventive Medicine, 1, no. 3 (1985); V.T. Chande, S.E. Mental Health Services Administration Oice of Applied Studies, NSDUH
Krug, and E.F. Warm, “Pediatric emergency department utilization habits: a Series H-38A, HHS Publication No., “Results from the 2009 National
consumer survey,” Pediatric Emergency Care, 12, no. 1 (1996). Survey on Drug Use and Health: Summary of National Findings,” 1, SMA
10-4586, (2010): 30, Chart 3.1.
3 These results were based on question 30, which was prefaced by: “Based
on being transgender/gender non-conforming, please check whether you 16 National Institute on Alcohol and Alcoholism, “Sexual Orientation and
have experienced any of the following in these public spaces,” and asked Alcohol Use Disorders” (2005): http://pubs.niaaa.nih.gov/publications/
respondents to indicate whether they had been “denied equal treatment or social/Module10GSexualOrientation/Module10G.html
service” for each of the various locations.
17 American Lung Association, “Smoking Out a Deadly Threat: Tobacco
4 These results were based on question 43, which was prefaced by: “Because Use in the LGBT Community” (2010): http://www.lungusa.org/assets/
you are transgender/gender non-conforming, have you had any of the documents/publications/lung-disease-data/lgbt-report.pdf
following experiences?” and asked respondents to indicate whether “a
18 Review of literature aggregated in American Lung Association, “Smoking
doctor or other provider refused to treat me because I am transgender/
Out a Deadly Threat: Tobacco Use in the LGBT Community” (2010):
gender non-conforming.”
http://www.lungusa.org/assets/documents/publications/lung-disease-
5 U.S. Census Bureau, “Current Population Reports, Income, Poverty, and data/lgbt-report.pdf
Health Insurance Coverage in the United States” (2008): http://www.
19 California Department of Health Services, “California Lesbians, Gays,
census.gov/prod/2009pubs/p60-236.pdf. Data for those 18 and over were
Bisexuals, and Transgender (LGBT) Tobacco Use Survey — 2004”
used.
(2005): http://www.cdph.ca.gov/programs/tobacco/Documents/CTCP-
6 U.S. Census Bureau, “Current Population Reports, Income, Poverty, and LGBTTobaccoStudy.pdf
Health Insurance Coverage in the United States” (2008): http://www.
20 The general population, lesbian and gay, and bisexual data in this table is
census.gov/prod/2009pubs/p60-236.pdf. Data for those 18 and over were
from California Department of Health Services, “California Lesbians, Gays,
used.
Bisexuals, and Transgender (LGBT) Tobacco Use Survey — 2004.” The
7 U.S. Census Bureau, “Current Population Reports, Income, Poverty, and data on transgender persons is ours.
Health Insurance Coverage in the United States” (2008): http://www.
21 “U.S.A. Suicide: 2002 Oicial Final Data,” prepared for the American
census.gov/prod/2009pubs/p60-236.pdf. Data for those 18 and over were
Association of Suicidology by John L. McIntosh, Ph.D. Oicial data source:
used.
Kochanek, K.D., Murphy, S.L., Anderson, R.N., & Scott, C. (2004). Deaths:
8 World Professional Association of Transgender Health, “Standards of Care Final data for 2002. National Vital Statistics Reports, 53 (5). Hyattsville,
for Gender Identity Disorders, Sixth Version” (2001): http://www.wpath. MD: National Center for Health Statistics DHHS Publication No. (PHS)
org/documents2/socv6.pdf 2005-1120. Population igures source: table I, p.108. of the National Center
for Health Statistics (Kochanek et al., 2004), see http://www.sprc.org/
9 The National Gay and Lesbian Task Force’s statement on reform of
library/event_kit/2002datapgv1.pdf
the American Psychiatric Association’s Diagnostic and Statistical
Manual (DSM) can be accessed at http://www.transgenderlaw.org/ 22 U.S Department of Health and Human Services, National Institute of
medicalhealthcare/NGLTF_DSM_Statement.pdf. The National Center Mental Health, “Suicide in the U.S.: Statistics and Prevention” (2010):
for Transgender Equality’s position may be found at http://transgende- http://www.nimh.nih.gov/health/publications/suicide-in-the-us-statistics-
requality.wordpress.com/wp-admin/post.php?post=264&action=edit and-prevention/index.shtml

10 The facial feminization surgery rate was determined diferently than 23 American Foundation for Suicide Prevention, “Risk Factors for
the other surgery data. We determined the rate by looking at how many Suicide” (2010): http://www.afsp.org/index.cfm?fuseaction=home.
respondents reported spending a valid dollar amount in Question 45. viewPage&page_id=05147440-E24E-E376-BDF4BF8BA6444E76 According
to the Substance Abuse and Mental Health Services Administration, adults
11 HIV rates are presented with two decimal places for closer comparison
who have had a major depressive episode—the leading risk factor for
with general population igures.
suicide—in the previous twelve months had an attempt rate of 10.4%.
12 United Nations Programme on HIV/AIDS (UNAIDS) and World Health
24 U.S. Department of Health and Human Services, National Institute of
Organization (WHO), “2007 AIDS Epidemic Update” (2007): http://data.
Mental Health, “Suicide in the U.S.: Statistics and Prevention” (2010):
unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf
http://www.nimh.nih.gov/health/publications/suicide-in-the-us-statistics-
and-prevention/index.shtml
88 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

FAMILY LIFE
Respondents answered several questions about family life, speciically about relationships with
their families, partners/spouses, and children. We wanted to know how living, parenting and
partnering as a transgender or gender non-conforming person had impacted relationships; we
also wanted to know if participants were the primary providers for the economic security of
children or others.
Our results showed a combination of improved relationships and successful development of
families alongside major challenges in retaining friendships, partnerships, and relationships with
children. Among some groups of respondents, coming out to family members and friends had a
positive impact, while for others, relationships faced considerable challenges.

KEY FINDINGS IN FAMILY LIFE

• Forty-ive percent (45%) of respondents reported that their family is as strong “When I asked my father
today as it was before coming out. to sign a ‘consent to
• Forty-three percent (43%) maintained the majority of family bonds. treat’ form so I could
• Thirty-eight percent (38%) of the sample were parents with 18% reporting that start hormone therapy
they currently have at least one dependent child. in 1970, he tore it up
• Seventy percent (70%) of respondents reported that their children continued to
and threatened to kill
speak to them and spend time with them after coming out. me if I went ahead
with transition.”
• Fifty-seven percent (57%) of respondents experienced family rejection.

• Relationships ended for 45% of those who came out to partners.

• Twenty-nine percent (29%) of those with children experienced an ex-partner limiting their contact with their children.

• Courts limited or stopped relationships with children for 13% of respondents, with Black, Asian, and multiracial
respondents experiencing higher rates of court interference.

• Nineteen percent (19%) of respondents reported experiencing domestic violence by a family member because they
were transgender or gender non-conforming.

• Family acceptance was strongly connected with a range of positive outcomes while family rejection was
connected with negative outcomes. Those who were rejected by family members had considerably elevated negative
outcomes, including homelessness (three times the frequency), sex work (double the rate), and suicidality (almost double),
compared to those that were accepted by their family members.

• Domestic violence at the hands of a family member was also strongly connected to negative outcomes, with
domestic violence survivors reporting four times the rate of homelessness, four times the rate of sex work, double
the HIV rate, and double the rate of suicide attempts compared to their peers who did not experience family violence.
 FAMILY LIFE 89

Outness to Family “My partner knows about my cross-dressing

but is not and does not want to be involved. My
We asked about outness to family members or “at home” in
two diferent ways. First, we asked respondents whether they
partner is afraid my being found out will afect
tell family members they are transgender or gender non- our relationship and our lives dramatically. If
conforming.1 Overall, 57% reported telling family members there was not such a stigma with appearing
they are transgender or gender non-conforming. Transgender or acting like another gender to any degree,
respondents reported this more often (64%) compared to gender
she would be ine with my dressing. I know in
non-conforming respondents (35%).
my lifetime this probably will not change.”
Outness to Family by Gender Identity/Expression

100
Outness to Family by Race

90
100
80
90
70 68%
62% 64% 80
60 57%
70
50 57% 57% 59%
60
51% 51%
40 35% 50 47% 46%
30 40

20 30

10 20

0 10
Overall Sample MTF FTM All Trans GNC 0
Overall American Asian Black Latino/a White Multiracial
Sample Indian

Whether or not respondents reported telling family members

varied somewhat by race; multiracial (59%) and white (57%)
We also asked how many people they were out to “at home.”
respondents more often reported doing so.
Because home does not necessarily include family members, and
may instead include friends, roommates, and other non-family
members, this is not an exact measure of outness to family.

Overall, 73% reported they were out at home to “most” or “all,”

17% were out to “some” or “a few,” and 10% were out to no one.

Of those who had transitioned, 88% were out to “most” or “all” at

home, 8% were out to “some” or “a few,” and 4% were out to no
one.
90 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Parenting Rate by Age of Transition

Parenting
100
Only 38% of respondents identiied themselves as parents,
90
compared to 64% of the general population.2 Part of this 82%
80
diference may be due to the relative age of our sample compared 69%
70
to the general population. Yet, looking at status as a parent by
60
age, reveals diferent patterns of parenting by age compared to
the general population. 50
40 38%

Parenting Rate by Age Compared to the General Population3 30

20%
20 14%
10
100 0
90 <18 18-24 25-44 45-54 55+
80 76% 78%
74% 75%
70%
70 63% 62%
60 Latino/a and white respondents reported the highest rates
50 of parenting of any racial/ethnic groups at 40% each. Asian
40 respondents had the lowest rate at 18%.
30 28%
18%19%
20 Parenting Rate by Race
10
0 100
18-24 25-44 45-54 55-64 65+ 90
Our Sample General Population 80
70

Being a parent appears to be strongly related to age of transition. 60

Those who transitioned later in life were much more likely to be 50 45%
38% 40% 40%
parents; 82% of those who transitioned at age 55 or older were 40 36%
29%
parents compared to 38% of those who transitioned between the 30
20 18%
ages of 25 and 44.
10
0
“My partner and I are in the process of adopting Overall American Asian Black Latino/a White Multiracial
Sample Indian
a child whom we’ve been fostering for the
past two years. We’ve been engaged in a legal
battle since November of 2007, when a social
worker decided (primarily, we’ve been told by a
number of sources, because of my transgender
status) to try to remove her from our home.”
 FAMILY LIFE 91

Transgender women were parents (52%) considerably more often Dependents

than transgender men (17%). However, our transgender female
sample was considerably older (44% were 45 or older) than the We asked respondents how many children currently rely on their
transgender male respondents (11% were 45 or older) and age is income. Note that the question did not ask whether the children
associated with increased rates of parenting. were under 18 years of age, or specify a biological or legal
relationship.
Transgender respondents, overall, reported being parents at 41%,
compared to 20% of gender non-conforming respondents (again, Federal surveys generally ask respondents about the number of
this may be partly explained by diferences in the age of these children in a household, rather than the number of dependents, so
groups). Sixty-one percent (61%) of male-born cross-dressers said it is diicult to compare federal statistics to these data.
they were parents.
Eighteen percent (18%) of the sample reported at least one
dependent.
Parenting Rate by Gender

100 Number of Dependent Children

90
80 Three dependents
Two or more
70 dependents
3%
60
52% One dependent 6%
50
39% 9%
40
30
20%
20 17%

10
0 Zero dependents
MTF FTM All Trans GNC 82%

“I am about to initiate change-of-name

procedures, so that my name on my child’s
Generally, those with higher levels of household income and
birth certiicate is the name I intend to education were more likely to be responsible for children, with
have for the rest of my child’s life.” 18% of respondents making more than $100,000 annually
reporting two or more dependents. People in the workforce
reported more dependents than those who were unemployed or
out of the workforce.
92 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Number of Dependent Children by Household Income Number of Dependent Children by Race

100 100
91% 91% 90%
90 85% 90 83%
81% 82% 82% 80% 81%
80 74% 80 75%
70 67% 70
60 60
50 50
40 40
30 30
15%
20 12% 20 15%
9% 8% 11% 9% 7% 8% 9% 9%
5% 5% 9% 7% 10% 6%
10 6% 5% 4% 10 6% 7% 7% 7% 5%
3% 3% 1% 3% 2% 2% 3% 2%1% 4% 4% 3% 4%
0%
0 0
Overall Under $10K $10K-under $20K-under $50K-under $100K+ Overall American Asian Black Latino/a White Multiracial
Sample $20K $50K $100K Sample Indian
0 1 2 3+ 0 1 2 3+

MTF respondents were supporting dependents much more often

Number of Dependent Children by Employment Status
(22%) than their FTM peers (12%).
100
90 86% 87% Number of Dependent Children by Gender Identity/Expression
79%
80
70 100
90 88% 88%
60 81%
80 77%
50
40 70
30 60
20 50
10%
10 7% 7% 5% 6% 4%
3% 2% 3% 40
0 30
In Workforce Out of Workforce – Out of Workforce -
Unemployed Not Looking 20 11%
8% 7% 9%
10 6% 5% 3% 3%
0 1 2 3+ 3% 3% 2% 3%
0
MTF FTM All Trans GNC
0 1 2 3+
Black and Latino/a respondents were slightly more likely to be
providing for two or more children.
 FAMILY LIFE 93

Family Strength and Acceptance “IMPROVING AFTER COMING OUT”

A majority of respondents (61%) reported that their family

“AS STRONG TODAY” relationships have slowly improved after coming out, with
Latino/a (65%) and white (61%) respondents reporting the
We asked three general questions about our respondents’ family
highest percentages of improvement. Those who had made
relationships. Depending on the individual respondent, answers
medical (63%) and surgical (66%) transitions, and visual
to these questions may relate to parents and siblings (family of
conformers (67%) also reported high rates of improving family
origin), spouse/partner and children, or both.
relationships.
Almost half of the sample (45%) reported that their family is as
strong today as before coming out. Conversely, 55% indicated “Improving After Coming Out” by Race
their family was not as strong today. Those who reported a higher
100
level of family resilience include Black (55%) and Asian (49%)
90
respondents as well as 52% of respondents without a high school
80
diploma. These data counters prevailing mythologies about race,
70 65%
culture and class and family acceptance of transgender and 61% 61% 62% 61%
60 57%
gender non-conforming people. 51%
50
40
“As Strong Today” by Race
30

100 20

90 10

80 0
Overall American Asian Black Latino/a White Multiracial
70 Sample Indian
60 55%
48% 49% 47%
50 45% 45%
40 37%

30 “I have been very fortunate to live in the

20 state where I do, where people for the most
10
part, are open-minded and accepting. I have
0
Overall American Asian Black Latino/a White Multiracial also been fortunate to have the support of
Sample Indian
my parents and my, now, 11 year-old son
who I came out to when he was age 6.”
“As Strong Today” by Educational Attainment

100
“After coming out to my family last year,
90 I was told they ‘support me 100%’ and
80 then they proceeded to change their phone
70
number and discontinued any contact.”
60
52%
47% 49%
50
41% 41%
40
30
20
10
0
No HS Diploma High School Some College College Degree Graduate
Diploma Degree
94 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

FAMILY ACCEPTANCE/REJECTION Family Rejection by Race

Two-ifths (40%) of respondents “I just wish my 100

reported that their parents or other 90
family members “chose not to speak
daughter would come
80
or spend time with me” due to their back to me. I fear 70
gender identity/expression. Sixty I have lost her.” 60
percent (60%) did not experience 49%
50 46% 44%
40% 41% 39% 39%
this type of family rejection. 40
30
Family rejection was worse for multiracial (49%), American
20
Indian (46%), and Latino/a (44%) participants. Also at higher
10
risk than the full sample for family rejection were those earning
0
$10,000 or less annually (47%), those earning between $10,000 Overall American Asian Black Latino/a White Multiracial
and $20,000 annually (48%), the unemployed (47%), those Sample Indian

working in the underground economy (52%) and those who

reported they lost a job due to bias (57%). MTFs and transgender
participants fared worse with their families than their FTM and Family Rejection by Gender
gender non-conforming counterparts.
100
90
80
70
60
50 45% 43%
40%
40
33%
30
20
10
0
MTF FTM All Trans GNC
 FAMILY LIFE 95

Partner and Spousal Relationships We also saw that whether or not relationships ended was
connected to gender identity. Transgender women were more
Nearly half (45%) of those who responded to the statement “my likely to experience the end of a relationship, compared to
relationship with my spouse or partner ended” reported that transgender men, except for those transitioned under the age of
their relationship with that spouse or partner ended due to their 18. This gender diference increased as the age of transition for
transgender identity or gender non-conformity; over half (55%) respondents increased.4
stayed in their relationship (or the relationship ended for other
reasons). These data indicate that relationships are maintained at End of Relationships by Gender Identity and Age of Transition
a much higher rate than some might expect.
100
Those respondents who had transitioned did see their 90
relationships end at a higher rate, with 55% of relationships 80 73%
ending. Additionally, the age the respondent began living full 69% 67%
70
time was closely connected to whether a relationship ended. 60
Those who transitioned at a younger age were more likely to have 50 45% 45%
40% 40% 39% 39%
maintained their relationship through a transition, with 59% of 40
people maintaining their relationship if they transitioned between 30

the ages of 18-24 compared to only 36% of relationships lasting 20

for those between the ages of 45-54. 10

*
0
<18 18-24 25-44 45-54 55+
Maintaining Relationships through Transition by Age of Transition
MTF FTM

100
* Sample size too low to report
90
80 Unemployed respondents (50%) and those who had lost jobs due
70 to bias (62%) reported higher rates of relationship disruption.
61% 59%
60 Male-to-female transgender respondents also reported higher
50
42%
rates of disruption (57%) than their FTM peers (39%) and
40 36% transgender respondents lost their partnerships more often (50%)
30%
30 than gender non-conforming respondents (22%).
20
For information on current relationship status of the survey
10
respondents, see the Portrait chapter.
0
<18 18-24 25-44 45-54 55+

“I am married, and my wife knew about my status by the time of our second
date. She said she could accept me as I was. After we were married, and
she was pregnant with our son, she told me I could not be who I wanted/
was. Out of a sense of commitment, I have stayed with her, and have not
been able to fully express who I really am. I have considered suicide. After
all, smoking and drinking are a civilized way of committing suicide.”
96 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

How Respondents’ Situation as a Parent

Relationships with Children
Changed by Underground Economy
For the majority of our respondents, relationships with children
50
remained the same, although for a sizable minority, contact with
45
their children was limited or denied. 40
36%
When asked if being transgender or gender non-conforming had 35
30
impacted their situation as parents, 22% of respondents reported 24%
25
an improved situation and 29% reported that their situation was 19%
20 17% 18%
worse. Almost half (49%) reported that their situation as parents 16%
15 12% 13% 13% 14%
either “remained the same” or was “in some ways better, in some 10%
10 8%
ways worse.” 5
0
Much Somewhat The same Somewhat Much worse Some better,
How Respondents’ Situation as a Parent Changed
improved improved worse some worse
Overall Sample Those who Worked in the Underground Economy
100
90
80
Those without a high school diploma were more likely to report
70
a much improved parenting situation (26%) versus the overall
60
50
sample (10%) and, in general, those without a high school
40 36% diploma and those with only a high school diploma were least
30 likely to report any of the “worse” options.
20 16%
12% 13% 13% Others reported that their parenting situation was “much worse.”
10%
10
This includes 23% of respondents who have lost a job due to bias
0
Much Somewhat The same Somewhat Much worse Some ways and 16% of the unemployed.
improved improved worse better, some
ways worse

Asian (21%), Latino/a (20%) and Black (14%) respondents all

had higher rates of improvement in their parenting situations
after coming out than their white counterparts (9%).

Lower household income respondents (under $10,000/year)

experienced a much improved situation somewhat more often
(15%) than their peers earning over $100,000 annually (11%).
However, they were also more likely to report a “much worse”
situation (24%) versus those with high household income (7%).

Respondents who had worked in the underground economy

reported a higher level of improvement (17%) than the sample as
a whole, as well as a higher rate of reporting “much worse.”
 FAMILY LIFE 97

How Respondents’ Situation as a Parent Changed by Race

50
45 42%
40
36% 36% 36% 36%
35
30 29%
24% 25%
25
21% 21% 20%
20 18% 17% 17% 17%16%
16% 15%
15 13%13% 13% 14% 14% 13% 13%13% 14%
12% 12% 11% 11%12% 12%
10% 9% 10% 9%
10 8% 8%
6%
5 3% 4%

0
Overall Sample American Indian Asian Black Latino/a White Multiracial

Much improved Somewhat improved The same Somewhat worse Much worse Some better, some worse

How Respondents’ Situation as a Parent Changed by Household Income

50
45
40% 40%
40
35 33%
30 28%
25% 24%
25
21%
20 17% 17% 17%
15% 15% 14% 15%
15 13% 13% 13% 13% 14% 12% 13% 12%
10% 11% 12%
10 8% 8% 9% 9%
7%
5
0
Under $10K $10K-under $20K $20K-under $50K $50K-under $100K $100K+
Much improved Somewhat improved The same Somewhat worse Much worse Some better, some worse

How Respondents’ Situation as a Parent Changed by Educational Attainment

50
45
40% 40%
40
35 34% 34%
32%
30
26%
25
20 19%
16% 15% 15% 16% 16%
15 13% 13% 14% 13% 14%
12% 11% 12% 12% 11%
10% 10% 11% 10% 10% 9%
10 8%
5%
5
0
No HS Diploma High School Diploma Some College College Degree Graduate Degree

Much improved Somewhat improved The same Somewhat worse Much worse Some better, some worse
98 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

EX-PARTNER/SPOUSE LIMITING OR STOPPING Of respondents who had children and were in a relationship that
RELATIONSHIPS WITH CHILDREN ended, 13% reported that a court or judge stopped or limited their
Of respondents who had relationships with children because of their transgender identity
children and were in a
relationship that ended, 29%
29% or gender non-conformity. However, this does not necessarily
mean that 87% of transgender parents who appeared before a
court in a custody dispute did not experience discrimination. The
reported that their ex-spouse My ex limited or
way we posed this question suggests that 87% of respondents
or partner limited or stopped stopped my relationship
their relationships with their either came to an agreement with their ex-spouse or partner over
with my children. the issue of custody outside of court or, if they went to court, had
children because of their
a positive outcome.

71%
transgender identity or gender
non-conformity. However, Compared to the 13% of the overall sample that experienced
71% have maintained their court interference, Black (29%) and multiracial (20%)
My ex did not limit or
relationships with their respondents were much more vulnerable to court interference, as
children, or if they were stop my relationship were respondents earning a household income of $10,000/year
limited or stopped it was not with my children. or less (29%), those working in the underground economy (27%)
due to bias. and those who had lost jobs due to bias (26%).

Male-to-female transgender respondents sufered court

Multiracial (33%) and Black (33%) respondents were more interference more often (16%) than their FTM peers (8%).
vulnerable to having their relationships with their children
limited or stopped as were those who worked in the underground Court Stopped/Limited Relationships with Children by Race

economy (35%) or had lost jobs due to bias (43%). Male-to-

50
female transgender respondents had their relationships with
45
their children limited or stopped more often (34%) than FTM
40
respondents (20%), and transgender participants were more
35
vulnerable (32%) than gender non-conforming respondents 29%
30
(19%).
25
20%
20 17%
Ex-Spouse/Partner Limited or Stopped 13%
15 12%
Relationships with Children by Race 9%
10
5
100 *
0
90
Overall American Asian Black Latino/a White Multiracial
80 Sample Indian
70
* Sample size too low to report
60
50
40 Court Stopped/Limited Relationships with
33% 33%
29% 30% 28% Children by Household Income
30 26% 25%
20
50
10
45
0
Overall American Asian Black Latino/a White Multiracial 40
Sample Indian 35
30 29%

25 24%

20
15
10% 10%
10 8%

5
0
Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K
 FAMILY LIFE 99

Thirty percent (30%) of respondents reported that their children Children Rejecting Parents by Respondent’s Education
have chosen not to speak with them or spend time with them due
100
to their gender identity/expression. Still, a large majority (70%)
90
reported that their children chose to continue their relationship.
80 74% 75%
67% 69%
White respondents experienced child rejection at the highest rate 70

of any racial group (31%). Respondents whose household income 60

49%51%
50
was $10,000/year or less (33%), those without a high school
40 33%
diploma (37%), and those who had lost jobs due to bias (43%) 31%
30 26% 25%
all reported high level of rejection by their children. Male-to-
20
female transgender respondents experienced child rejection more 10
often (37%) than female-to-male transgender participants (10%). 0
No HS Diploma High School Some College College Degree Graduate
Transgender respondents endured child rejection more often Diploma Degree
(33%) than gender non-conforming participants (10%). Those
Rejected by Children Not Rejected by Children
who reported living full time in their preferred gender (37%),
and those who had undertaken a medical (35%) or surgical
(37%) transition all reported higher rates of child rejection.

Children Rejecting Parents by Race

50
45
40
35
30% 31%
30 28% 28%
25%
25 23%

20
15
(10%)
10
5
0
Overall American Asian Black Latino/a White Multiracial
Sample Indian

( ) Sample size too low for reliable data

Children Rejecting Parents by Respondent’s Household Income

100
90
80 74% 72%
70%
70 67%
63%
60
50
40 37%
33%
30% 28%
30 26%
20
10
0
Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K
Rejected by Children Not Rejected by Children
100 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Family Violence by Educational Attainment

Family Violence
Nineteen percent (19%) of respondents have experienced 50
domestic violence at the hands of a family member because of 45
their transgender identity or gender non-conformity. 39%
40
35
American Indian (45%), Asian (36%), Black (35%) and Latino/a
30 28%
(35%) respondents reported higher rates of domestic violence
25 22%
than the full sample, as well as undocumented non-citizens
20
(39%), those earning under $10,000 annually (38%), those
15 13% 14%
without a high school diploma (39%), the unemployed (30%),
10
respondents who have lost jobs due to bias (35%) and those who
5
worked in the underground economy (42%). MTF respondents
0
endured family violence more often (22%) than FTM respondents No HS Diploma High School Some College College Degree Graduate
(15%), while gender non-conforming respondents were Diploma Degree

victimized more often (21%) than their transgender peers (19%).

Family Violence by Race Friendships

50
45% Over half the sample (58%) experienced the loss of close
45
friendships as a result of their gender identity/expression.
40
36% 35% 35%
35 Black and Asian respondents were least likely to have lost a close
31%
30 friend than other racial cohorts. Those most at risk for losing
25 close friends included undocumented non-citizens (66%), those
20 19% who had lost jobs due to bias (79%) and those engaged in the
15%
15 underground economy (70%). MTFs lost friends more often (67%)
10 than FTMs (51%) and transgender respondents lost friends at a
5 higher rate (61%) than their gender non-conforming peers (49%).
0
Overall American Asian Black Latino/a White Multiracial
Sample Indian Lost Close Friendships by Race

100
90
Family Violence by Household Income 80 74%
70 64%
50 58% 57% 57%
60
52%
45
50
38% 42%
40
40
35
30
30
20
25 23%
10
20 18%
0
15 12% 12% Overall American Asian Black Latino/a White Multiracial
Sample Indian
10
5
0
Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K “I cannot come out of the closet until I have
graduated college and/or have a steady job,
because I would be disowned by my parents and
they would stop paying for my education.”
 FAMILY LIFE 101

Making the Connections: Incarceration

Family Rejection and Domestic Nineteen percent (19%) of those who experienced family
rejection had been incarcerated compared to only 11% of those
Violence, Homelessness, whose families were accepting.
Incarceration, and Health
Underground Economy
In this section, we examine the connections between
Nineteen percent (19%) of those who experienced family
negative experiences at home and how they relate to income,
rejection had worked in the underground economy for income,
incarceration, homelessness, work in the underground economy
compared to only 11% of those whose families were accepting.
and health outcomes.
Speciically, 13% of those who experienced family rejection had
FAMILY REJECTION OR ACCEPTANCE done sex work for income, compared to 7% of those whose
To compare the experiences of respondents who had been families were accepting.
accepted by their families with those who were rejected, we
HIV
created a new variable using the answers to several statements
about family acceptance.5 Fifty-seven percent (57%) faced some The contrast between HIV rates of the two groups was less stark,
rejection by their family and 43% were accepted. with 2.46% of those who experienced family rejection also
reporting an HIV-positive status, compared to 2.04% of those
Family Acceptance/Rejection by Household Income whose families were accepting. 6

50 Suicide
45
40 Family rejection dramatically increased the likelihood of suicide
35 33% attempts. Fifty-one percent (51%) of those who experienced
30% 31%
30 family rejection reported having attempted suicide, compared to
26%
25 32% of those whose families were accepting.
20
16% 16%
15 13% 13% 12% Smoking
11%
10
Thirty-two percent (32%) of those who experienced family
5
rejection reported being current smokers. For those whose
0
Under 10K 10K-under 20K 20K-under 50K 50k-100k 100k+ families were accepting, the rate was slightly lower at 27%.
Those whose families accepted them Those whose families rejected them
Drugs and Alcohol

Thirty-two percent (32%) of those who experienced family

Household Income rejection also reported having used drugs or alcohol to deal with
Those whose families accepted them tended to have higher the mistreatment they faced as a transgender or gender non-
current household incomes than those who experienced family conforming person. This compared with 19% of those whose
rejection. For example, 47% of those whose families accepted families were accepting.
them made more than $50,000/year compared to 38% of those
whose families rejected them. “My parents threatened to disown me. ‘It was
a sin,’ ‘I was sick,’ ‘I wanted to mutilate my
Homelessness
body,’ etc. I drank fairly heavily from when
Twenty-six percent (26%) of those who experienced family I was 14 on. And I just kept drinking.”
rejection also reported having experienced homelessness, nearly
three times higher than those whose families were accepting
(9%).
102 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

DOMESTIC VIOLENCE

Of those who experienced family rejection, we found that

those who experienced domestic violence by family members
experienced other negative outcomes at particularly alarming
rates, explained below.

Homelessness

Family violence had a strong apparent link to homelessness.

Forty-eight percent (48%) of those who experienced domestic
violence also reported having experienced homelessness, nearly
four times the rate of those whose families were accepting (9%).

Incarceration

Twenty-nine percent (29%) of those who experienced domestic

violence reported having been incarcerated, compared to only
11% of those whose families were accepting.

Underground Economy

Thirty-eight percent (38%) of those who experienced domestic

violence also reported having worked in the underground
economy for income, compared to only 11% of those whose
families were accepting.

Speciically, 29% of those who experienced domestic violence

also reported having done sex work for income, a rate more than
four times as high than those whose families were accepting
(7%).

HIV

Five and a half percent (5.5%) of those who experienced

domestic violence also reported being HIV-positive. This
compared to 2.04% of those whose families were accepting and
our overall sample rate of 2.64%.7

Suicide

Sixty-ive percent (65%) of those who experienced domestic

violence also reported having attempted suicide, compared to
32% of those whose families were accepting.

Alcohol and Drugs

Forty-seven (47%) of those who experienced domestic

violence also reported drinking or misusing drugs to cope with
the mistreatment they faced as transgender or gender non-
conforming people. This compared with 19% of those whose
families were accepting.
 FAMILY LIFE 103

CONCLUSIONS FOR FAMILY LIFE

Our analysis shows that many transgender and gender non-conforming people experienced improvement in their family
relationships after coming out. Others endured considerable challenges including rejection by partners, friends, and family
members. A majority experienced both good and bad, and this didn’t differ much by race.

Occasionally, family rejection took severe forms including domestic violence, which was associated with some of the most
alarming rates of negative outcomes later in life.

Nonetheless, these data contradict the assumption that coming out as transgender or gender non-conforming always causes
relationships with spouses or partners to end; we found about half of respondents staying in the same relationship (or having
broken up for other reasons).

Children of transgender and gender non-conforming parents were generally accepting although their relationships were
sometimes limited by ex-partners/spouses or family court judges. It appears that partner and judicial biases towards
transgender and gender non-conforming parents often obstruct ties with children.

While family rejection was shown to be related to a number of negative outcomes including homelessness, HIV and suicide
attempts, those respondents whose families accepted them had better health outcomes and enjoyed higher levels of social
and economic security that the full sample. It appears that family support and safety nets can have a major positive impact
on the lives of transgender and gender non-conforming people even in the face of pervasive mistreatment and discrimination
outside of the home.

All of these statistics appear to conirm the groundbreaking indings of the Family Acceptance Project (FAP),8 a multi-year
study that examines the impact of family rejection on LGBT youth health outcomes. Aligned with FAP indings, data in this
study show a strong correlation between family acceptance and health as well as social and economic security for adult
transgender and gender non-conforming adults, making a strong case for more research in this emerging arena of study.
104 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

RECOMMENDATIONS FOR FAMILY LIFE

• Family members of transgender and gender non-conforming people who are coming out should educate themselves so
that they can accept and continue to support their loved one and provide a place to turn to in the face of mistreatment or
discrimination in wider society.

• Those involved with the family court system should be educated about transgender and gender non-conforming people,
their continuing ability to be good parents, and the destructive consequences of separating parents and children.

• Family court judges should be educated about research9 showing that remaining in a strong relationship with a
transgender or gender non-conforming parent is in “the best interest of the child,” and that transgender or gender
non-conforming children need to be in custody of parents or guardians who accept them. Furthermore, transgender
and gender non-conforming parents should not be restricted from expressing their identity or gender non-conformity
during visitation.

• Guardians Ad Litem and Court Appointed Special Advocates should be trained to understand that transgender and
gender non-conforming children need to be in custody of parents or guardians who are accepting of their gender
identity/expression. They also need to understand that it is in “the best interest of the child” to have contact with their
transgender or gender non-conforming parent.

• Lawyers involved in family court issues should not make arguments to limit custody or contact with children a parent is
transgender or gender non-conforming.

• Experts or professionals that the court relies on for analysis and advice who express bias against transgender or
gender non-conforming children or adults should be removed from their cases.

• Adoption and foster care agencies should similarly be educated and establish policies of nondiscrimination for potential
parents based on gender identity/expression and race.

• Social service providers should be aware of the likelihood of family rejection and domestic violence for transgender and
gender non-conforming people and be prepared to be a resource or intervene as appropriate.

• School counselors should be aware of the potential challenges transgender and gender non-conforming youth may be
facing at home as well as in school, so that they can provide needed assistance.

• Social workers should provide services friendly to transgender and gender non-conforming people as well as develop
referral lists of other social service providers accessible to transgender and gender non-conforming people including
homeless shelters and domestic violence shelters.

• Counselors and therapists in private practice should be prepared to counsel individuals and families who have a
transgender or gender non-conforming family member and assist these families in accepting and supporting their identity.

• Family and marriage counselors should be able to assist spouses and partners dealing with gender identity/expression
issues and what they may mean for their relationship. They should encourage understanding on the part of all parties and,
if separation is warranted, they should also assist with an amicable breakup and ensure that any children continue to have
relationships with their parents.
 FAMILY LIFE 105

Endnotes
__________________________________________________________________________

1 We included those that tell “everyone” in this calculation.

2 U.S. Department of Commerce, Bureau of the Census and U.S. Department

of Labor, Bureau of Labor Statistics, “Current Population Survey”
(Washington, DC: GPO, November2008).

3 Ibid.

4 No data is available in this study to explain the diferences between

MTF and FTM respondents in relationship preservation. However, based
on anecdotal evidence, this may be due to a diference in the sexual
orientation of the partner of the transitioning individual and the norms
that go with that sexual orientation.

5 Those who responded “Yes” to any of the following statements were in

the family rejection group: “my relationship with my spouse or partner
ended,” “my ex limited or stopped my relationship with my children,” “a
court/judged limited or stopped my relationship with my children,” “my
children chose not to speak with me or spend time with me,” “my parents
or family chose not to speak with me or spend time with me,” or “I was a
victim of domestic violence by a family member.”

6 HIV rates have not been rounded for better comparison to national rates.

7 HIV rates have not been rounded for better comparison to national rates.

8 For more, see The Family Acceptance Project at http://familyproject.sfsu.

edu/home.

9 T. White and R. Ettner, “Children of a Parent Undergoing a Gender

Transition: Disclosure, Risk, and Protective Factors,” (paper presented
at XVI Harry Benjamin International Gender Dysphoria Association
Symposium, London, England, August 17 — 21, 1999): http://www.
symposion.com/ijt/greenpresidental/green17.htm; R. Green, “Sexual
Identity of 37 Children Raised by Homosexual or Transsexual Parents,”
American Journal of Psychiatry, 135 (1978): 692; R. Green, “Transsexuals´
Children,” International Journal of Transgenderism, 2 (1998):4. http://
www.symposion.com/ijt/ijtc0601.htm.
106 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

HOUSING AND HOMELESSNESS

Housing is a necessity and a basic human right but one that is often denied to transgender
and gender non-conforming people. Direct discrimination as well as the aggregate efects of
mistreatment and denied opportunities across multiple aspects of life create a tenuous and often
threatening housing landscape for participants in this study.
We asked a series of questions to evaluate the impact of anti-transgender bias in housing.
Respondents reported substantial housing insecurity while employing a variety of strategies to
secure shelter and make a home.
We also asked several questions speciically about shelters, including homeless and domestic
violence shelters. These responses conirmed the study team’s anecdotal experience that
emergency shelter systems as a whole are utterly failing to provide safety or relief for
transgender and gender non-conforming people facing a housing crisis.

KEY FINDINGS IN HOUSING AND HOMELESSNESS

• The various forms of direct housing discrimination faced by respondents included 19% being denied a home or
apartment and 11% being evicted because they were transgender or gender non-conforming.

• Nineteen percent (19%) of respondents became homeless at some point because they were transgender or gender
non-conforming, and 1.7% of respondents were currently homeless.1

• Those who had experienced homelessness were 2.5 times more likely to have been incarcerated (34%) than those
who had not (13%), and were more than four times more likely to have done sex work for income (33%) than those
who had not (8%). They were more likely to be HIV-positive (7.12%) than those who had not (1.97%), and were much
more likely to have attempted suicide (69%) than those who had not (38%).2

• For those respondents who had attempted to access homeless shelters, 29% were turned away altogether, 42%
were forced to stay in facilities designated for the wrong gender, and others encountered a hostile environment. Fifty-ive
percent (55%) reported being harassed, 25% were physically assaulted and 22% were sexually assaulted.

• Respondents were forced to use various strategies to secure shelter including moving into a less expensive home/
apartment (40%), moving in with family or friends (25%), and having sex with people to sleep in a bed (12%).

• Thirty-two percent (32%) of respondents reported owning their home, compared to 67% of the general population.

• Respondents demonstrated resilience: Of the 19% who reported facing housing discrimination in the form of a denial
of a home/apartment, 94% reported being currently housed.

“I’m homeless, sleeping in makeshift housing under a bridge.”

 HOUSING AND HOMELESSNESS 107

Current Housing Situation Currently Homeless by Race5

25
We asked respondents to indicate their current housing situation,
in order to establish a national snapshot of their living situation at
20
the time the survey was ielded.

15
Current Housing Situations of Respondents3 13.0%

100 10
8.0%
House/apt./condo I own 32.0%
90 5.0%
House/apt./condo I rent 42.0% 5
80 3.0%
Partner/spouse who pays 8.0% 1.7% 1.5%
70 0.5%
0
60 Friends/family temporarily 4.0%
Overall American Asian Black Latino/a White Multiracial
Sample Indian
50 Living with
45%parents/family
45% 7.0%
39%
40Campus/university housing 4.0% 33%
30 Nursing/adult care facility 0.1%
20 16% Currently Homelessness by Educational Attainment
Group home/foster care 0.5%
10
Homeless or living in a shelter 1.7% 25
0
18-24 0
25-44 5 1045-54
15 20 2555-64
30 35 40 65+
45 50
20

15
CURRENT HOMELESSNESS OR LIVING IN A SHELTER

We irst asked about homelessness; 1.7% of the sample responded 10

8%
that they were currently homeless or living in a shelter, which is
5%
nearly double the percentage that the National Coalition for the 5
Homeless estimates for the U.S. population.4 Those particularly 2%
0% 0%
vulnerable to being currently homeless included African 0
No HS Diploma High School Some College College Degree Graduate
Americans (13%), American Indians (8%) and undocumented Diploma Degree
non-citizens (4%). The unemployed (7%), those working in the
underground economy (7%) and those without a high school
diploma (8%) also reported high rates of homelessness. Three
percent (3%) of those who had lost a job due to bias were
currently homeless.

As will be demonstrated later in this chapter, transgender people

faced real barriers accessing shelter resources; therefore, it is
possible that an even higher percentage of our sample needed
shelter services but were unable or afraid to access them.

“I am now being evicted from the garage I have been living in the last
several months, and in parting fashion, this afternoon I was informed
that I have been denied access to renting a two-decade-old mobile
home, the only place I could ind with my limited income.”
108 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

LIVING WITH FAMILY OR FRIENDS TEMPORARILY GROUP HOMES AND FOSTER CARE

Four percent (4%) of the sample reported living with family Less than 1% of respondents were currently living in a group
members or friends temporarily. Those who were younger were home or foster care. However, Black (5%), Latino/a (1%) and
more likely to report this experience, as were Black (8%), and multiracial respondents (1%) were in group or foster care
Latino/a (7%) respondents, as well as those who worked in situations at slightly higher rates, as were those making less than
the underground economy (8%). Although these respondents $10,000/year (2%) and those without a high school diploma
are not currently homeless, their “temporary” status suggests a (4%).
substantial level of housing insecurity.
Living in Group Homes or Foster Care by Race
Living with Family or Friends Temporarily by Age
25
25
20
20
15
15
10
10
5%
5
5% 5%
5 4% 1% 1% 1%
3% 0% 0% 0%
2% 0
0% Overall American Asian Black Latino/a White Multiracial
0 Sample Indian
Overall 18-24 25-44 45-54 55-64 65+
Sample

SKILLED NURSING AND ADULT CARE FACILITIES

Living with Family or Friends Temporarily by Race
Only .1% of the overall sample reported living in a skilled nursing
25 or adult care facility. Due to small sample size, we are unable to
provide more details about this group.
20

“I fear growing old as I feel I would be treated

15
poorly if I ever ended up in an elder care home.”
10 9%
8%
7%
5%
5 4% 4%
3%

0
Overall American Asian Black Latino/a White Multiracial
Sample Indian
 HOUSING AND HOMELESSNESS 109

CAMPUS AND UNIVERSITY HOUSING Living with Family Members by Race

Four percent (4%) of respondents reported living in university or 25

campus housing. As expected, the age category with the highest
rate was 18-24 year olds (8%); the percentage for 25-44 year olds 20
was 3%.
16%
15
13%
Campus and University Housing by Age
10%
10
25 7% 7%
5%
5
3%
20

0
15 Overall American Asian Black Latino/a White Multiracial
Sample Indian

10
8%

Those with less education were more likely to be living with their
5 4%
3% parents/family members. Thirty percent (30%) of respondents
0% 0% 0% with no high school diploma and 19% of those with only a high
0
Overall 18-24 25-44 45-54 55-64 65+ school diploma were living with parents or family.
Sample

Living with Family Members by Educational Attainment

LIVING WITH PARENTS OR FAMILY MEMBERS 50

45
Seven percent (7%) of the sample reported currently living with 40
their parents or family “they grew up with.” Though younger 35
respondents were more likely to have marked this response, 3% of 30%
30
45-54 year olds did as well. We did not ask whether respondents 25
were living with family members because they needed to for 20 19%
inancial reasons, wanted to, or had invited aging relatives into 15
their homes to care for them. 10 9%
7%
5 3%
1%
Living with Family Members by Age 0
Overall No HS HS Diploma Some College College Graduate
Sample Diploma Degree Degree
25

20
LIVING WITH PARTNER OR SPOUSE WHO PAYS
15 14%
Eight percent (8%) of respondents said they lived with a
partner or spouse who paid for their housing. Those who
10
7% 7%
were unemployed (18%) and out of the workforce (10%) were
particularly likely to be relying on a spouse or partner to cover
5
3% housing expenses. In terms of race, Latino/as were the most likely
1%
0% to have marked this response at 14%.
0
Overall 18-24 25-44 45-54 55-64 65+
Sample

Asian respondents had the highest rate of living with parents or

family members of any race.
110 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Living with Partner or Spouse who Pays by Race OWNING A HOUSE, APARTMENT, OR CONDO

25
Thirty-two percent (32%) 32% of respondents
of respondents reported
reported owning their
20
owning their place of
residence. This is less than home, compared to
15 14% half of the national average 67% of the general
11%
of 67.4% reported by the U.S. population.”
10% Department of Housing and
10 9% 9%
8%
7% Urban Development (HUD) in the second quarter of 2009,6 at
5 approximately the same time as the survey was launched.

Transgender women were more likely to own their homes (36%)

0
Overall American Asian Black Latino/a White Multiracial
than transgender men (20%), and transgender respondents were
Sample Indian more likely to own their homes (30%) than their gender non-
conforming peers (24%). As might be expected, home ownership
rose with age, from 15% of those aged between 18 and 24 to 71%
RENTING A HOUSE, APARTMENT, OR CONDO of those over 65 years old.

Forty-two percent of respondents said they lived in a house,

Owning a House, Apartment, or Condo by Age
apartment, or condo that they rent. Renting did not vary widely
across race. However, transgender men were much more likely to 100
rent their homes (52%) than transgender women (40%). 90
80
Those making between $10,000 and $50,000/year were the most 71%
70
likely to be renting their homes.
60 57%
51%
50
Renting a House, Apartment, or Condo by Household Income
40
32%
100 30 26%

90 20 15%

80 10

70 0
64%
Overall 18-24 25-44 45-54 55-64 65+
60 54% Sample
50
42%
39%
40 35%
30 People of color were much less likely to own their homes than
19% white respondents. African American respondents were the
20
10 least likely to own their homes at 14%. By comparison, the U.S.
0 Department of Housing and Urban Development reports that
Overall Under $10K $10K-Under $20K-Under $50K-Under $100K+
Sample $20K $50K $100K
“minority home ownership” nationwide was 49.7% during the
comparable period.7
 HOUSING AND HOMELESSNESS 111

Owning a House, Apartment, or Condo by Race

Negative Housing Outcomes
50
We asked respondents to report on experiences related to
45
housing conditions and situations they’ve encountered due to
40 37% anti-transgender bias over their lifetime. We found high levels of
35 32% homelessness and eviction, as well as spending down of assets
30
24%
and moving into less desirable housing due to bias.
25
21% 21%
20 17% “I MOVED INTO A LESS EXPENSIVE HOME/APARTMENT”
15 14%

10 Forty percent (40%) of respondents said they had moved into a

5 less expensive home or apartment due to bias. Those hit hardest
0 were Black (52%) and Latino/a (51%) respondents, as well as
Overall American Asian Black Latino/a White Multiracial
Sample Indian
those making under $10,000/year (55%), and those who: were
unemployed (54%), had lost a job due to bias (65%), had worked
in the underground economy for income (63%) and had no high
Home ownership also rose with income, but even in the highest school diploma (54%).
income categories, our respondents have a lower rate of home
ownership that the general population (67%). “I moved into a less expensive home/apartment” by Race

100
Owning a House, Apartment, or Condo by Household Income
90

100 80

90 70

80 60 56%
52% 51% 49%
70 50
62% 40%
60 40 37%
49% 27%
50 30

40 20
32%
30 25% 10

20 0
9% 11% Overall American Asian Black Latino/a White Multiracial
10 Sample Indian
0
Overall Under $10K $10K-Under $20K-Under $50K-Under $100K+
Sample $20K $50K $100K

“I moved into a less expensive home/apartment”

by Household Income

100
90
80
70
60 55%
50 48%
42%
40 33%
30 24%
20
10
0
Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K
112 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

“I moved into a less expensive home/apartment” “I became homeless” by Race

by Educational Attainment
50
100 45
41%
90 40
80 35 33% 32%
30 29%
70
60 54% 25
49% 19%
50 45% 20
36% 15 14%
40 34%
10 9%
30
20 5
10 0
Overall American Asian Black Latino/a White Multiracial
0 Sample Indian
No HS Diploma HS Diploma Some College College Degree Graduate
Degree

The U.S. Conference of Mayors cites a number of causal factors for

Transgender women were much more likely to have moved into homelessness. For families: a lack of afordable housing, poverty
a less expensive home or apartment due to bias (50%) than their and unemployment, while for single people: substance abuse,
transgender male counterparts (34%). Transgender respondents lack of afordable housing and mental illness were the leading
were more likely to have done so (44%) than gender non- factors.9 As we’ve seen in this report, transgender and gender
conforming respondents (28%). non-conforming people experience many of these situations and
conditions at much higher rates than the general population due
“I BECAME HOMELESS” to discrimination.

Nineteen percent (19%) of African Americans As expected, respondents who faced economic challenges
respondents said they became were at increased risk for homelessness: 39% of those who
were over three
homeless as a result of reported incomes of less than $10,000 per year had experienced
discrimination or family rejection times as likely to homelessness, while those with incomes between $10,000 and
based on gender identity. This become homeless $20,000 were at 26%, compared with 19% of the sample as a
igure is more than 2.5 times than the rest of whole. Losing a job due to bias also led to highly elevated levels
higher than the general population of homelessness. Forty percent (40%) of those who had been ired
the population.
lifetime rate of homelessness because of their gender identity reported having been homeless.
(7.4%).8
“I HAVE BEEN EVICTED”
Fewer older people reported having been homeless with 10% of
55-64 year olds reporting homelessness at some point in their Eleven percent (11%) of respondents said they had been
lives and 8% of those 65 and above experiencing homelessness evicted from housing at some point in their lives because they
at some point. Transitioning later in life was inversely related are transgender or gender non-conforming. African American
to homelessness, with the percentage of those who had been respondents reported an exceptionally high eviction rate of 37%.
homeless decreasing as the age of transition increased. A possible Others reporting high rates included those with no high school
explanation is that prior to a late-life transition process, these diploma at 33%, those making under $10,000/year at 26%, and
respondents may have hidden their transgender identity or gender undocumented immigrants at 21%.
non-conformity and thus been better able to preserve jobs and
secure housing over time.
 HOUSING AND HOMELESSNESS 113

“I have been evicted” by Race “I WAS DENIED A HOME/APARTMENT”

50
Nineteen percent (19%) of respondents said they had been
45
denied a home or apartment because they were transgender
40
or gender non-conforming. This number varied dramatically
37%
35 according to race; American Indians reported a 47% denial rate
30% and African American respondents reported a 38% denial rate..
30
25 Other groups with high rates of denial included those working in
20 the underground economy (42%), those who had lost a job due
15% 16%
15 to bias (40%), those without a high school diploma (32%) and
11%
10 8% those making under $10,000/year (31%).
5%
5
0 “I was denied a home/apartment” by Race
Overall American Asian Black Latino/a White Multiracial
Sample Indian
100
90
80
“I have been evicted” by Household Income 70
60
50 47%
50
45 38%
40
32%
40 30 26%
35 19% 17%
20 15%
30 10
26%
25 0
20 Overall American Asian Black Latino/a White Multiracial
Sample Indian
15 14%
11%
10
5%
5 2%
0 “I was denied a home/apartment” by Household Income
Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K
50
45
40
“I have been evicted” by Educational Attainment 35
31%
30
50
25 24%
45 20%
20
40 13%
15
35 33% 8%
10
30
5
25
0
20 19% Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K
15 14%

10 7%
6%
5
0
No HS Diploma HS Diploma Some College College Degree Graduate
Degree

MTF respondents reported nearly twice the rate of eviction (16%)

as their FTM counterparts (8%), and transgender respondents
had twice the rate (13%) as gender non-conforming respondents
(6%).
114 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

“I HAD TO MOVE BACK IN WITH FAMILY OR FRIENDS” “I HAD TO FIND DIFFERENT PLACES TO SLEEP FOR
SHORT PERIODS OF TIME, LIKE A FRIEND’S COUCH”
Twenty-ive percent (25%) of respondents said they had to move
in with family or friends because they were transgender or gender Twenty-six percent (26%) of respondents reported having to
non-conforming. Black respondents reported the highest rate of ind diferent places to sleep for short periods. Those working
this outcome at 47%, followed by multiracial respondents at 36%. in the underground economy reported a rate of 56%, and Black
Those without a high school diploma reported living with family respondents reported a rate of 48%. Those who had lost a job
or friends at 47%. Those working in the underground economy reported having to ind diferent places to sleep for short periods
had a rate of 49%. at a rate of 49%. Also reporting high rates were those with no
high school diploma (53%) and those making under $10,000/
“I had to move back in with family or friends” by Race year (45%).

100 “I had to ind different places to sleep for short

90 periods of time, like a friend’s couch” by Race
80
70 100
60 90
51%
50 47% 80
40 36% 70
33%
30%
30 25% 60
22%
50 48%
20 45%
40 36% 38%
10
0 30 26% 26%
Overall American Asian Black Latino/a White Multiracial 22%
Sample Indian 20
10
0
Overall American Asian Black Latino/a White Multiracial
Sample Indian
“I had to move back in with family or friends” by Household Income

100
90 “I had to ind different places to sleep for short periods of
80 time, like a friend’s couch” by Household Income
70
60 100
50 43% 90
40 34% 80
30 26% 70
20 16% 60
11%
10 50 45%
0 40
Under $10K $10K-under $20K-under $50K-under $100K+ 32%
30 26%
$20K $50K $100K
20 16% 14%
10
0
Under $10K $10K-under $20K-under $50K-under 100K+
$20K $50K $100K
 HOUSING AND HOMELESSNESS 115

“I HAVE HAD SEX WITH PEOPLE TO SLEEP IN THEIR “I HAD TO USE EQUITY IN MY HOME TO
BED/AT THEIR HOMES OR TO PAY RENT” PAY FOR LIVING EXPENSES”

Twelve percent (12%) of the sample reported having had sex Fourteen percent (14%) of respondents reported having to use
with people to secure a place to stay. Those exchanging sex for equity in their home to pay for living expenses. Those reporting
housing in high numbers were those working in the underground the highest rates included those with no high school diploma
economy (43%), those with no high school diploma (43%), Black (34%), those who had lost jobs due to bias (28%), those 55-64
respondents (38%), Latino/a respondents (27%), and those years old (27%), and African American respondents (26%).
making under $10,000/year (25%).
“I had to use equity in my home to pay for living expenses” by Race
“I have had sex with people to sleep in their bed/
at their homes or to pay rent” by Race 50
45
50 40
45 35 32%
40 38% 30
26%
35 25
30 27% 27% 20
16%
15 14% 13% 13%
25
20% 11%
20 10
15 12% 12% 5
10 7% 0
Overall American Asian Black Latino/a White Multiracial
5 Sample Indian
0
Overall American Asian Black Latino/a White Multiracial
Sample Indian

“I had to use equity in my home to pay for living

expenses” by Household Income
“I have had sex with people to sleep in their bed/at their
homes or to pay rent” by Household Income 50
45
50 40
45 35
40 30
35 25
20%
30 20
25% 15% 14%
25 15 13%
10%
20 10
15 12% 12% 5
10 0
6% Under $10K $10K-under $20K-under $50K-under 100K+
5 3% $20K $50K $100K
0
Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K

Male-to-female respondents were nearly twice as likely to

have traded sex for housing (15%) as their female-to-male
counterparts (8%), but transgender respondents, overall, were
equally likely to have traded sex for housing as gender non-
conforming respondents (12%).
116 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

“I had to use equity in my home to pay for living expenses” by Age Outright Denial of Shelter Access by Race

50 100

45 90

40 80

35 70

30 60 (53%)
26% 27%
50 (45%)
25 40%
40
20 29%
30 23%
15 12% 20%
11% 20
10 7%
10
5 *
0
0 Overall American Asian Black Latino/a White Multiracial
18-24 25-44 45-54 55-64 65+ Sample Indian

Male-to-female respondents were more than twice as likely * Sample size too low to report
to have had to use equity in their home to pay for living ( ) Sample size too low for reliable analysis
expenses (21%) as their female-to-male counterparts (8%) , and
transgender respondents were more than three times as likely
Transgender women were much more likely to have been denied
(16%) as gender non-conforming respondents (5%).
access to shelters (34%) than their transgender male counterparts
(20%), and transgender respondents, overall, were far more likely
(30%) to have been refused shelter than gender non-conforming
respondents (12%).
Access to Shelters
In addition to those who were denied access outright, 25%
Of the 19% of respondents who had experienced homelessness, of respondents reported being evicted after their transgender
about a quarter (25%) reported trying to access a homeless identity or gender non-conformity became known and 47%
shelter during that time. Their reports of attempting to access reported leaving a shelter due to poor treatment. Sixteen percent
shelter describe a system in which abuses against transgender and (16%) reported experiencing all three of these outcomes.
gender non-conforming people are commonplace. These include
denial of access, ejection when transgender status was disclosed,
harassment by staf and residents, assault and forced presentation
in the wrong gender. Nearly half of all respondents who accessed
a shelter (47%) left due to poor treatment.

OUTRIGHT DENIAL

Housing insecurity for

For those respondents
transgender and gender non-
conforming people in the U.S. who had attempted
goes beyond eviction and to access homeless
homelessness; they are also shelters, 29% were
frequently barred from access
turned away altogether.
to safety nets meant to help
people in crisis. Twenty-nine
percent (29%) of respondents who attempted to access shelter
reported being denied access to shelters altogether because they
were transgender or gender non-conforming.

Groups reporting particularly high rates of denial of access to

shelters included documented non-citizens (45%), Latino/a
respondents (45%), those with no high school diploma
(44%), those who had lost a job due to bias (40%), and Black
respondents (40%).
 HOUSING AND HOMELESSNESS 117

HARASSMENT AND ASSAULT Harassment in a Shelter by Gender Identity/Expression

When provided access to shelter, respondents often reported 100

living in hostile and dangerous environments. Many experience
90
harassment, physical and sexual assault perpetrated by either
80
shelter residents or staf.
70
60% 58%
60
Harassment 51%
50

40 (35%)
Over half of respondents (55%) reported being harassed by
30
residents or staf members of shelters. Looking at race, Latino/as
20
reported the highest rate of harassment at 63%, followed by Black
10
respondents at 61%.
0
MTF FTM All Trans GNC
Harassment in a Shelter by Race

( ) Sample size too low for reliable analysis

100
90
Physical Assault
80
70
61% 63% One quarter (25%) of respondents who accessed shelter reported
60 55% (56%) 55% having been physically assaulted by either another resident or
51%
50 a staf person. Looking at race, Black respondents reported the
40 highest rate at 31%.
30
20 Physical Assault at a Shelter by Race
10
* 100
0
Overall American Asian Black Latino/a White Multiracial 90
Sample Indian
80
70
* Sample size too low to report 60
( ) Sample size too low for reliable analysis 50 (47%)

40 (33%)
31%
30 25% 27%
Others reporting high rates of harassment included documented
20 17%
non-citizens (62%), those who had lost a job due to bias (70%),
10
and those working in the underground economy (65%). *
0
Overall American Asian Black Latino/a White Multiracial
Sample Indian

* Sample size too low to report

( ) Sample size too low for reliable analysis

Others reporting high rates of physical assault included

undocumented non-citizens at 50% and those who had lost a job
due to bias at 35%.

Transgender women were almost twice as likely to have been

physically assaulted in a shelter (29%) than transgender men
(15%), and transgender respondents were more likely to have
been assaulted (25%) than gender non-conforming respondents
(20%).
118 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Sexual Assault Forced to Live as the Wrong Gender

Twenty-two percent (22%) of respondents who accessed shelter Among respondents who accessed a shelter, 42% reported that
reported being sexually assaulted by either another resident or they were forced to live as the wrong gender to be allowed to
a staf person. Looking at race, Black respondents reported the stay. Being forced to live as the wrong gender can range from
highest rate of sexual assault at 33%, followed by Latino/as at being required to alter a hairstyle or make-up to radically altering
31%. gender presentation from head to toe. More than half of those
who had lost a job due to bias (51%) said they had had to live
Sexual Assault at a Shelter by Race as the wrong gender to access a shelter, along with 47% of the
100 unemployed and 47% of those who worked in the underground
90 economy. African-American respondents experienced high levels
80 of coerced presentation, with 48% being forced to live in the
70 wrong gender.
60
(50%)
50 Forced to Live as the Wrong Gender by Race
40 33% (31%)
30 25% 100
22%
20 90
10%
10 80
*
0 70
Overall American Asian Black Latino/a White Multiracial (59%)
60
Sample Indian
50 48%
42% 43% 42%
* Sample size too low to report 40
( ) Sample size too low for reliable analysis
30
20

Others reporting high rates of sexual assault included 10

* *
undocumented non-citizens (40%) and those who had lost a job 0
Overall American Asian Black Latino/a White Multiracial
due to bias (32%). Sample Indian

MTF respondents were more likely (26%) than FTM respondents

(15%) to report sexual assault. Transgender respondents were * Sample size too low to report

nearly six times more likely to report sexual assault (23%) than ( ) Sample size too low for reliable analysis

gender non-conforming respondents (4%).

Also hard hit were those who reported that they were not visually
conforming (51%).

Those who had had surgery were less likely to be subjected to

coerced gender presentation; nonetheless, 35% of those who had
surgically transitioned were still required to live as the wrong
gender.

In addition to those who were forced to present in the wrong

gender to stay in a shelter, 41% of respondents also reported
presenting in the wrong gender in order to be or feel safe in a
shelter.
 HOUSING AND HOMELESSNESS 119

Making the Connections more than four times the rate of those who had not experienced
homelessness (8%).
In this section, we examine the connections between
homelessness and how it relates to incarceration, work in the Physical and Sexual Assault
underground economy and health outcomes. We ofer analysis
Sixty-six percent (66%) of those who experienced homelessness
concerning both those who reported having experienced
also reported experiencing physical assault and 33% also reported
homelessness at some point in their lives because of bias due to
sexual assault.
gender identity and those who reported being currently homeless
for any reason. Smoking

THOSE WHO EXPERIENCED HOMELESSNESS Forty-seven percent (47%) of those who had experienced
homelessness reported being smokers. Those who have not been
We found that having experienced homelessness seemed to align
homeless smoked at a rate of 28%.
with several other negative conditions and outcomes.
Drinking and Drugs
Household Income
Forty-nine percent (49%) of those who had experienced
Respondents who had experienced homelessness reported
homelessness said they had used alcohol or drugs to deal with
earning lower incomes at the time of survey. Fifty-four (54%) of
the discrimination they faced as transgender or gender non-
those who experienced homelessness said they were currently
conforming people. This is almost double the rate of those who
making less than $20,000/year, while only 24% of those who had
had not experienced homelessness.
not experienced homelessness were earning under $20,000.
HIV
Household Incomes of those who Experienced Homelessness
The HIV rate for those who had experienced homelessness
50 (7.12%) was dramatically higher than those who had not
45 (1.97%).10
40
35%
35 33%
31% Suicide
30 28%
25 Sixty-nine percent (69%) of those who had experienced
19%
20 homelessness said they had attempted suicide. This compared to
13% 14%
15 12% 12% 38% of those who had not experienced homelessness.
10
5 2% CURRENTLY HOMELESS
0
Under $10K $10K-under $20K-under $50K-$100K $100K+
$20K $50K
Being currently homeless (including those living in a shelter)
Experienced homelessness Never experienced homelessness seemed to correlate with several other negative outcomes.

Incarceration

Incarceration Fully 49% of currently homeless respondents said they had been
incarcerated at some point in their lives. This is more than 3 times
Thirty-four percent (34%) of those who had experienced
higher than the rate of incarceration for those who were not
homelessness had been incarcerated for any reason. This is
currently homeless (15%).
nearly 2.5 times the rate of those who had not experienced
homelessness (13%).
Underground Employment

Underground Economy Sixty-nine percent (69%) of respondents who were currently

homeless had worked in the underground economy for income.
Forty-seven percent (47%) of respondents who had experienced
This is nearly ive times the rate of those who were not currently
homelessness said they had worked in the underground economy
homeless (15%).
for income, more than 3.5 times the rate of those who had not
experienced homelessness (13%). Fifty-ive percent (55%) of those who were currently homeless
reported having done sex work for income. This is compared to
Thirty-three percent (33%) of respondents who had experienced
only 10% of those who were not currently homeless.
homelessness said they had done sex work for income. This is
120 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Smoking “I experienced a lot of discrimination during my

Sixty-one percent (61%) of those who were currently homeless time of being homeless, in group homes, shelters,
reported being smokers. This compares with 30% of those who and transitional living houses. Additionally, I was
were not currently homeless.
been kicked out of several colleges, but I never
Drinking and Drugs gave up. For the last 6 years, I have used my past
experiences, as a transgender person of color, to
Fifty-four percent (54%) of currently homeless respondents said
they had used drugs or alcohol to cope with the discrimination improve best practices for youth in systems, get
they face as transgender or gender non-conforming people. This more services for them, and help youth become
was nearly twice as high as the rate for those who were not assertive. I am on the local government-run HIV
currently homeless (25%).
prevention planning council. I continue to struggle
HIV to ind a job that pays enough, but I always have
a positive attitude and that has gotten me far.”
The HIV infection rate for currently homeless respondents was
22.11%, over eight times the rate of those who were not currently
homeless (2.27%).11

Suicide

Sixty-eight percent (68%) of those who said they were currently

homeless also reported having attempted suicide, compared to
40% of those who said they were not currently homeless.
 HOUSING AND HOMELESSNESS 121

CONCLUSIONS FOR HOUSING AND HOMELESSNESS

Housing insecurity for transgender and gender non-conforming people is a crisis. Respondents reported direct discrimination
by housing providers and negative housing impacts of discrimination in other critical areas of life such as employment, health
care and criminal justice. Accordingly, respondents were forced to employ various strategies to secure places to live.

For transgender and gender non-conforming people who became homeless, safety nets meant to help people in a housing
crisis often failed. Respondents experienced being refused shelter due to bias and when admitted, often faced a hostile
environment. Study participants reported enduring harassment, physical attack, and sexual assault perpetrated by both
shelter staff and other residents.

Finally, for respondents who experienced homelessness, we found a correlation to life-threatening, devastating outcomes
including incarceration, work in the underground economy, smoking, drinking and drug use, HIV infection and suicide
attempts.
122 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

RECOMMENDATIONS FOR HOUSING AND HOMELESSNESS

• Stronger laws are needed to address housing discrimination and insecurity.

• Congress should amend the Fair Housing Act to include transgender and gender non-conforming people in its
protections and pass employment protections so that they can better afford to provide shelter for themselves.

• State legislatures and local governments should pass laws prohibiting both housing discrimination and employment
discrimination based on gender identity/expression, so that transgender and gender non-conforming people are better
able to provide shelter for themselves and have recourse when they experience discrimination.

• Government agencies should fully enforce housing discrimination laws, including already existing protections based on
race and gender as well as gender identity/expression.

• Free trainings on how to comply with the law should be developed and made widely available for housing providers
and real estate professionals.

• Pair testing and other ways to detect discrimination should be regularly used to ensure that housing non-discrimination
laws are being followed and corrective actions should be taken when non-compliance is found.

• Individual complaints should be investigated thoroughly and housing providers who discriminate should face harsh
penalties.

• Shelters should be made accessible and safe for all transgender and gender non-conforming people.

• Shelters should have clear policies on housing transgender residents, ensuring that they are housed according to their
gender identity.

• Gender non-conforming expression and presentation should not be prohibited in order to gain access to shelters.

• Policies should be developed to minimize the risk of violence directed at transgender and gender non-conforming
residents by other residents.

• Shelter staff should be fully trained on these policies as well as how to respectfully serve transgender and gender non-
conforming residents. Staff members who violate policy or serve residents disrespectfully should be disciplined or
dismissed.

• Shelter staff who physically or sexually assault residents should be terminated and reported to law enforcement
authorities for investigation.

• Group homes should have policies that ensure transgender and gender non-conforming residents are respected and
safe from harm.

• Assisted care facilities should have policies of respect for residents’ gender identity/expression and house them
accordingly.

• Foster care systems should ensure that before placing a transgender or gender non-conforming child in a home that
the foster family is accepting and supportive of the child’s gender identity/expression.

• Colleges and universities should develop policies to ensure that transgender and gender non-conforming students are
housed according to their gender identity and that there are gender-neutral options available.

• State and local support programs should be developed that holistically approach and resolve the various challenges and
barriers that transgender and gender non-conforming people need addressed in order to house and support themselves.
This includes assistance in such things as: earning a G.E.D., work training, inding a job, transitional housing, health care,
updating ID documents, legal services, counseling, and/or assistance with applying for beneits.
 HOUSING AND HOMELESSNESS 123

Endnotes
__________________________________________________________________________

1 Some numbers have not been rounded due to their small size.

2 HIV rates are provided to two decimal points for easier comparison with
national rates.

3 Some numbers have not been rounded due to their small size.

4 National Coalition for the Homeless, “How Many People Experience

Homelessness?” (July 2009): http://www.nationalhomeless.org/
factsheets/How_Many.html.

5 Some numbers have not been rounded due to their small size.

6 U.S. Department of Housing and Urban Development, “U.S. Housing

Market Conditions, 2nd Quarter, 2009” (Washington, DC: GPO, 2009):
http://www.huduser.org/portal/periodicals/ushmc/summer09/nat_data.
pdf.

7 U.S. Department of Housing and Urban Development, “U.S. Housing Market

Conditions, 2nd Quarter, 2009” (Washington, DC: GPO, 2009):http://www.
huduser.org/portal/periodicals/ushmc/summer09/nat_data.pdf. HUD did
not deine “minority” in this report.

8 United States Conference of Mayors, “Hunger and Homelessness Survey”

(2006): 48, http://usmayors.org/hungersurvey/2006/report06.pdf.

9 United States Conference of Mayors, “Hunger and Homelessness

Survey” (2008): 19, http://usmayors.org/pressreleases/documents/
hungerhomelessnessreport_121208.pdf.

10 HIV rates are provided out to two decimal points for easier comparison
with national rates.

11 HIV rates are provided out to two decimal points for easier comparison
with national rates.
124 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

PUBLIC ACCOMMODATIONS
We asked respondents to report on experiences they have had in various places of public
accommodation, such as restaurants, hotels and emergency services. Participants were asked if
they had experienced being denied equal treatment or service, verbal harassment or disrespect,
and physical assault or attack “based on being transgender/gender non-conforming” in 15 kinds
of public accommodation. Ninety-three percent (93%) of survey respondents had attempted to
access one or more of these types of public accommodation as a transgender or gender non-
conforming person.

KEY FINDINGS IN PUBLIC ACCOMMODATIONS

• Over half (53%) of respondents reported being verbally harassed or disrespected in a place of public accommodation.

• Forty-four percent (44%) of respondents reported being denied equal treatment or service at least once at one or
more of the 15 types of public accommodation covered in the study.

• Eight percent (8%) of respondents reported being physically attacked or assaulted in places of public
accommodation.

• Respondents of color generally experienced higher rates of abuse in public accommodations than their white peers.
African American respondents endured much higher rates of physical assault than their non-Black peers, at 22%
(relative to the 8% mentioned above).

• Police services were the most highly problematic aspect of government services overall, with respondents reporting
the highest rate of assault when attempting to access police services (6%), along with very high rates of harassment/
disrespect (29%) and denial of equal service (20%). More information about police treatment can be found in the Police
and Incarceration chapter.

• Gender non-conforming respondents experienced higher rates than transgender respondents of refusal of service,
harassment/disrespect and violence when accessing retail stores, hotels, and transportation; transgender respondents
experienced higher rates of unequal treatment, harassment/disrespect and violence in accessing government services
and interacting with judges.

• Those who had lost jobs due to anti-transgender bias experienced among the highest rates of harassment/
disrespect, denial of service and physical assault in nearly every setting.

“I was intentionally discriminated against by a motel owner. He told me he would not

give me a room because I was a cross dresser, and to leave the property or he was going
to call the police and tell them that a hooker was in the parking lot selling drugs.”
 PUBLIC ACCOMMODATIONS 125

Denied Equal Treatment or Service at Any Location of

Denied Equal Treatment in
Public Accommodation by Gender Identity/Expression
Public Accommodations
100
Forty-four percent (44%) of 44% of respondents 90
respondents reported being reported being denied 80
denied equal treatment or
equal treatment at 70
service at least once at one
or more of the types of public a place of public 60
50%
50 44% 44% 46% 46%
accommodation covered in accommodation.
40
this survey. Experiences difer
30
depending on race, income, employment status, gender, transition
20
status, visual non-conformity and whether the respondent had ID
10
documents consistent with his or her gender identity/expression.
0
Those who had lost their jobs due to discrimination and those Overall Sample MTF FTM All Trans GNC
who have worked in the underground economy reported the
highest rate of discrimination in public accommodations, at 67%
and 63%, respectively.
Denied Equal Treatment or Service at Any Location of
American Indian (49%), Latino/a (50%) and multiracial (57%) Public Accommodation by Household Income
respondents reported higher rates of gender identity/expression
discrimination in public accommodation than the full sample.
100
Denied Equal Treatment or Service at Any Location 90
of Public Accommodation by Race 80
70
100 60 53% 53%
90 50 46%
44%
80 40 37% 36%
70 30
60 57%
20
49% 50%
50 44% 10
42% 42%
39%
40 0
30 Overall Under $10K $10K-under $20K-under $50K-under $100K+
Sample $20K $50K $100k
20
10
0
Noticeable diferences in experiences of discrimination in public
Overall American Asian Black Latino/a White Multiracial accommodations appear based on the age a respondent began
Sample Indian
living full-time in a gender other than that assigned at birth,
current transition status, and whether a person has undergone
Respondents with household incomes of $50,000 a year or less any medical or surgical transition procedures. Those who began
reported higher rates of discrimination in public accommodation living full-time at a younger age seem to have experienced more
than those in households with incomes over $50,000 a year. discrimination in public accommodations than those who began
Respondents who were currently unemployed reported living full-time at an older age, possibly because they are able to
discrimination in public accommodations at a rate 6 percentage report about discrimination over a longer period of time.
points higher than the full sample. Transgender men reported
a higher rate of discrimination in public accommodation (50%) “A lot of people tell me I’m lucky because
than transgender women (44%). I ‘pass’ and am considered beautiful as a
transgender woman, but... I sure don’t feel
lucky. I’m always fearful every time I step out
the door into the real world, that someone
will harass or physically harm me.”
126 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Denied Equal Treatment or Service at Any Location of Public

Verbal Harassment in Places
Accommodation by Age Respondents Began Living Full-time
of Public Accommodation
100
90 Fifty-three percent (53%) Over half of
of respondents reported
80 respondents
70 being verbally harassed or
disrespected in a place of public reported being
60 55%
52%
50 44%
51%
46% accommodation. Subgroups that verbally harassed
40
32%
reported higher rates of being or disrespected in
denied equal treatment or service
30 a place of public
20 also reported higher rates of
verbal harassment or disrespect in
accommodation.
10
0 places of public accommodation.
Overall <18 18-24 25-44 45-54 55+
Sample Those groups reporting higher rates of verbal harassment
included those with lower household incomes (ranging from
56% to 63%), those who lost their jobs (72%), or were currently
Those who are currently living full-time in a gender other
unemployed (63%), those who began living full-time at younger
than that assigned at birth reported discrimination in public
ages (ranging from 59% to 68%), those who were currently living
accommodations at a rate 6 percentage points higher than
full-time (59%), those who were visual non-conformers (64%),
respondents as a whole. Those who had any medical or surgical
and those who were generally out (59%). In addition, 67% those
transition treatments or procedures also reported higher rates
who have transitioned and tried to update the gender on their
than all respondents, at 48% and 51%, respectively. Visual non-
driver’s license and were denied were harassed/disrespected.
conformers (53%) and those open about their transgender or
gender non-conforming identity in general (48%) or at work Respondents who have worked in the underground economy
(51%) also reported higher rates of discrimination in public reported the highest rate of verbal harassment/disrespect, at
accommodations. 77%.

Finally, people who have transitioned and tried to update Respondents’ reports of verbal harassment/disrespect difered
the gender marker on their driver’s license, but were denied more sharply by race than was the case with other types
the change, reported discriminatory treatment in public of mistreatment. Those who identify as Black, Latino/a, or
accommodations at a high rate (57%). multiracial (at 56%, 57%, and 65%, respectively) all reported
higher rates of verbal harassment/disrespect than the full sample.

“The fear of being the victim of a hate crime has also meant that I haven’t
lived completely freely; I know that if people on the street knew that I
was born female, I’d be at risk of violence or harassment.”
 PUBLIC ACCOMMODATIONS 127

Verbal Harassment/Disrespect in Places of

Physical Attack or Assault in Places
Public Accommodation by Race
of Public Accommodation
100
90 Eight percent (8%) of respondents reported being physically
80 attacked or assaulted in places of public accommodation.
70 65% Some groups reported much higher rates of physical attack or
60 56% 57%
53% 53% 51% assault than the full sample. African American respondents
50 48%
endured the highest rate of assault (22%) of any demographic
40
group — much higher than any other. Multiracial (13%), Asian
30
(11%), and Latino/a (11%) respondents also reported high rates of
20
physical assault.
10
0
Overall American Asian Black Latino/a White Multiracial Physical Assault in Places of Public Accommodation
Sample Indian
50
45
FTM respondents and gender non-conforming respondents 40
reported higher rates of verbal harassment/disrespect (at 62% 35
and 59%, respectively) than MTF and transgender respondents 30
(52% and 56%, respectively). 25 22%
20
Verbal Harassment/Disrespect in Places of Public 15 13%
11% 11%
Accommodation by Gender Identity/Expression 10 8%
6% 6%
5
100 0
Overall American Asian Black Latino/a White Multiracial
90
Sample Indian
80

70
62%
59%
60 56% Those who have lost their jobs due to bias (17%) or are currently
52%
50 unemployed (12%) reported higher rates of physical attack or
40 assault. Twenty-two percent (22%) of those who had worked in
30 the underground economy reported physical assault.
20 Respondents who are younger (9-10%) also reported higher rates
10 of physical assault than older respondents.1
0
MTF FTM All Trans GNC Non-citizens (documented at 13% and undocumented at 12%)
reported higher rates of physical attack or assault than those
who identiied as U.S. citizens (7%). Although there are some
diferences in reported rates of physical assault based on the
educational attainment and household income of the respondents,
the diference is not as great as some might expect.
128 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Physical Assault in Places of Public Accommodation Physical Assault in Places of Public Accommodation
by Educational Attainment by Age Respondents Began Living Full-time

25 25

20 20
17%

15 15
13%
11%
10%
10 10
8% 8% 8% 8%
7%
6%
5 5 4% 4%

0 0
Overall No HS High School Some College College Graduate Overall <18 18-24 25-44 45-54 55+
Sample Diploma Diploma Degree Degree Sample

Respondents who are visual non-conformers reported higher rates

Physical Assault in Places of Public
of physical attack or assault (10%) than those who are visual
Accommodation by Household Income
conformers (6%).
25

20

15
13%

10%
10
8% 8%

5% 5%
5

0
Overall Under $10K $10K-under $20K-under $50K-under $100K+
Sample $20K $50K $100K

Those who transitioned at younger ages reported higher rates of

physical attack or assault than those who began living full-time at
an older age.
 PUBLIC ACCOMMODATIONS 129

Places of Public Accommodation Physical attack or assault was also reported in all 15 listed
settings. Rates of reported assaults range from 1% to 6%. The
Discrimination, verbal harassment/disrespect, and physical attack highest reported rate of physical attack or assault related to
or assault were reported more often in some types of public police services, with 6% of respondents reporting physical attack/
accommodation or when accessing certain services. This study assault.3 The second-highest rate of reported assaults occurred on
ofered 15 types of public accommodation for which respondents buses, trains or taxis (4%). Three percent (3%) of respondents
could report their experiences. The following table lists those reported physical attack or assault at retail stores. Two percent
types and the corresponding rates of denial of equal treatment, (2%) of respondents reported physical assault at doctor’s
verbal harassment/disrespect, and physical attack or assault that oices or hospitals, and the same rate was reported at hotels or
respondents reported in those areas. restaurants.

Respondents reported denial of equal treatment or service at Retail stores, hotels, transportation services, government and
all 15 listed types of accommodation, ranging from 3% to 32%. legal services, including police, and social services are all areas
The highest rate of such mistreatment occurred at retail stores where respondents reported experiencing unequal treatment,
(32%), followed by doctor’s oices or hospitals (24%) and verbal harassment/disrespect and physical assault. In the
when interacting with a government agency or oicial (22%). following sections, we will look at those groups that experienced
Police oicers were reported to have denied equal service or disproportionally high rates of mistreatment in these settings.
treatment to 20% of respondents. Other accommodations where More detailed reporting of respondents’ experiences with medical
respondents reported relatively high rates of discrimination services and law enforcement is provided in the chapters on
included emergency rooms (13%), by a judge or oicial of the Health and Police and Incarceration.
court (12%), on an airplane or airport (11%), and at a mental
health clinic (11%).

Respondents also reported verbal harassment or disrespect at

all listed types of accommodations, at rates ranging from 4% to
37%. Retail stores were the location where respondents reported
the highest rate of verbal harassment or disrespect (37%).
The second highest rate was related to police services; 29%
of respondents reported that police oicers verbally harassed
or disrespected them.2 Other settings that proved to be highly
problematic for respondents in terms of verbal harassment or
disrespect include hotels and restaurants (25%), doctor’s oices
or hospitals (25%), buses, trains or taxis (22%), by a government
agency or oicial (22%), airplanes or airports (17%), emergency
rooms (16%), by a judge or court oicial (12%) and mental
health clinics (12%).
130 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Experiences of Discrimination and Violence in Public Accommodations by Location

44%
53%
Any location 8%
65%

32%
37%
Retail Store 3%
46%

20%
29%
Police Of cer 6%
35%

24%
25%
Doctor's Of ce or Hospital 2%
35%

19%
25%
Hotel or Restaurant 2%
33%

22%
22%
Government Agency/Of cial 1%
32%

9%
22%
Bus, Train, or Taxi 4%
26%

13%
16%
Emergency Room 1%
22%

11%
17%
Airplane or Airport Staff/TSA 1%
21%

12%
12%
Judge or Court Of cial 1%
19%

11%
12%
Mental Health Clinic 1%
18%

8%
6%
Legal Services Clinic 1%
12%

5%
7%
Ambulance or EMT 1%
10%

6%
4%
Domestic Violence Shelter/Program 1%
9%

5%
4%
Rape Crisis Center 1%
7%

3%
4%
Drug Treatment Program 1%
6%

0 10 20 30 40 50 60 70

Denied Equal Treatment or Service Harassed or Disrespected Physically Assaulted Any Problem
 PUBLIC ACCOMMODATIONS 131

RETAIL STORES Mistreatment in Retail Stores by Employment Status

Retails stores were the setting for which respondents reported 100
the highest rates of unequal treatment and verbal harassment/ 90
disrespect. Those groups most afected by discrimination, verbal 80
harassment/disrespect and physical assault in retail stores were 70
largely those who experienced the highest overall rates of these 60 56%
51%
50 44%
problems in all public accommodations. These include those of
40 37% 36% 37%
34%
younger current age, people of color, non-citizens, people living 32%
29% 31%
30
on lower household incomes, those who are unemployed or have
20
lost jobs, those who have worked in the underground economy 10 5%
8%
2% 3% 2%
and those who identify as FTM or gender non-conforming. 0
In Workforce Unemployed Out of Lost a Job Due Did not Lose a
Asian, Latino/a, and multiracial respondents reported higher rates Workforce to Bias Job Due to Bias

of unequal treatment and verbal harassment/disrespect (38-44% Denied Equal Treatment Harassed/Disrespected Physically Assaulted
unequal treatment and 39-46% verbal harassment/disrespect).
Black, Latino/a, and multiracial respondents reported higher rates
of physical assault than the full sample and those of other races Those who identify as FTM reported higher rates of unequal
(4-6% physical assault).4 treatment in retail stores (34%) and verbal harassment/disrespect
(40%) than those who identify as MTF transgender (29% and
36%). Respondents who identiied as gender non-conforming
Mistreatment in Retail Stores by Race
also reported higher rates of unequal treatment (46%) and verbal
100 harassment/disrespect (49%) than transgender respondents (31%
90 and 37%).
80
70 Mistreatment at Retail Stores by Gender Identity/Expression
60
50 44% 46% 100
38% 39% 40% 41%
40 36%
33% 31% 90
28% 30% 30%
30
80
20
70
10 4% 6% 5%
3% 3% 2% 60
0 49%
American Asian Black Latino/a White Multiracial 50 46%
Indian 40%
40 36% 37%
34%
Denied Equal Treatment Harassed/Disrespected Physically Assaulted 29% 31%
30
20
10 3% 3%
People living on lower household incomes (less than $50,000 2% 2%
0
per year) reported higher rates of all reported problems in MTF FTM All Trans GNC
retail stores than those with higher household incomes.5 Those Denied Equal Treatment Harassed/Disrespected Physically Assaulted

respondents with the highest educational attainment (graduate

degree) reported higher rates of unequal treatment (35%) and
verbal harassment/disrespect (40%) than those with lower
educational attainment.6 However, those with lower educational
attainment (high school diploma or less) reported higher rates
of physical assault, at 4%.7 The higher rates of reported unequal
treatment and harassment/disrespect by those with high
household income and educational attainment may be accurate
or may be due to a diferent sense of what is equal treatment/
harassment/disrespect, whereas the question of physical violence
is less subjective.

Those who worked in the underground economy reported among

the highest rates of unequal treatment in retail stores (51%),
verbal harassment/disrespect (56%), and had the highest rate of
physical assault of all groups in the survey (10%).
132 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Those who began living full-time in a gender other than that Mistreatment at Hotels or Restaurants by Gender Identity/Expression
assigned at birth at younger ages (age 24 or younger) reported
50
higher rates of unequal treatment in retail stores (37% for under
45
18, 36% for 18-24), verbal harassment/disrespect (38% for under
40
18, 44% for 18-24), and physical assault (6% for under 18, 4% for 34%
35 31%
18-24).8 Visual non-conformers reported among the highest rates 30
29%
25%
of unequal treatment (50%), verbal harassment/disrespect (54%) 25 23%
21%
and physical assault (5%). 20 17% 18%
15
In addition, of those whose driver’s licenses did not relect the 10
gender they have transitioned to, 41% reported denial of equal 5 3% 2% 2% 2%
treatment or service and 48% reported harassment/disrespect in 0
MTF FTM All Trans GNC
retail stores.
Denied Equal Treatment Harassed/Disrespected Physically Assaulted

HOTELS OR RESTAURANTS

Respondents reported relatively high rates of unequal treatment

(19%) and verbal harassment/disrespect (25%) at hotels or Mistreatment at Hotel or Restaurant by Race
restaurants. The demographic patterns detailed in the Retail
Stores section above also apply to hotels or restaurants. Those 50
reporting the highest rates of unequal treatment at hotels or 45
40
restaurants included those who: are visual non-conformers
35 32% 32%
(32%), identify as gender non-conforming (31%), are Latino/a or 30%
30 28% 28%
multiracial (28%) or earn under $10,000 annually (26%). 24% 24% 24% 24%
25 22%
20 18% 17%
The highest rates of verbal harassment/disrespected in hotels 15
or restaurants were reported by those who are visual non- 10
5% 6%
3% 3% 4%
conformers (38%), identify as gender non-conforming (34%), or 5 2%
are American Indian, Latino/a, or multiracial (30-32%). 0
American Asian Black Latino/a White Multiracial
Indian
Two percent (2%) of respondents reported being physically
Denied Equal Treatment Harassed/Disrespected Physically Assaulted
attacked or assaulted at a hotel or restaurant. Those reporting the
highest rates of physical assault included those who are African
American (6%) or Asian (5%).

TRANSPORTATION
Mistreatment at Hotels or Restaurants by Household Income
The survey asked respondents to report experiences in two areas
50 of transportation: ground transportation (buses, trains or taxis)
45 and air travel (airplanes, airports, during TSA screening). When
40
using buses, trains or taxis, respondents reported experiencing
35 32%
30
29% unequal treatment (9%), verbal harassment or disrespect (22%),
26% 25%
25 21% 21% 21% 21% and physical attack or assault (4%). During air travel, whether
20
15% 15%
on a plane or at the airport, respondents reported experiencing
15
unequal treatment (11%), verbal harassment or disrespect (17%)
10
4% 4% and physical attack or assault (1%).
5 2% 1% 2%
0
Under $10K $10K-under $20K-under $50K-under $100K+
Experiences based on demographic patterns, again, largely relect
$20K $50K $100K the patterns described in the section on retail stores above.
Denied Equal Treatment Harassed/Disrespected Physically Assaulted

“Travel is a nightmare. Searches, IDs, pat-downs,

the new low-power X-ray, power-drunk guards,
etc….and if your ID doesn’t match, you are
immediately guilty until proven innocent.”
 PUBLIC ACCOMMODATIONS 133

GOVERNMENT AND LEGAL SERVICES Mistreatment by Government Agency by Race

The survey asked respondents to report their experiences when 50

interacting with government agencies or oicials, judges or courts, 45
and legal services clinics. Rates of mistreatment at government 40
35%
35 33%
agencies or by government oicials were among the highest rates 30% 29% 30%
30
for unequal treatment (22%) or verbal harassment/disrespect 25%
25
(22%). When dealing with judges and courts, respondents reported 20% 20%
20 17% 18%
15%
lower overall rates of mistreatment, including unequal treatment 15
10%
(12%) and verbal harassment/disrespect (12%). When utilizing 10
5 3% 3% 3%
legal services clinics, respondents reported unequal treatment 0% 0% 1%
0
(8%) and verbal harassment/respect (6%). One percent (1%) of American Asian Black Latino/a White Multiracial
Indian
respondents reported being physically attacked or assaulted at a
Denied Equal Treatment Harassed/Disrespected Physically Assaulted
government agency or by a government oicial, by a judge or court
oicial, or when utilizing a legal services clinic.

In the areas previously discussed, retail stores, hotels or

restaurants, and transportation, gender non-conforming In dealing with judges, courts and legal services clinics
respondents have consistently reported higher rates of speciically, transgender respondents reported higher rates of
mistreatment than transgender respondents and all respondents. mistreatment than gender non-conforming respondents. Yet, an
The reverse is true in the area of government agencies and oicials. additional exception to the overall demographic trends appears
In these responses, transgender respondents consistently reported in the area of judges, courts, and legal services clinics. In all prior
higher rates of unequal treatment (24%) and verbal harassment/ areas discussed thus far, respondents who identify as FTM have
disrespect (24%) than gender non-conforming respondents. consistently reported higher rates of mistreatment than MTF
Gender non-conforming respondents reported rates lower than respondents. In the area of judges, courts, and legal services
all respondents (17% for unequal treatment and 19% for verbal clinics, however, the reverse is true; MTF respondents reported
harassment/respect). consistently higher rates of mistreatment than FTM respondents.

Mistreatment by Judges/Courts by Gender Identity/Expression

Mistreatment by Government Agency/Oficial
by Gender Identity/Expression
50
45
50
40
45
35
40
30
35
25
30 27%
24% 25% 24% 24% 20
25 21% 14%13%
15 13%13%
20
19% 11%12% 10%10%
17%
10
15
5 2% 1%
10 0% 0%
0
5 2% 1% 1% 1% MTF FTM All Trans GNC
0 Denied Equal Treatment Harassed/Disrespected Physically Assaulted
MTF FTM All Trans GNC
Denied Equal Treatment Harassed/Disrespected Physically Assaulted

Latino/a and multi-racial respondents reported the most denial of

equal treatment/service by government agencies or oicials. Black
and Asian respondents reported the lowest rates of denial of equal
service and verbal harassment/disrespect. Physical assault was
most was most often reported by Black, Latino/a and multiracial
respondents.
134 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

SOCIAL SERVICES

The survey asked respondents to report on their experiences with

a variety of social services: rape crisis centers, domestic violence
shelters or programs, mental health clinics and drug treatment
programs. Respondents reported mistreatment with all of these
services, including unequal treatment, verbal harassment/
disrespect and physical assault. For purposes of demographic
breakdowns and analysis, the lower number of those who
utilized these services creates the problem of sample sizes too
small within various demographic groups to conduct a complete
analysis.

Respondents reported unequal treatment (5%), verbal

harassment/disrespect (4%), and physical assault (1%) when
utilizing rape crisis centers. When being housed in or utilizing
domestic violence shelters or programs, respondents reported
unequal treatment (6%), verbal harassment/disrespect (4%), and
physical assault (1%).9 In drug treatment programs, respondents
reported unequal treatment (3%), verbal harassment/disrespect
(4%), and physical assault (1%).

Higher rates of unequal treatment and verbal harassment/

disrespect were reported with mental health clinics. Eleven
percent (11%) of respondents reported unequal treatment and
12% reported verbal harassment/disrespect. One percent (1%)
reported physical attack or assault.

“It is a lonely place illed with seemingly endless scorn, ridicule and
humiliation and the constant threat of violence.”
 PUBLIC ACCOMMODATIONS 135

CONCLUSIONS FOR PUBLIC ACCOMMODATIONS

Transgender and gender non-conforming people experience grave abuses when accessing Respondents of color
everyday goods and essential services, from retail stores and buses to police and generally experienced
court systems. From disrespect and refusal of service to harassment and violence, this higher rates of
mistreatment in so many settings contributes to severe social marginalization and safety risk.
abuse in public
Study participants’ experiences demonstrate the overwhelming need for legal and policy
protections to ensure access to essential services and prospects for living fully and moving
accommodations
freely in public and social settings. Throughout this chapter, we discussed physical assault in than their white peers.
numerous places of public accommodation. In the Health chapter we examine the impact of
surviving assault on other social, economic and health outcomes.

The data on public accommodation show that gender non-conforming respondents and transgender men generally reported
higher rates of unequal service and verbal harassment/disrespect than transgender women (though not true in regard to
interactions with judges/court oficials and legal services). More research is needed into why there is a different reported
experience based on gender: we speculate that the difference may be that transgender women were under-reporting
discrimination and verbal harassment/disrespect that occurred.

“I was at irst verbally assaulted and then physically assaulted in broad daylight on a
crowded street. As a result of the assault I didn’t leave my house for several weeks unless it
was absolutely necessary (due to mental anguish). I didn’t report the incident but I have since
helped start a self-defense class for trans-men and masculine-identiied genderqueers.”

“Being androgynous has given me such a diferent perspective on how rigid people’s ideas
of gender are. When I was younger I was picked on for being a tomboy, and now I get
picked on for the fact that, at irst glance, they can’t tell if I’m a boy or girl.”
136 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

RECOMMENDATIONS FOR PUBLIC ACCOMMODATIONS

• Enact strong federal, state and local laws prohibiting discrimination on the basis of gender identity/expression in places of
public accommodation.

• Government enforcement agencies should develop compliance regulations and guidelines, provide trainings for
entities covered by the laws, and should effectively and thoroughly investigate complaints of discrimination, and when
discrimination is found, use strong penalties to deter other entities from violating the law.

• Places of public accommodation should develop their own non-discrimination policies related to gender identity/
expression and train staff on how to follow these policies. Service organizations should develop cultural competency.
Institutions include:

• Retail stores

• Hotels

• Restaurants

• Transportation agencies, including mass transit and taxi systems

• Airline and airport staff, including Transportation Security Oficers

• Rape crisis centers and domestic violence shelters

• Government agencies

• Judges and court systems

• Legal services agencies

• Police departments (see the Police and Incarceration chapter for more speciic recommendations)

• Doctor’s ofices, hospitals, and other health related services (see the Health chapter for more speciic
recommendations).
 PUBLIC ACCOMMODATIONS 137

Endnotes 6 Respondents who did not have a high school diploma reported being
__________________________________________________________________________
denied treatment at retail stores at 31%, those who had only a high school
diploma at 29%, those who had some college at 31%, those who had a
college degree 34%, and those who had a graduate degree at 35%.
1 Respondents aged 18-24 reported physical assault in any place of public
accommodation at 9%, those aged 25-44 at 10%, those aged 45-54 at 4%, 7 Respondents who did not have a high school diploma reported verbal
those aged 55-64 at 3%, and those 65 and older at 6%. harassment at retail stores at 37%, those who had only a high school
diploma at 36%, those who had some college at 36%, those who had
2 We asked questions about mistreatment by police both in our public
a college degree 37%, and those who had a graduate degree at 40%.
accommodations question, Question 30, as well as in a police-speciic
Respondents who did not have a high school diploma reported being
question, Question 32, and we did so in slightly diferent ways.
assaulted at retail stores at 4%, those who had only a high school diploma
Respondents answered the questions consistently. When asked about
at 4%, those who had some college at 3%, those who had a college degree
harassment and/or disrespect in Question 30, 29% selected yes. When
2%, and those who had a graduate degree at 2%.
asked about disrespect in Question 32, 30% selected yes (and 22%
selected harassment). The minor numeric diference between 29% and 8 The only exception is people who began living full-time in a gender other
30% are not meaningful and likely relect the slightly diferent wording than assigned at birth between the ages of 25 and 44, who reported verbal
of the question. For more information, see the Police and Incarceration harassment at a rate of 38%, the same as the youngest age group.
chapter.
9 See the Housing chapter for more detailed reporting and analysis.
3 We asked about assault by police in two diferent ways. In Question 30,
which asked about public accommodations, “physical attack or assault”
was an option that 6% of respondents chose. In Question 32, “oicers
physically assaulted me” and “oicers sexually assaulted me” were
options in a list with a “mark all that apply” instruction. Six percent
(6%) of respondents chose physical assault and 2% of respondents chose
sexual assault; these respondents generally overlapped. Thus, the data
correspond as one would expect. For more information, see the Police and
Incarceration chapter.

4 The breakdown of mistreatment in retail stores by race is as follows.

Unequal treatment was reported by American Indians at 33%, Asians at
38%, Black respondents at 28%, Latino/as at 40%, white respondents at
30%, and multiracial respondents at 44%. Verbal harassment was reported
by American Indians at 31%, Asians at 39%, Black respondents at 30%,
Latino/as at 41%, white respondents at 36%, and multiracial respondents
at 46%. Physical assault was reported by American Indians at 3%, Asians
at 3%, Black respondents at 6%, Latino/as at 4%, white respondents at
3%, and multiracial respondents at 5%.

5 For physical assault, those making between $20,000 and $50,000 annually
broke from the trend of higher reported incidence and reported a lower
rate than the overall sample, at 2%. Those whose household incomes were
less than $10,000/year reported being denied equal treatment at a retail
store at 38%, those whose household incomes were between $10,000/year
and $20,000/year at 38%, those whose household incomes were between
$20,000/year and $50,000/year at 34%, those whose household incomes
were between $50,000/year and $100,000/year at 27%, and those whose
household incomes were $100,000/year or more at 27%. Those whose
household incomes were less than $10,000/year reported being verbally
assaulted in a retail store at 43%, those whose household incomes were
between $10,000/year and $20,000/year at 43%, those whose household
incomes were between $20,000/year and $50,000/year at 39%, those
whose household incomes were between $50,000/year and $100,000/
year at 34%, and those whose household incomes were $100,000/year or
more at 29%. Those whose household incomes were less than $10,000/
year reported being physically assaulted at a retail store at 5%, those
whose household incomes were between $10,000/year and $20,000/
year at 4%, those whose household incomes were between $20,000/year
and $50,000/year at 2%, those whose household incomes were between
$50,000/year and $100,000/year at 2%, and those whose household
incomes were $100,000/year or more at 1%.
138 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

IDENTITY DOCUMENTS
Possessing accurate and consistent identiication documents is essential to basic social and
economic functioning in our country. Access to employment, housing, health care and travel all
can hinge on having appropriate documentation. Yet, for many of the respondents, obtaining
identity documents that match their gender is a major hurdle.
We provided survey respondents with a list of nine commonly used identity documents and asked
them to tell us whether they had a) succeeded in changing the gender on each document, b)
tried and failed, c) did not try at all, or d) if the question didn’t apply (i.e. If they didn’t have that
particular form of ID or they didn’t want that document updated).
Throughout this chapter, except as noted otherwise, we are reporting only on those who have
transitioned gender from male to female or from female to male—since these are primarily the
people who need updated identity documents in order to function in society.
Some of the laws and policies relating to changing gender on identiication documents require
that evidence of surgical sex reassignment must be produced. Because laws and written policies
often emphasize transgender people’s surgical status, we examined how having or not having the
most common gender-related surgical procedures afected people’s ability to get accurate and
updated identity documents.
The costs of transition-related surgeries, which are rarely covered by health insurance, are
beyond the reach of most transgender people, particularly because the community experiences
such high rates of employment discrimination and poverty. In addition, some people who want
such surgery cannot have it for medical reasons. Furthermore, some do not want surgery because
they do not feel it is necessary for them personally.
Study participants conirmed anecdotal evidence that gender incongruent identiication exposes
people to a range of hostile outcomes, from denial of beneits and employment to violence. Legal
and bureaucratic barriers to amending transgender people’s identity documents marginalize and
stigmatize transgender people.
It is unjust to require people to obtain inancially-unobtainable or undesired medical care in
order to change identiication. The extent of this injustice and related abuses is detailed in this
chapter.
 IDENTITY DOCUMENTS 139

KEY FINDINGS IN IDENTITY DOCUMENTS

• Of people who had already transitioned from male to female or female to male:

• Only one-ifth (21%) have been able to update all of their IDs and records with their new gender and one-third
(33%) had updated none of their IDs/records.

• Fifty-nine percent (59%) reported updating the gender on their driver’s license/state ID.

• About half (49%) reported updating the gender in their Social Security record.

• About one quarter (26%) reported updating the gender on their passport.

• About one quarter (24%) reported updating the gender on their birth certiicate.

• More than half (59%) of those who have work ID reported updating it.

• Less than half (46%) of current students have updated their student records, although 81% of those who have
tried to do so have been successful.

• Whether or not an individual has had some type of transition-related surgery dramatically affects his or her
likelihood of having changed each of the ID documents and records we studied. For example, 81% of those who
have had some type of surgery have updated their driver’s license compared to 37% of those who have not had any
surgery.

• People of color, and those with lower household incomes and educational attainment, were generally less likely to
have updated their IDs/records across the board, even when controlling for surgical status, with few exceptions.

• Forty percent (40%) of those who presented ID (when it was required in the ordinary course of life) that did not match
their gender identity/expression reported being harassed and 3% reported being attacked or assaulted. Fifteen
percent (15%) reported being asked to leave the setting in which they had presented incongruent identiication.

• Rates of reported hiring discrimination, and discrimination in housing, including campus housing, are much higher
for those who do not have an updated driver’s license.
140 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Ability to Change Gender on Unfortunately, it appears that the ability to update driver’s
licenses is afected by the type of surgery undergone. Sixty-three
Identiication and in Records percent (63%) of transgender women who have only had breast
augmentation were able to update their license, with 18% denied
DRIVER’S LICENSES / STATE IDENTIFICATION CARDS and 19% not trying; of those that tried, 78% were successful.
Ninety-four percent (94%) of transgender women who had an
For driver’s licenses, 59% of those who had transitioned were
orchiectomy4 or vaginoplasty were able to update their driver’s
able to change the gender marker on their driver’s license. Eleven
license; of those who tried, 96% were successful.
percent (11%) were denied an updated license, 30% did not try or
indicated not applicable (meaning that they do not have this form
Driver’s License Updates for Transgender Women by Surgical Status5
of identiication or they did not desire to change it).

Transgender women were more likely to have an updated driver’s All MTF Respondents MTFs with No Surgery
license (65%) than transgender men (57%).1 Who Transitioned
White respondents (62%) were most likely to have updated
their driver’s license, and American Indian (37%) and Black
respondents (42%) were least likely.
22%
Driver’s License Updates by Race
Not Tried 37% 43%
Not Tried Allowed
80 13%
Denied
70 65%
62% 20%
59% 57% Allowed
60 56% Denied
50%
50
42% 42%
40 35%
35% 31%
27% 37%
30 25% MTFs with Any Surgery MTFs with Breast Augmentation
22%
20 16%
11% 13% 11% 10%
9% 11%
10 5%
3% 10% 10% 2% 8%
6% 3%
0 7% Not Tried 19%
All Who American Asian Black Latino/a White Multiracial Not Tried
Denied
transitioned Indian

Yes, changes allowed No, changes denied Not tried Not applicable
18%
Denied 63%
Even though many states have abandoned outdated surgery 85% Allowed
requirements for a change of driver’s license gender marker, the Allowed
data shows that surgery has made a diference for respondents’
ability to update their license,2 with 81% of those who have
had some type of surgery able to update their driver’s license
MTFs with Orchiectomy/
compared to 37% of those who have had no surgery. 3 Seven
Vaginoplasty
percent (7%) of those who had had some type of transition-
related surgery were denied an updated license, and 12% did not
seek to update their ID.
3% 3%
Denied Not Tried
Eighty-ive percent (85%) of transgender women who have had
some type of transition-related surgery were able to update their
licenses, with 7% denied, while 8% did not try; of those who had
some type of surgery and tried to change their license, 92% were
successful. Only 43% of those who did not have surgery were able 94%
Allowed
to update their driver’s license.
 IDENTITY DOCUMENTS 141

Similarly, 76% of transgender men who had some type of surgery Driver’s License Updates for Transgender Men by Surgical Status8
were allowed to update their driver’s license with 6% denied, and
All FTM Respondents FTMs with No Surgery
18% not trying; of those who tried, 92% were successful. 6
Who Transitioned
Which surgeries were performed also afected transgender men’s
ability to update their licenses. Seventy-six percent (76%) of
those who have had chest surgery were able to update their
26%
licenses, with 7% denied and 17% having not tried; of those who
Allowed
tried, 92% were successful. Ninety-four percent (94%) of those 35%
with a metoidioplasty7 or surgery to create testes have been able Not Tried 64%
Not Tried 11%
to update their licenses; of those who tried, 97% were successful. 57%
Allowed Denied
Ninety percent (90%) of those who have had phalloplasty were 8%
able to update their driver’s licenses; of those who tried, 93% Denied
were successful. Because of the small numbers of those who
have had metoidioplasty and/or phalloplasty in the sample, the
diference in rates between these two (97% and 93%) was likely
FTMs with Any Surgery FTMs with Chest Surgery
not meaningful.

18% 17%
Not Tried Not Tried
6% 7%
Denied Denied

76% 76%
Allowed Allowed

FTMs with Metiodioplasty/

Creation of Testes FTMs with Phalloplasty

3%
3% 3% 7% Not Tried
Denied Not Tried Denied

90%
94% Allowed
Allowed
142 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Of the variables we asked about in the survey, surgical status Ability to Change Driver’s License by Race,
seems most strongly associated with the ability to update driver’s Among Those with No Surgery
licenses. We also found that visual conformity was associated. Of
75
those who have not had surgery but have tried to update their
65
license, 76% of visual conformers were successful in obtaining
52% 53%
the change, while only 60% of visual non-conformers succeeded. 55 48%
44% 45% 43%
Common wisdom among transgender people is that the more a 45
person looks like the gender he or she identiies in, the easier it 35
27%
is to change a driver’s license; survey responses seem to bear this 31%
35%
32%
35% 37%
25
out. 17%
15% 15% 14%
15 12%
8%
We also wanted to see if we looked only at those who have 6% 6% 4%
5 8% 9% 4%
not had any transition-related surgery, what the efect of race,
household income and educational attainment was on the All Who American Asian Black Latino/a White Multiracial
likelihood of having updated one’s driver license. Among people transitioned Indian

who have not had any surgery, Latino/as (45%) were the most Yes, changes allowed No, changes denied Not tried Not applicable

likely to have updated their licenses, with multiracial respondents

(37%) next most successful. Asian and American Indian
Ability to Change Driver’s License by Household
respondents were the least likely.
Income, Among Those with No Surgery
Those with higher household incomes were generally more likely
50
to have updated their licenses, and, of those who tried, generally
45 43% 42%
47% 41%
more likely to have been successful. We also found that those 46%
40
with higher educational attainment were more likely to have 40% 39%
35
37%
successfully updated their ID, and, of all of those who tried, they 30
28% 35%

were the most likely to have obtained the changes they sought. 25
20%
20 16% 15%
13% 14%
15
10
4% 3%
5
6% 5% 5%
0
Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K
Yes, changes allowed No, changes denied Not tried Not applicable

Ability to Change Driver’s License by Educational

Attainment, Among Those with No Surgery

70

60
51%
50 46% 47%
41% 43%
40

30 25% 35% 36%

33% 33%
20 15% 18%
13% 14%
18%
10 4%
11% 3% 6%
7%
0
No HS Diploma High School Some College College Degree Graduate
Diploma Degree

Yes, changes allowed No, changes denied Not tried Not applicable
 IDENTITY DOCUMENTS 143

BIRTH CERTIFICATES Unfortunately, the type of surgery an applicant has undergone

appears to matter to state agencies charged with amending
With some exceptions, birth certiicate laws and policies (which
birth certiicates. Of MTF respondents who have had some type
are established at the state level) generally require that surgery
of surgery, 43% had changed their birth certiicates. Of MTFs
must take place before an updated document is issued. These laws
who have only had breast augmentation surgery, only 15% had
and policies have been slow to catch up to the current medical
changed their birth certiicates; of those with breast surgery who
understanding that medical treatments should not be required to
tried, 32% were able to. Of transgender women who have had an
update gender on identity documents.9 Some states also require
orchiectomy or vaginoplasty, 55% have been able to change their
a court order for a change of birth certiicate, presenting added
birth certiicate; of those who tried, 74% were able to do so.
inancial and logistical barriers.

Overall, 24% were able to change the gender marker on their Ability to Update Birth Certiicate for Transgender Women
birth certiicates. by Surgical Status

However, 18% of respondents were denied and 53% had not

even attempted to change their birth certiicate, with another 5% All MTF Respondents MTFs with No Surgery
choosing “not applicable,” meaning that they either did not have a Who Transitioned
birth certiicate11 or they did not desire to change it. Many of those
who did not attempt to change their birth certiicates may have 7%
Allowed
chosen not to do so because they knew they would not meet the
requirements of the written policies; for example, because they 26% 21%
had not had any surgery. Alternatively, they may not have had the Allowed Denied
resources to pay an attorney for assistance in obtaining a court order. 53% 72%
Not Tried Not Tried
Gender identity was not a factor, with 26% of MTF respondents 21%
and 24% of FTM respondents able to change gender markers.10 Denied

Looking at race, White (25%) and Latino/a (23%) respondents were

the most likely to have changed their gender markers and American
Indians were the least likely, with only 7% having done so.
MTFs with Any Surgery MTFs with Breast Augmentation

Ability to Update Birth Certiicate by Race

70 67% 15%
Allowed
60 56% 56%
53% 53% 35%
50
49% 48% Not Tried 43%
Allowed 52%
Not Tried 32%
40 Denied
30 25% 22%
24% 23%
22% 21% Denied
18%
20 14%
16% 20% 17%
18% 12% 18% 17%
10 4%
10% 9% 12%
5% 7% 5% MTFs with Orchiectomy/
0
All Who American Asian Black Latino/a White Multiracial Vaginoplasty
transitioned Indian

Yes, changes allowed No, changes denied Not tried Not applicable

Many state laws and policies require surgery for changing a birth- 25%
certiicate gender marker; not surprisingly, having had surgery Not Tried
dramatically changes the likelihood of updating a birth certiicate.
Those who have had some type of surgery were able to change their 19% 55%
Denied Allowed
gender marker over six times as frequently (39%) than those without
(6%).12 Twenty percent (20%) have been denied the change even
with some type of surgery. Thirty-eight percent (38%) with some
type of surgery have not tried to change their birth certiicate.13
144 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

For FTM respondents who have had some type of transition- Ability to Update Birth Certiicate for Transgender Men
related surgery, 37% have updated their gender markers on their by Surgical Status
birth certiicates. Twenty-nine percent (29%) of FTMs with chest
surgery only were able to change their birth certiicate, while 23%
All FTM Respondents FTMs with No Surgery
were denied an updated document, and about half had not tried
Who Transitioned
(48%); of those with chest surgery who tried to change their
birth certiicate, 56% were able to do so. Seventy percent (70%)
4%
of those with a metoidioplasty or surgery to create testes were Allowed
able to change their birth certiicates (15% were denied) and 15% 9%
Denied
did not try; of those who tried, 82% with this surgery or surgeries 24%
Allowed
were allowed the change. Of those with a phalloplasty, 72% have
been granted changes (21% were denied) and 7% have not tried;
60%
Not Tried 86%
of those who tried, 78% were successful. Because of the low 15% Not Tried
Denied
numbers of FTMs with phalloplasty, the diferent rates of ability to
change their birth certiicates between metoidioplasty (82%) and
phalloplasty (78%) is probably not meaningful.

“I cannot get my birth certiicate changed in FTMs with Any Surgery FTMs with Chest Surgery

Illinois unless I have a penis! This is wrong!

I look like, act like and am seen as a man by
everyone around me until I have to show my
Driver’s License, which still says Female. The 29%
44% 37% Allowed
Not Tried
picture on my license is me with a beard!” Allowed 48%
Not Tried
23%
19% Denied
Denied

FTMs with Metiodioplasty/

Creation of Testes FTMs with Phalloplasty

7%
15% Not Tried
Not Tried
21%
15% Denied
Denied

70%
Allowed
72%
Allowed
 IDENTITY DOCUMENTS 145

Of all of those who have transitioned, those who are visual Higher-income respondents who have had some type of surgery
conformers are more likely to have a change to their birth were able to change their birth certiicates more often than
certiicate approved, regardless of their level of surgical transition. those with lower household incomes; and, among those who
Of those who have had some type of surgery as part of transition tried to update such documents, higher-income respondents had
and who have tried to update their birth certiicate, those who are much higher rates of being allowed to do so. It is possible that
visual conformers are more likely to be granted a change on their those with higher household incomes were able to aford legal
birth certiicate (70%) than visual non-conformers (57%).14 representation for the gender change process, as many states
require a court order to change a birth certiicate; however, we did
We also wanted to see how race, household income and
not ask if people used the services of an attorney.
educational attainment afected rates of updating birth
certiicates. Since most birth certiicate policies generally require Similarly, those in the higher educational attainment categories
some type of transition-related surgery, we looked at respondents were more likely to have changed their birth certiicate and
who only had some type of surgery. more likely to report success if they tried. Because the process
for changing birth certiicates in most states is complex, those
Among those who have had some type of surgery, white
with formal education may have fared better in navigating the
respondents were the most likely to have updated their birth
government bureaucracy.
certiicates (41%), with black respondents next most likely (37%).

Ability to Update Birth Certiicate by Race, Among Those with Any Surgery
50 45%
41% 41%
39% 39%
40 37% 37%
34%
29% 29%
30
20% 20% 21%
19% 18%
20
10%
10 6% 7%
5%
3%
* * * *
0
American Indian Asian Black Latino/a White Multiracial
Yes, changes allowed No, changes denied Not tried Not applicable

* Sample size too low to report

Ability to Update Birth Certiicate by Household Income, Among Those with Any Surgery
50 48%
44%
38% 38% 39% 39%
40 37%
35%
33%
30 27% 27%
23%
21%
20 16% 16%

10 8%
4% 3% 3%
1%
0
Under $10K $10K-under $20K $20K-under $50K $50K-under $100K $100K+
Yes, changes allowed No, changes denied Not tried Not applicable

Ability to Update Birth Certiicate by Educational Attainment, Among Those with Any Surgery
50
41% 42%
40% 39% 39%
40 38% 37%
36% 36%

30
24%
21% 22%
20% 19%
20 18%
14%
10
3% 4% 3%
2%
0
No HS Diploma High School Diploma Some College College Degree Graduate Degree
Yes, changes allowed No, changes denied Not tried Not applicable
146 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

SOCIAL SECURITY Given the written policy requiring completed surgery, it is not
surprising that the ability to change the Social Security record
The Social Security Administration keeps a record of gender,
was strongly connected to whether an individual had had surgery.
although Social Security cards are issued without gender markers.
It is the Social Security Administration’s current policy to change For transgender women, 75% who have had some surgery
the gender in a transgender person’s records only upon proof updated their Social Security records, compared to 30% of those
of “completed” sex reassignment surgery (although the policy who have not had any surgery; 15 of those have had surgery and
does not specify what types of surgery must be done). Before this tried to update their records, 89% succeeded. Interestingly, more
current policy was adopted, it is our understanding that surgery than half (56%) of those who tried to update their record but
was not always required and there are reports that even after the had not had any surgery were also successful. About half (48%)
written policy went into efect, some people have been to update of those who have only had breast augmentation updated their
their records without showing proof of surgery. record, with 23% denied, and 29% who have not tried; of those
who tried, 67% were successful. Of those who had orchiectomy
Only about half (49%) of those who transitioned have updated
or vaginoplasty, 88% have changed their record, with 4% denied
their Social Security gender record. Twelve percent (12%)
and 8% not tried; of those who tried, 95% were successful.
were denied the change, 37% have not tried, and 3% chose not
applicable (meaning they do not have a Social Security account or
they did not want to update it). Transgender women were more
likely to have updated their accounts, with 51% having done so,
compared to 44% of transgender men.

Ability to Change Gender in Social Security Record by Gender Identity

70
60
49% 51%
50 44% 46%
40 37%
30%
30
20 15%
12%
10 6%
3% 3% 4%
0
Yes, changes No, changes denied Not tried Not applicable
allowed
All Who Transitioned MTF FTM

Of those who tried to update their gender in Social Security

records, transgender men fared better than women. Transgender
men who tried to update their records were able to do so in 89%
of cases, compared to 77% for transgender women.

Whether or not respondents had changed their Social Security

gender record difered by race. American Indian (35%), Asian
(38%), and Black (38%) respondents were least likely to have
changed their records.

Ability to Change Gender in Social Security Record by Race

60
51%
49%
50 47% 47%
45% 44% 43%
38% 38% 39%
40 37%
35% 35%
32%
30

20
14% 14%
12% 12% 11% 12%
9% 10%
10 7% 7%
5%
3% 3% 3%
0
All Who American Indian Asian Black Latino/a White Multiracial
Transitioned
Yes, changes allowed No, changes denied Not tried Not applicable
 IDENTITY DOCUMENTS 147

Ability to Change Gender in Social Security Record for Transgender record; of those who tried, 97% were successful. For those who have
Women by Surgical Status phalloplasty, 93% have updated their Social Security record; and,
of those who tried, 96% were successful. Because the numbers of
All MTF Respondents transgender men in our sample who have had metoidioplasty and/or
Who Transitioned MTFs with No Surgery phalloplasty are low, the diferences in the rates between them may not
be meaningful.

Ability to Change Gender in Social Security Record for Transgender Men

by Surgical Status17
31% 30%
Not Tried Allowed
53% 47% All FTM Respondents
Not Tried
Allowed Who Transitioned FTMs with No Surgery
16% 22%
Denied Denied

16%
Allowed
MTFs with Any Surgery MTFs with Breast Augmentation 7%
46% Denied
48%
Not Tried Allowed 77%
Not Tried
15%
Not Tried 6%
29% Denied
10% Not Tried
Denied
48%
Allowed
75% FTMs with Any Surgery FTMs with Chest Surgery
Allowed 23%
Denied

31% 33%
MTFs with Orchiectomy/ Not Tried Not Tried
Vaginoplasty
64% 62%
5% Allowed Allowed
6%
Denied Denied
4% 8%
Denied Not Tried

FTMs with Metiodioplasty/

88% Creation of Testes FTMs with Phalloplasty
Allowed

6% 3% 3%
3% Not Tried
Denied Not Tried
For transgender men, 64% of those who had some type of surgery Denied
updated their Social Security records, compared to 16% of those who
have had no surgery. 16 Of those who have had some type of surgery
and tried to update their records, 92% were successful. Interestingly,
more than two-thirds (71%) of those without any surgery who tried 93%
91% Allowed
to update their record were successful. Sixty-two percent (62%) who Allowed
had only chest surgery were able to change their Social Security
records; of those who tried, 91% were successful. Of those who had
a metoidioplasty or surgery to create testes, 91% have updated their
 148 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

We also wanted to see how race, household income and Among those who have had some type of surgery, those in the
educational attainment afected rates of updating Social Security higher household income brackets reported more often having
records when we held surgery constant. Since current Social Social Security records updated, and, among those who tried
Security policy requires surgery, we looked at respondents who to change their records, much higher rates of being allowed to
only had some type of surgery. change their records. Those in the higher educational attainment
categories were more likely to have changed their Social Security
With regard to race, among those who have had some type of
records and more likely to report success if they tried.
surgery, white respondents were the most likely to have updated
their Social Security records (72%), with multiracial respondents
next most likely (63%).

Ability to Change Gender in Social Security Record by Race Among Those With Surgery
80
72%
70
63%
60 58%
55% 54%
50

40 35%
32%
30 25%
24%
20%
20 15%
10%
10 6% 7% 7% 7% 7%
1% 2%
* * * * 0%
0
American Indian Asian Black Latino/a White Multiracial
Yes, changes allowed No, changes denied Not tried Not applicable

* Sample size too low to report

Ability to Change Gender in Social Security Record by Household Income Among Those With Surgery
79%
80 75%

70 66%
64%
60%
60

50

40

30 25%
24% 23%
19%
20 16%
10% 10% 10%
10 5% 6%
2% 2% 3% 2%
1%
0
Under $10K $10K-under $20K $20K-under $50K $50K-under $100K $100K+
Yes, changes allowed No, changes denied Not tried Not applicable

Ability to Change Gender in Social Security Record by Educational Attainment Among Those With Surgery

80 76%
72%
70
64%
62%
60

50
44%
40
30%
30 27%
24%
20%
20 18%
15% 15%
10%
10 6% 6% 5%
2% 2% 1% 1%
0
No HS Diploma High School Diploma Some College College Degree Graduate Degree
Yes, changes allowed No, changes denied Not tried Not applicable
 IDENTITY DOCUMENTS 149

Looking at whether visual conformity appears to afect the

outcome of attempts to update Social Security records, among
those who have had surgery, we found that visual conformers
were much more likely to be granted the updated records.

Ability to Change Gender on Social Security Record by

Visual Conformity Among Those With Surgery18
100
90
80
70%
70
60
52%
50
40 37%

30
22%
20
12%
8%
10
0
Visual Non-Conformers Visual Conformers
Yes, changes allowed No, changes denied Not tried or N/A
150 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

PASSPORTS Among those with some type of surgery, those with higher
household incomes and higher educational attainment were more
From 1992 until June 2010, “I don’t want to
likely to have changed their passports.
the U.S. Department of State have document-
had a policy of requiring proof
of “sex reassignment surgery”
mismatch Ability to Change Gender on Passport by Household

before changing gender markers problems down Income, Among Those With Surgery

on passports. In 2010, the the road crossing 100

department, eliminated the international 90
surgery requirement, but ield
borders.” 80
work for our study was done 70 62%
58%
before that action. 60 56%
53%
50 47% 47%
Twenty-six percent (26%) of respondents who had transitioned 40 36%
34% 34% 34%
reported having updated the gender markers on their passport. 30
Seven percent were denied, and 68% either did not try or chose 20 12%
9%
“not applicable” likely meaning they did not have a passport. 10 6% 5% 4%
0
Of those who had some type of surgery, 43% reported having an Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K
updated passport, compared to only 5% of those who did not
Yes, changes allowed No, changes denied Not tried or N/A
have surgery. 19 Six percent (6%) of those who have had surgery
reported being denied an updated passport and 51% either did
not try to update it or did not have a passport.20
Ability to Change Gender on Passport by Educational
Of those who have tried to change their passport, and have had
Attainment, Among Those With Surgery
some type of surgery, 87% reported success and 13% reported
denials. Of those who had not had surgery and tried to change 100
the gender on their passport anyway, 40% reported success and 90
60% reported denials. 80
70 64%
We wanted to know whether race, household income and 59% 57% 57%
60
51%
educational attainment appeared to have an efect on whether 50 44%
people were able to update their passports. Among those who 38%
40 35%
have had some type of surgery, Asian respondents were the most 30 26% 27%

likely to have updated a passport and had the highest success rate 20 14%
9% 8%
10 6%
among those who tried to update their passport. 4%
0
No HS Diploma High School Some College College Degree Graduate
Ability to Change Gender on Passport by Diploma Degree

Race, Among Those With Surgery Yes, changes allowed No, changes denied Not tried or N/A

100
90
80
70
59% 57%
60 55%
48% 49%
50 44%
39% 39% 37%
40
30%
30
20 12% 13%
10 6% 6% 7%
* * *
0
American Asian Black Latino/a White Multiracial
Indian
Yes, changes allowed No, changes denied Not tried or N/A

* Sample size too low to report

 IDENTITY DOCUMENTS 151

WORK ID denied coverage for a mammogram). Furthermore, transgender

people are aware that updating gender markers could out the
Overall, 59% of those who have work ID21 were able to update
person as transgender to the insurance company. This could
gender markers. Six percent (6%) were denied the change and
trigger a denial of coverage for care that the insurance company
35% have not tried. Transgender women were more likely to
considers related to gender transition (much of which is excluded
have made this change, with 64% having received an updated ID,
by most insurance plans).
compared to 51% of transgender men. Thirty percent (30%) of
transgender women and 43% of transgender men have not tried. Transgender women (44%) were more likely to have updated
Six percent of both groups were denied the change. their records; however, transgender men were less likely to try to
do so. Of those who tried, transgender men have a lower denial
The likelihood of trying to change one’s work ID, and the
rate (14%) than transgender women (17%).
likelihood of being successful in doing so, also increased by
household income.
Updated Health Insurance Records by Gender Identity Respondents

Updated Work ID by Household Income

100
90
100
80
90
79% 70
80 73% 62%
60
70
60% 50 47%
60 55% 44%
49% 40
50 32%
41%
40 35% 34% 30
30 24% 20
20% 9%
20 10 5%
10% 10%
10 6% 0
3% 1%
0 MTF FTM
Under $10K $10K-under $20K-under $50K-under $100K+ Yes, changes allowed No, changes denied Not tried or N/A
$20K $50K $100K
Yes, changes allowed No, changes denied Not tried or N/A

STUDENT RECORDS

MILITARY DISCHARGE PAPERS Overall, less than one half (46%) of current students23 who have
transitioned have updated the gender on their student records.
Thirty-ive percent (35%) of those who tried to update discharge
Eleven percent (11%) attempted to update their records and were
records (by receiving a DD-215 form) were allowed to do so.22
denied, and 38% have not tried. Of those who tried, 81% were
Those who had some type of surgery, and who tried to update
successful.
their discharge papers, were only slightly more likely to have been
allowed the change, with 40% successful.
PROFESSIONAL LICENSES AND/OR CREDENTIALS

HEALTH INSURANCE RECORDS Eighty-eight percent (88%) of those who tried to change the
gender on their professional license or credential were successful,
Generally, 39% percent
of people who have
“I have not attempted while 12% were denied such changes.

transitioned updated their to change my gender ID

health insurance records, on my health insurance
and a small number (7%) policy because I am
reported being denied.
A large group has not
afraid of discrimination
attempted to do so (41%). if my health insurer
Anecdotally, we know that knows I’m transgender.”
many people fear updating
their health insurance
records because doing so may prevent them from getting
preventive and necessary care for their sexual and reproductive
systems (for example, someone listed as male is likely to be
152 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Whether ID/Records Match Current Gender Identity by Race

Living With Incongruent
Identity Documents 100
90
We asked respondents whether “All,”
Only one-ifth 80
“Some,” or “None” of their IDs and 70
records match the “gender you prefer.” (21%) of those 60
49% 49%
Of those who had transitioned, only who have 50 46% 44%
41%
48% 46%
36%
21% reported that they had been able transitioned have 40
30% 40%
31% 32%
30 33% 38%
to update all of their IDs and records.
been able to 20 16% 15%
About half (46%) indicated that they 21% 21% 22%
have been able to update some of their
update the gender 10
21% 20%

IDs and/or records, and one-third on all their IDs 0

All Who American Asian Black Latino/a White Multiracial
(33%) indicated that none of their and records. Transitioned Indian

IDs and records matched their current All match Some match None match

gender identity.

Respondents’ success in updating all, some or none of their IDs Whether ID/Records Match Current Gender
and records varied by race and household income. Although Identity by Household Income
the percentages of respondents reporting that they had been
able to change all of their IDs/records was relatively even across 100
the board, respondents of color (except Latino/as) were more 90

likely to be living with no matching IDs and/or records. Similarly, 80

70
respondents with higher household incomes were also more likely
60 51%
to have been able to change all or at least some IDs and records. 47% 51% 49%
50 45%
40 34%
41%
“When I tell people my birth name or show 30 37%
34%
26%
17%
20
IDs with my birth name, people at irst 19% 23%
10 14%
don’t believe me. Often when I am trying to 0
12%
Under $10K $10K-under $20K-under $50K-under $100K+
buying something, people squint at my ID $20K $50K $100K

and usually let me buy it, but I can tell they All match Some match None match

are not sure that is really who I am.”

 IDENTITY DOCUMENTS 153

Harassment and Violence When Presenting

Harassment and Violence
Incongruent Identity Documents by Race
When Presenting Incongruent 100

Identity Documents 90
80

All respondents, not only those 70

“My documents 60
who have transitioned, may need 53%
50%
match now, but they 50 45% 46%
to present ID during at times 38% 37%
in the ordinary course of their didn’t for most of 40
30
lives when their visible gender my life. I lived in 20
expression doesn’t match the 9% 9%
terror of losing my 10 5% 5%
2%
6%
gender or name on their IDs. 0
life, my freedom, American Asian Black Latino/a White Multiracial
We asked respondents to tell us Indian
what happened to them when my employment, Harassed Assaulted
they presented incongruent ID and my friends.”
documents.

Forty percent (40%) of respondents who presented gender Working in the underground economy and losing a job due
incongruent identiication reported harassment and 3% reported to bias were highly associated with harassment (61% and
being assaulted or attacked. Fifteen percent (15%) reported that 56% respectively) due to incongruent ID. These groups also
they were asked to leave an establishment. Overall, 44% had one experienced high exposure to violence (8% and 7% respectively).
of these problems (harassment, assault, or being asked to leave) Transgender men reported much higher rates of harassment
and 56% had no problems. (50%) than transgender women (33%); gender non-conforming
African American (50%) and multiracial (53%) respondents respondents reported more harassment due to gender
reported higher rates of harassment than the overall sample. incongruent identiication (47%) than their transgender peers
While only 3% of the full sample reported being assaulted when (40%).
presenting incongruent identiication, 9% of African American
and Latino/a respondents and 6% of multiracial respondents Harassment and Violence When Presenting Incongruent
reported assault. Identity Documents by Gender Identity/Expression
50
50%
45 47%
Harassment and Violence When Presenting 40%
40
Incongruent Identity Documents
35 33%
50
44% 30
45
40% 25
40
20
35
15
30
10
25 5 3% 3% 3% 3%
20 0
15% MTF FTM All Trans GNC
15
Harassed Assaulted
10

5 3%

0
Harassed Asked to Leave Assaulted Any of these
Problems
154 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Making the Connections: The Impact We also examined denials of home/apartments and housing
on campus in terms of ID gender congruence. Showing ID is
of Incongruent Identiication a typical step toward renting or buying a home or apartment
and checking ID or student records is typically a determinant
For transgender and gender non-conforming people, not having
in deciding eligibility for housing on campus. Among those
identiication consistent with their gender identity or expression
who have transitioned, about one-third (32%) of those with a
can have far-reaching negative consequences. Whenever people
non-matching driver’s license reported being denied a home or
with incongruent identiication documents must produce them,
apartment, compared to 20% of those who did have an updated
they are potentially revealed as transgender, whether to an
driver’s license.
employer, clerk, police oicer, or airport personnel. Each of these
“outings” presents the possibility for disrespect, harassment, Among those who transitioned and reported seeking campus
discrimination or violence as outlined above. housing, those with updated driver’s licenses were less likely to
be denied housing, with 7% being denied housing, compared to
In the hiring process, ID is required by employers who need to ill
20% being denied among those without updated licenses. We also
out government forms relating to taxes and Social Security when
asked about whether respondents were denied gender-appropriate
adding an employee to payroll. Anecdotal evidence indicates
student housing. Gender congruent licenses also appeared to
that some transgender people are ofered jobs by employers who
matter here — 36% of those without an updated driver’s license
don’t realize these job candidates are transgender, and when ID is
reported being denied gender-appropriate housing, compared to
provided that doesn’t match gender identity/expression, the result
18% of those with an updated driver’s license.
can be withdrawal of the ofer of employment.

Among those who have transitioned, we looked at the relationship

between reported rates of hiring discrimination and updating of
driver’s licenses. Of those who had an updated driver’s license,
52% reported experiencing discrimination in hiring. Among those
who did not have an updated driver’s license, the reported rate
was 64%. More research is needed to determine whether the lack
of gender-congruent ID is a direct cause of hiring discrimination.

“These are hard times, I know, but there is still no reason for me to not be able to ind
adequate employment. I am very passable until the employer runs my driver’s license. I have
to work as a Drag King for now and hope to at least make my mortgage payment.”

“My worst experience involved how the police saw me and what my Pennsylvania
driver’s license listed as my sex was when I was in New Jersey. I was held and verbally
abused by two oicers for a burned-out headlamp for about 45 minutes.”
 IDENTITY DOCUMENTS 155

CONCLUSIONS FOR IDENTITY DOCUMENTS

Having gender-congruent identiication is clearly important to the well-being of transgender people. However, substantial
barriers to obtaining gender-congruent identiication remain in place in states, localities and federal agencies.

Gender-incongruent identiication presents barriers to travel, employment, health care, housing, education and other
essential arenas areas of life. Further, data here indicate that presenting gender-incongruent identiication exposed
respondents to harassment and violence.

Having transition-related surgery is, by far, the single biggest factor in obtaining gender-congruent identiication and, it
appears that government agencies and other institutions that maintain IDs and records discriminate based on what type of
surgery the respondent has had.

Health data on gender related surgeries analyzed earlier in this report indicate that a high percentage of our study
respondents do not have access to the gender-related surgeries they need. Accordingly, requiring surgery to change gender
markers on essential identity documents effectively condemns a major portion of transgender and gender non-conforming
people to social and economic marginalization and harassment and violence.

RECOMMENDATIONS FOR IDENTITY DOCUMENTS

• Gender markers on all identity documents and in all records, at every level of government and by every institution that
records gender, should be determined by the gender the person identiies as. This includes:

• Federal agencies, such as the Social Security Administration, Department of Transportation, Department of Defense,
Department of Veteran’s Affairs, Ofice of Personnel Management

• State Bureaus of Vital Statistics

• State Departments of Motor Vehicles

• Employers and professional licensing organizations and associations

• Educational institutions of all levels

• Health systems and health insurance companies

• All entities should evaluate whether there is a legitimate programmatic purpose for collecting gender information and
putting this information on identity documents; if not, gender markers should be removed.

• Sensitivity training is urgently needed for staff who administer the changing of IDs and records, to ensure that transgender
people are treated respectfully and IDs and records are updated appropriately.

• Research should be funded to further assess the impacts of gender-incongruent identity documents on transgender
people’s social and economic security; studies should be constructed to explore potential race and income discrimination
at agencies that issue identity documents.
156 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Endnotes 12 See note 1.

__________________________________________________________________________
13 See note 1.
14 See note 1.
1 Data here is calculated with Not Applicables removed, as we typically do in
15 See note 1.
this report. However, in some instances in this section, data are reported
with Not Applicable responses included in order to better describe the 16 See note 1.
percent of respondents who have updated that particular ID/record. If 17 See note 1.
Not Applicable responses are not mentioned in the text or in the relevant
18 See note 1.
chart, as done here, the reader should assume that they were not included
in the calculations. 19 See note 1.

2 Many states have policies that require proof of surgery, while many others 20 A reader might note that it appears from these numbers and charts that
allow applicants to obtain updated licenses in order to match their current our sample has a higher rate of holding a passport than the general
gender identity with or without surgery. More research could be done to population (28%). Note that we have segmented our sample for most of
divide respondents based on the type of policy in each state, and then the this section to examine only those who have had surgery, which means
further inquire into the how having had surgery, or not, afects the percent that they are more likely to have higher income, which in turn means it
of those able to change their driver’s licenses. is more likely they hold a passport. Furthermore, because many surgeons
who do transgender-related procedures practice in other countries, a
3 See note 1.
larger number of these respondents may have acquired a passport to
4 Please see the Glossary for deinitions of various medical terms. travel abroad for their surgery. For general population igures, see http://
5 See note 1. www.gao.gov/new.items/d08891.pdf.

6 See note 1. 21 We presume that those who have work ID without a gender marker chose
7 Please see the Glossary for deinitions of various medical terms. “not applicable” or answered this question with regard to being able to
update a gender-speciic name.
8 See note 1.
22 The DD-214, which are discharge papers, are generally considered
9 The World Professional Association for Transgender Health, a professional historical documents and are generally not updated. However, according
association of those who provide medical and other health care for to the policy, veterans should be able to receive a DD-215 with updated
transgender people, develops the current worldwide Standards of information.
Care, referred to in the Health chapter. In June of 2010, they issued
the following statement (excerpt): “The WPATH Board of Directors 23 We presume that these students are primarily college, graduate or
urges governments and other authoritative bodies to move to eliminate technical school students because our sample includes only those 18 and
requirements for identity recognition that require surgical procedures.” older.
In 2010, the U.S. Department of State abandoned its surgery-based policy
in favor of a new policy requiring a letter from a physician (without
reference to the patient’s surgical status) to update the birth certiicates
of U.S. citizens born in other countries, referred to as Consular Reports of
Birth Abroad, making them one of the irst government agencies to catch
up with medical understandings of transgender people.

10 See note 1.

11 Some people do not have a birth certiicate because they were born in a
diferent country without a formal certiicate system; others do not have a
birth certiicate because of record storage problems, among other reasons.
158 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

POLICE AND INCARCERATION

Most people interact with police oicers during the ordinary course of their lives. Transgender
and gender non-conforming people may have higher levels of interaction with police. They are
more likely to interact with police because they are more likely to be victims of violent crime,
because they are more likely to be on the street due to homelessness and/or being unwelcome
at home, because their circumstances often force them to work in the underground economy,
and even because many face harassment and arrest simply because they are out in public while
being transgender. Some transgender women report that police proile them as sex workers and
arrest them for solicitation without cause; this is referred to as “Walking While Transgender.”
The survey brought to light a wide range of alarming experiences of transgender and gender
non-conforming people with police and the criminal justice system. It also provides the irst
look at abuse in jails and prisons nationwide; other studies have documented abuse in speciic
geographic areas or within certain systems.

KEY FINDINGS IN POLICE AND INCARCERATION

• One-ifth (22%) of respondents who have interacted with police reported harassment by police due to bias, with
substantially higher rates (29-38%) reported by respondents of color.

• Six percent (6%) reported physical assault and 2% reported sexual assault by police oficers because they were
transgender or gender non-conforming.

• Twenty percent (20%) reported denial of equal service by police. More information about denial of equal service can
be found in the Public Accommodation chapter.

• Almost half of the respondents (46%) reported being uncomfortable seeking police assistance.

• While 7% of the sample reported being held in a cell due to their gender identity/expression alone, these rates
skyrocketed for Black (41%) and Latino/a (21%) respondents.

• Respondents who served time in jail reported harassment by correctional oficers (37%) more often than harassment
by peers (35%).

• Physical and sexual assault in jail/prison is a real problem: 16% of respondents who had been to jail or prison
reported being physically assaulted and 15% reported being sexually assaulted.

• African-American respondents reported much higher rates of physical and sexual assault in prison, by other
inmates and corrections oficers, than their counterparts.

• Health care denial was another form of abuse in prison, with 12% of people who had been in jails or prisons reporting
denial of routine health care and 17% reporting denial of hormones.
 POLICE AND INCARCERATION 159

Respectful and Disrespectful Treatment by Gender Identity/Expression

Police Interaction
Fifty-four percent (54%) of all One-ifth of 100
90
respondents reported that they respondents
80 74%
had interacted with the police as a who have 70%
70
transgender or gender non-conforming 61%
interacted with 60
52%
person. When asked about their
50 46%
experience, 68% of those interacting police reported
40 37%
with police reported that “oicers harassment 30 25%
29%
generally have treated me with respect.” by police 20
Almost a third, (30%), indicated that 10
“oicers generally treated me with 0
disrespect.” MTF FTM All Trans GNC
Of cers have treated me with respect
Respect increased with household income (51% of those Of cers have treated me with disrespect

earning $10,000/year or less compared to 79% of those earning

$100,000/year or more reported respectful treatment) and
educational attainment (43% among those with no high school Respectful and Disrespectful Treatment by Household Income
diploma compared to 74% of those with a graduate degree).
100
We were curious if respondents who had never worked in the 90
underground economy and who had never been incarcerated 78% 79%
80
would report difering degrees of respectful treatment by police. 70 63%
67%

We found that incidence of respectful treatment and harassment 60

51%
increased for these respondents, but not dramatically. Seventy- 50 44%
40 36%
seven (77%) of those who have never worked in the underground 32%
30
economy and have never been to jail or prison reported 22%
18%
20
that oicers treated them with disrespect (compared to our
10
overall rate of 68%) and 22% reported disrespectful treatment 0
(compared to 30% of the overall sample). Under $10K $10K-under $20K-under $50K-under 100K+
$20K $50K $100K
Race had a larger impact on interactions with the police, with Of cers have treated me with respect
Of cers have treated me with disrespect
white respondents experiencing respectful treatment at much
higher levels than their peers who are people of color. Gender
non-conforming respondents and transgender men reported
higher rates of disrespect than transgender women. Respectful and Disrespectful Treatment by Educational Attainment

100
Respectful and Disrespectful Treatment by Race
90
80 74%
100 70%
70 65% 67%
90
80 74% 60
68% 65% 47%
70 50 43%
59%
60 53% 40 34%
49% 47% 31%
50 44% 43% 47% 42% 30
29%
25%
40 35%
30% 20
30 25%
20 10
10 0
No HS Diploma High School Some College College Degree Graduate
0
All Who American Asian Black Latino/a White Multiracial Diploma Degree
Interacted Indian Of cers have treated me with respect
with Police
Of cers have treated me with disrespect
Of cers have treated me with respect
Of cers have treated me with disrespect
160 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

HARASSMENT AND ASSAULT Police Harassment and Assault, Due to Bias, by Race

We asked respondents whether they were harassed,1 physically

50
assaulted, or sexually assaulted by police oicers because they 45
were transgender or gender non-conforming. There were notable 40 38%
36%
35
diferences between reported frequency of harassment compared 29%
30
to reported frequency of physical and sexual assault. 25 22%
24% 23%
20 18%
Twenty-two percent (22%) of respondents interacting with police 15%
15 12%
9% 10%
reported harassment by oicers. Higher rates of harassment 10 6% 6% 7% 8%
3% 4% 4%
were reported by Black (38%), multiracial (36%) and Asian 5 2% 2% 2%
0
(29%) respondents. Higher household income and educational All Who American Asian Black Latino/a White Multiracial
Interacted Indian
attainment made it less likely that a person experienced
with Police
harassment. Female-to-male and gender non-conforming
Harassed by Police
respondents reported higher rates of police harassment than
Physically Assaulted by Police
their MTF and transgender counterparts. Looking at whether
Sexually Assaulted by Police
harassment was also directed at those who had never worked
in the underground economy and had never been incarcerated,
we found still high rates of harassment, with 15% reporting that
Police Harassment and Assault, Due to Bias, by Gender
oicers harassed them, compared to the 22% overall rate for all
respondents who interacted with police. 50
45
Six percent (6%) of study participants who had interacted with
40
police reported physical assault, and 2% reported sexual assault
35
because of being transgender or gender non-conforming. Fifteen 30
29%
26%
percent (15%) of Black respondents interacting with police 25 22%
20%
reported physical assault and 7% reported sexual assault. Those 20
who have worked in the underground economy experienced high 15
rates of physical (15%) and sexual assault (8%). Two percent 10 6% 6% 6% 6%
5 3% 3% 2%
(2%) of those who have never worked in the underground 1%
0
economy and have never been incarcerated reported physical MTF FTM All Trans GNC
assault.
Harassed by Police
Physically Assaulted by Police
“After I was raped, the oicer told Sexually Assaulted by Police

me that I got what I deserved.”

 POLICE AND INCARCERATION 161

Police Harassment and Assault, Due to Bias, by Household Income “I did not pass as male, but I was obviously
50
presenting as a masculine person at a nightclub.
45 I kissed the cheek of my girlfriend at the time.
40
35 33% … The security guard picked me up and carried
30
25%
me towards the door, kicked the door open with
24%
25
20
his foot and launched me out the door of the
15% 14%
15 12% nightclub. I tumbled to the ground to ind three
10
5
4%
6%
4%
6%
3% 3% 4% police oicers standing over me. One said, ‘Do we
1% 1%
0 have trouble here?’ The security guard said, ‘The
Under $10K $10K-under $20K-under $50K-under $100K+
$20K $50K $100K trouble is that this fucking lesbian needs to know
Harassed by Police
what it’s like to be with a man.’ They all started
Physically Assaulted by Police
Sexually Assaulted by Police to laugh. ‘I could show her,’ one police oicer said.
Just then my friends bolted through the door and
Police Harassment and Assault, Due to Bias, by Educational Attainment instructed me to run. I stumbled to my feet and
narrowly escaped the oicer’s hands. ‘Fucking
50
45 dykes! Don’t come back here unless you wanna get
40
fucked!’ one of the oicers screamed as we ran of.”
35
30 28%
26% 25%
25
20 18% 18%
15 11% 10%
10 7% 7%
4% 5%
5 2% 3% 2%
1%
0
No HS Diploma High School Some College College Degree Graduate
Diploma Degree

Harassed by Police
Physically Assaulted by Police
Sexually Assaulted by Police
162 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Levels of Comfort and Discomfort in Seeking Help from Police

Comfort in Seeking Police Assistance
50
Police harassment and Almost half of the 45
assault had an apparent
respondents reported 40
deterrent efect on 35
respondents’ willingness
being uncomfortable 30 26% 26%
25
to seek out help from law seeking police 18% 19% 19% 20% 20%
20 17% 18% 16%
enforcement; 46% of the assistance. 15
sample reported that they 10
5
were uncomfortable seeking help from police while only 35%
0
reported that they were comfortable doing so. Very Somewhat Neutral Somewhat Very
comfortable comfortable uncomfortable uncomfortable
Those who have never worked in the underground economy Overall Sample
nor were ever incarcerated reported only a slight decrease in Those who had never worked in the underground economy and were never incarcerated
discomfort in seeking police assistance, with 42% uncomfortable
and 37% comfortable.

Levels of Comfort and Discomfort in Seeking Help

“My boyfriend and I were jumped last year from Police by Gender Identity/Expression
because he was wearing a dress. I didn’t call
100
the police because we are both gender non-
90
conforming and he is a person of color.” 80 40% 45% 47%
54%
70
60
“Street harassment is the most constant gender- 50 17%
17%
related experience of discrimination in my day- 40
18%
24%

30
to-day life: from cops, other government workers,
20 43% 38%
as well as fellow city residents. My experience 10
28% 29%

ranges from catcalls, to being followed (on foot 0

MTF FTM All Trans GNC
and in cars) by threatening groups of people,
Comfortable Neutral Uncomfortable
to having things thrown at me. Enough of
this harassment comes from cops that I can’t
imagine a situation in which I’d either report
it to the police or want them to intervene.”
Levels of Comfort and Discomfort in Seeking Help from Police by Race

100

90

80 42% 44% 44%

46% 48% 51% 55%
70

60

50 20%
19% 19%
17%
40 30% 19%
20%
30

20 38% 37%
35%
35% 26% 30%
25%
10

0
Overall Sample American Indian Asian Black Latino/a White Multiracial
Comfortable Neutral Uncomfortable
 POLICE AND INCARCERATION 163

Incarceration Because the Department of Justice data is limited to prisons

and does not include jails, the comparison with our data is not
Seven percent (7%) of study 41% of Black exact.3 However, the diference in reported rates is stark, with
participants reported being respondents in our sample reporting many times the rate of
respondents reported
arrested or held in a cell incarceration than the general population, based on the best
strictly due to bias of police
being held in a cell available data for comparison.
oicers on the basis of because of their gender
gender identity/expression. identity alone. Incarceration by Race
Four percent (4%) of those
who have not worked in the underground economy reported 50
47%
45
being arrested or held in a cell due to this same bias. 41%
40
This experience was heightened for respondents of color. Black 35
30%
and Latino/a incidences of being incarcerated due only to gender 30
25%
identity/expression were much higher than the overall sample’s 25 21% 21%
20
experience, at 41% and 21% respectively. 16%
15 13% 13% 12%
10% 10%
Sixteen percent (16%) of respondents reported being sent to 10 7%
4%
jail or prison “for any reason,” with Black (47%) and American 5

Indian (30%) respondents at highest risk for going to jail/ 0

Overall American Asian Black Latino/a White Multiracial
prison. Twenty-one percent (21%) of male-to-female transgender Sample Indian
respondents reported having been sent to jail for any reason, in Arrested/Jailed Due to Bias Jailed for Any Reason

contrast with 10% of female-to-male respondents.

These statistics exceed those of the general population for prisons,

in some cases by many times. A 2003 report of the Department Incarceration by Gender Identity/Expression
of Justice shows that 2.7% of the general American population
50
is imprisoned at some point in life.2 However, the Department of
45
Justice report does not include jails, so the general population
40
rate for being held in jail or prison should be higher than the
35
simple prison rate.
30

Despite this diference, the Department of Justice data provides a 25

21%
useful benchmark. Their data reported an overall rate for males 20 17%
of 4.9%, and for females, 0.5%. They provide only limited racial/ 15 12%
11% 10% 9%
ethnic data. 10
4% 4%
5
0
Incarceration by Gender and Race/Ethnicity in the MTF FTM All Trans GNC
General Population from the Department of Justice Arrested/Jailed Due to Bias Jailed for Any Reason

All Males Females

General
2.7% 4.9% 0.5%
Population

White 1.4% 2.6% 0.3%

Black 8.9% 16.6% 1.7%

Latino/a 4.3% 7.7% 0.7%

164 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

LENGTH OF INCARCERATION

Respondents were asked to “I was arrested recently

provide the total amount and the oicer thought
of time they have been in
jail/prison throughout their
it necessary to announce
lives. in a loud tone to the
In terms of race, Black
entire jail that I was a
respondents had by far the transgender man.”
worst outcomes in terms
of length of stay in jails/prisons. Five percent (5%) of African
Americans sent to jail for any reason were incarcerated for 10 or
more years and 10% were incarcerated for 5-10 years. By contrast,
the only 4% of the full sample served 5 or more years in jail.

As is true in other populations, participants’ jail time decreased

as household income increased; educational attainment was also
inversely correlated with jail time.

Male-to-female transgender respondents reported servng

more time than FTMs. In general, transgender respondents
served longer sentences (or more sentences) than gender non-
conforming participants, faring worse in every category except the
lowest (serving under 6 months).

Total Length of Incarceration by Gender Identity/Expression

(of Those Incarcerated)
100
94%
90 87%

79%
80 75%

70

60

50

40

30

20
10%
10 7% 8% 7%
6%
4% 3% 2% 4%
2% 2% 2% 3% 1%
0% 0% 1% 1% 1% 0%
0
MTF FTM All Trans GNC
Under six months Six months to a year One to three years Three to ve years Five to ten years Ten or more years
 POLICE AND INCARCERATION 165

Total Length of Incarceration by Race

(of Those Incarcerated)
89%
90
81% (83%) 82%
80
(71%) 72%
70

60

50 47%

40

30
(19%) 18%
20 14%
(11%)
13%
8% 6% 10% 9% 8%
10 (5%) (5%) (0%) (6%) 6% 5% 5% 4% 5% 3%
2% 3%1% (0%) (0%) (0%) (0%) 1%3%1% 1%2%0% 0% 2%
0
All who went to Jail/ American Indian Asian Black Latino/a White Multiracial
Prison
Under six months Six months to a year One to three years Three to ve years Five to ten years Ten or more years

( ) Sample size too low for reliable analysis

Total Length of Incarceration by Household Income

(of Those Incarcerated)
100
94%
90 88%
84%
80 78%
74%
70

60

50

40

30

20
10% 8% 9%
10 6% 6%
3% 3% 2% 4% 2% 5% 5% 3%
1% 1% 3% 1% 0% 2% 1%
3% 1%
0% 1% 0%
0
Under $10K $10K- under $20K $20K-under $50K $50K-under $100K $100K+
Under six months Six months to a year One to three years Three to ve years Five to ten years Ten or more years

Total Length of Incarceration by Educational Attainment

(of Those Incarcerated)
100
94%
89%
90
81%
80
71%
70 66%

60

50

40

30
20%
20
10% 11%
9%
10 7% 6%
5% 4% 5% 4%
2% 1% 1% 2% 2% 2% 1% 2% 1% 1% 1% 2% 2% 1%
0%
0
No HS Diploma HS Diploma Some College College Degree Graduate Degree

Under six months Six months to a year One to three years Three to ve years Five to ten years Ten or more years
166 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Harassment in Jail/Prison by Race

Experiences in Jail and Prison
100
Not surprisingly, the mistreatment and abuse by law enforcement
90
oicers that transgender and gender non-conforming people 80
experienced on the street and in their communities continued 70
when respondents were in custody. Harassment and assault at the 60 (55%) (56%) 56%
51%
(50%) 50% 47%
hands of corrections oicers and by other inmates from whom 50 (44%) 43% 44%
40 35% 37%
they have no escape was frequent both for transgender and
30 26% 29%
gender non-conforming respondents. 20
10
HARASSMENT AND ASSAULT IN JAIL AND PRISON 0
All Who American Asian Black Latino/a White Multiracial
Went to Indian
Harassment Jail/Prison
Harassed by Inmates Harassed by Staff
Thirty-ive percent (35%) of respondents who served time in jail/
prison reported harassment by other inmates. Latino/a (56%), ( ) Sample size too low for reliable analysis

Black (50%), and multiracial (43%) respondents all report much

higher incidence of peer harassment than the full sample. MTFs Harassment in Jail/Prison by Gender
(40%) and transgender (38%) respondents report higher rates
100
of peer harassment than their FTM (29%) and gender non-
90
conforming (29%) peers.
80
Of respondents who went to jail/prison, 37% reported they 70
were harassed by correctional oicers or staf. Respondents 60
of color experienced oicer/staf harassment at higher rates 50 44%
40% 38% 38% 39%
(44%-56%) than their white peers. Transgender male inmates 40 33%
29% 29%
experienced oicer/staf harassment at higher incidence than 30

their transgender female peers. 20

10
0
MTF FTM All Trans GNC
Harassed by Inmates Harassed by Staff

“While I only experienced verbal harassment and rape threats during a night in jail, I
watched a trans woman arrested with me experience physical and sexual assault from
the police that night as well as extensive verbal harassment and humiliation.”
 POLICE AND INCARCERATION 167

Physical and Sexual Assault It is not easy to compare this information with the general
population of people who go to jail/prison, since most surveys
When someone is sent to jail or prison, society agrees that rape
ask about sexual assault that occurred in the prior year only. One
should never be part of the sentence. Unfortunately, for many of
study from California that was not limited to the last year, shows
our respondents, it is. Respondents who went to jail/prison report
an overall sexual assault rate of 4.4% of all inmates in male
alarming levels of physical assault (16%) and sexual assault
California correctional facilities.4
(15%) perpetrated both by other inmates and by staf. Black
respondents reported the highest incidence of sexual assault in
prison (34%) by other inmates or by staf.

Male-to-female transgender respondents reported higher incidence

of physical assault (21%) than their FTM peers (11%). MTF
respondents also reported a higher rate of sexual assault (20%)
than FTM respondents (6%). Transgender inmates experienced
physical and sexual assault at higher frequencies (19% and 16%)
than their gender non-conforming peers (4% and 8%).

Physical Assault in Jail/Prison by Race

50
(45%)
45
(41%)
40

35 33%

30 29%

25
21%
20
17% 17%
16%
15 14% (14%)
13%
12%
(11%) (11%) 11% 11% 11%
10 9%
8%
(6%) 6%
5

0
All who went to Jail/ American Indian Asian Black Latino/a White Multiracial
Prison
Physical Assault by Inmates Physical Assault by Staff Physical Assault by Anyone

( ) Sample size too low for reliable analysis

Sexual Assault in Jail/Prison by Race

45

40

35 34%
32%
30
(27%) (27%)
25 24%
21%
20 (18%)
15% 16%
15 13% 14%
(11%)
10 9% 9% 8%
6% (6%) (6%) 7% 7%
5 4%

0
All who went to Jail/ American Indian Asian Black Latino/a White Multiracial
Prison
Sexual Assault by Inmates Sexual Assault by Staff Sexual Assault by Anyone

( ) Sample size too low for reliable analysis

168 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Physical Assault in Jail/Prison by Gender Transgender women of color were particularly vulnerable to
50 sexual assault in jail/prison. Thirty-eight percent (38%) of Black
45 MTF respondents reported being sexually assaulted by either
40 another inmate or a staf member in jail/prison. Unfortunately,
35
breaking our respondents who had gone to jail/prison down both
by race and gender created individual sample sizes too small for
30
analysis, including for nearly all FTM respondents. However, we
25
21%
19%
include the following table below to highlight the experiences of
20 18%
16% transgender women by race. We have indicated where sample size
15
11% was too low to present reliable data.
9% 9%
10 7% 8%
5 3% 2% 4% Sexual Assault in Jail/Prison for Transgender Women by Race
0
MTF FTM All Trans GNC
50
Physical Assault by Inmates Physical Assault by Staff Physical Assault by Anyone 45
40 38%
35
30%
Sexual Assault in Jail/Prison by Gender 30
25% 24%
50 25
19%
45 20
15 12%
40
10
35 5
*
30 0
All MTFs American Asian Black Latino/a White Multiracial
25 Who Went Indian
20% to Jail/
20 18% Prison
16%
15 14%
* Sample size too low to report
10 7% 7% 8%
6% 6% ( ) Sample size too low for reliable analysis
5 4% 4%
2%
0
MTF FTM All Trans GNC

Sexual Assault by Inmates Sexual Assault by Staff Sexual Assault by Anyone

“I was arrested one day regarding something minor. Due to my gender being marked as
male, I was put in with the men. Within 15 minutes, I was raped by 3 diferent men. My
mother even called and warned the oicers NOT to put me in with general population
as I would be an easy target. When I got out I tried to seek help from Victims Services
but was denied. I was also discouraged from trying to press charges on the men.”
 POLICE AND INCARCERATION 169

DENIAL OF HEALTH CARE IN PRISON Denial of Health Care in Jail/Prison by Household Income

Respondents also reported 12% of those in jails or

abuse through denial of
prisons reported being 50
general health care as well
as hormone therapy.
denied routine health care. 45
40
The damaging efects of being denied general health care are self- 35

evident; however, it is important for readers to also understand 30

24% 25%
25
that denial of hormone treatment to transgender inmates also has 20%
20 18%
serious health consequences. Interruptions in hormone therapy 16%
14%
15
can be physically painful and damaging to a person’s physical and 8%
10 6%
mental health, and the initiation of hormone therapy for those 5% 4%
5
who need it is highly important. 0
Under $10K $10K-under $20K-under $50K-under 100K+
Seventeen percent (17%) reported they were denied hormones by $20K $50K 100K

while incarcerated and 12% reported denial of routine medical Denied Regular Health Care Denied Hormones

care because of bias.

Black and multiracial respondents, those with low household

Denial of Health Care in Jail/Prison by Gender Identity/Expression
incomes, and transgender women all reported higher incidences
of hormone and routine health care denial than the full sample.
50
45
Denial of Health Care in Jail/Prison by Race 40
35
50
30
45 24%
25
40 (36%) 20%
35 20
30% 16%
14%
30 15
25 9%
10 7%
20 17% (18%) 16% 16% 5 2% 3%
15%
15 12% 12% 13%
10% 0
10 (6%) 7% MTF FTM All Trans GNC
5 Denied Regular Health Care Denied Hormones
(0%)
0
All Who American Asian Black Latino/a White Multiracial
Went to Indian
Jail/Prison
Denied Regular Health Care Denied Hormones

( ) Sample size too low for reliable analysis

170 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

CONCLUSIONS FOR POLICE AND INCARCERATION

Respondents revealed gross differences in treatment by police and prison systems based on race, with African Americans
incarcerated more often and at greater length within a much more abusive and violent context than for others. Latino/a
respondents also experienced much worse police abuse, longer sentences and greater harassment and violence than the
sample as a whole. While the sample of American Indians who had been incarcerated was too low to report on, the data we
do have demonstrates a need for further research. The data also demonstrate gender-based biases, with male-to-female
respondents experiencing high rates of physical and sexual assault.

Household income and education level were also relevant to treatment by police and the prison system, with lower
educational attainment and household income associated with higher risk for incarceration, harassment and violence; in this
regard, our sample relected the experiences of Americans in general. Male-to-female transgender prisoners of color face
violence at the highest numbers and at every turn — whether at the hands of police, corrections oficers or other inmates. A
nexus of biases based on gender identity, race and household income combine to leave some respondents in this study in
particularly desperate circumstances at the hands of the law enforcement system.

All transgender and gender non-conforming people experience high levels of police harassment and abuse. A substantial
number have been stopped — arrested or held in a cell — simply because they are transgender or gender non-conforming
(known as “Walking While Transgender”). Police harassment and abuse has translated to a lack of trust of police, with about
half of transgender and gender non-conforming people uncomfortable asking the police for assistance when needed. Only
a third feel comfortable contacting police for help. Given the higher than normal rates of harassment and violence that
transgender and gender non-conforming people face, this means that many feel unable to access one of the major resources
that society provides to protect the safety of individuals in their time of need.

In jail and prison, abuse and violence continues in situations where transgender and gender non-conforming inmates often
have no protection or escape. Correctional staff are frequently cited as participating in harassment, violence, and sexual
assault—a serious abuse of authority.

As noted in the health care section, access to health care is a fundamental right often denied to study participants. Data from
the prison context conirms this, showing regular denial of both routine and transgender-related health care services.

From every angle, the justice system is broken for transgender and gender non-conforming people. Instead of administering
justice, it perpetrates injustice.
 POLICE AND INCARCERATION 171

RECOMMENDATIONS FOR POLICE AND INCARCERATION

The data provides clarity on what is not working in the justice system. We recommend the following afirmative steps for
police departments, corrections systems, and the justice system overall.

• Police departments should reform their approach to transgender and gender non-conforming people:

• All oficers, both new and those who are already serving, should be given comprehensive training to treat transgender
and gender non-conforming people respectfully, regardless of whether the person is seeking assistance or is being
arrested.

• In order to sustain and reinforce the effect of training, departments need written policies related to respectful
treatment, arrest procedures, and placement in housing, so that all oficers know the expected protocols or can
consult them when necessary.

• Oficers who fail to follow these policies, or otherwise engage in disrespectful treatment or violent behavior, should
face discipline, including termination when warranted.

• A culture of respect for diversity, including of transgender and gender non-conforming people should be established
by departmental leadership.

• Police departments should establish LGBT liaison units to be an internal voice for fairness, respectful treatment, and
appropriate policies. Existing lesbian and gay units should expand to include transgender and gender non-conforming
oficers and issues as well.

• Jail and prison oficials and systems, including the Federal Bureau of Prisons, should reform their approach and policies
related to transgender and gender non-conforming inmates:

• The U.S. Department of Justice should swiftly adopt strong, binding national regulations to implement the Prison Rape
Elimination Act of 2003.

• Until national regulations are established, prisons, jails and detention facilities should fully implement the
recommendations of the National Prison Rape Elimination Commission.

• Corrections staff should be given comprehensive training on how to treat transgender and gender non-conforming
inmates with respect, including allowing people to express their gender identity through clothing and grooming.

• Jail and prison systems need written policies on transgender and gender non-conforming inmates, to ensure they are
housed according to their gender identity, unless their safety is jeopardized by this classiication; however, this does
not mean transgender and gender non-conforming inmates should be held in solitary coninement or administrative
segregation or otherwise have their privileges reduced in a misguided attempt to keep them safe.

• Jail and prison systems should enact policies and procedures that ensure all inmates are free of physical and sexual
assault.

• Jail and prison systems should provide appropriate medical care to transgender and gender non-conforming inmates.

• Department of corrections must terminate staff who physically or sexually assault prisoners and otherwise ensure that
staff are accountable for their actions when they endanger the health and well-being of inmates.
172 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Endnotes
__________________________________________________________________________

1 We asked respondents to report whether oicers had treated them with

respect or disrespect, harassed, physically assaulted, or sexually assaulted
them. We left it up to respondents to select which terms best described
their experience.

2 U.S. Department of Justice, Bureau of Justice Statistics, Prevalence of

Imprisonment in the U.S. Population, 1974-2001 by Thomas P. Bonczar
(Washington, DC: GPO, 2003): http://bjs.ojp.usdoj.gov/content/pub/pdf/
piusp01.pdf .

3 Generally, a jail is a facility administered by a local jurisdiction to conine

people for short periods of time. A prison is administered by the state and
used to house convicted criminals for generally longer periods.

4 Valerie Jenness et al., Violence in California correctional facilities: An

empirical examination of sexual assault. Center for Evidence-Based
Corrections, Department of Criminology, Law and Society, University of
California, Irvine (2007): http://ucicorrections.seweb.uci.edu/pdf/PREA_
Presentation_PREA_Report_UCI_Jenness_et_al.pdf.
174 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

A SNAPSHOT OF THE EXPERIENCES

OF CROSS-DRESSERS
tudy participants included 702 cross-dressers1 who were born
S male and cross-dress as women, about 11% of our overall
sample. This group identiied themselves by stating that they
About half (46%) indicated that they did not want to transition,
and the other half (54%) reported that they did want to transition
someday. This implies that for about half of those who identify
strongly identiied with the term “cross-dresser.”2 with the term “cross-dresser,” this may be an interim identity on
the way to a transsexual identity. On the other hand, half of these
They were spread amongst the racial categories, with a bit more
respondents intend to remain in this category, which indicates
concentration in white and Latino/a groups, making up 13%
that it is a permanent identity. This contradicts assumptions
of white respondents, 7% of Latino/as, 5% of Asian and multi-
that those who identify as cross-dressers are moving toward a
racial respondents, 4% of American Indians, and 3% of African
transsexual identity.
Americans.
Cross-dressers were more likely to be partnered (60%) than
As a group, cross-dressers were less “out” to their family, friends
transgender (46%) and gender non-conforming (57%)
and colleagues at work or school, than the rest of the sample.
respondents; 52% reported being married. Almost half (44%)
Twenty-eight percent (28%) never tell anyone about their
reported a heterosexual sexual orientation, 38% bisexual,
transgender/gender non-conforming identity, 57% tell close
9% gay/lesbian/same-gender, 3% queer, 3% asexual and
friends, 28% tell some family members, 17% tell casual friends,
2% other. Accordingly, cross-dressers were much more often
and 7% tell work colleagues. Only 4% tell everyone. Since social
heterosexual or bisexual and much less often same-sex oriented
isolation can have major impacts on mental and physical health,
or queer than the full sample.3
this reduced level of “outness” deserves further study.
Thirty-two percent (32%) of cross-dressers served in the military
At home, only 32% are out to “all,” with 22% out to “none” and
compared to 20% in the full sample, and 10% of the general
38% out to a few or some. On the job, 3% are out to “all,” 68%
population.4
are out to “none,” with 24% out to a few or some. At school, 2%
are out to “all,” 81% are out to “none,” with 15% out to some or
a few. “As a part-time lifelong cross-dresser, I would
In addition, cross-dressers reported being visual conformers; 37%
love to see a day when a male can dress as a
reported that other people never know they are transgender/ female, in public, without ridicule and fear of
gender non-conforming if they are not told, 29% reported that physical abuse. My need to dress on the feminine
other people only occasionally can tell, and 26% reported that side is real. It makes me whole as a person.
others only sometimes can tell. We presume that respondents
Women have enjoyed cross dressing for 50+
were answering this question about times when they were not
cross-dressed, but there may have been some confusion about years, and no one gives it a second thought.”
whether to answer this question in regard to occasions when they
were cross-dressed or not.

“As a cross-dresser in Atlanta I have had very

few problems. I have been stopped at police road
blocks 3 times and had no problems other than a
few extra questions about the ID/picture issue.”
 A SNAPSHOT OF THE EXPERIENCES OF CROSS-DRESSERS 175

Education Public Accommodation

Because cross-dressers made up only 11% of our overall Cross-dressers reported “I was intentionally
sample, the sample size of those who were also open about denial of equal treatment and
their gender non-conforming status in school was too small to harassment when accessing
discriminated against
ofer meaningful analysis. We can say, however, that 58% of public accommodation. Of by a motel owner. He
cross-dressers who expressed a transgender identity or gender the settings we studied, equal told me that he would
non-conformity in school experienced some type of problem, service was denied most often not give me a room
including harassment, physical or sexual assault, or expulsion. at retail stores (22%) and
because I was a cross-
hotels and restaurants (11%)
with troubling rates of denial of dresser, and to leave the
Employment equal treatment reported when property or he was going
interacting with government to call the police and
Respondents who identify as cross-dressers reported faring better
agencies/oicials (7%), police
in the workplace than the overall sample, likely due to higher tell them that a hooker
(7%), and judges or court
rates of visual conformity and their much lower rates of being out
oicials (4%). Respondents
was in the parking
at work. lot selling drugs.”
also reported denial of equal
Only 7% reported being unemployed, which was the treatment when taking buses/
unemployment level in the general population during the trains/taxis (5%) and accessing
period of data collection. Thirty-eight percent (38%) reported a rape crisis centers (3%).
household income of $50,000-100,000 per year with another 25%
Harassment was also a major problem. Twenty-two percent
reporting $100,000 per year or above. These household income
(22%) said they had been harassed in a retail store, 11% when
levels were much higher than the full sample, of which 41%
using buses, trains or taxis, 11% by hotel/restaurant personnel,
percent earns $50,000 or more annually. Seven percent (7%) of
12% by government agencies, 7% by judges or court oicials, 8%
cross-dressers reported household income of $10,000 annually or
by airline/airport personnel or the TSA, 8% in doctor’s oices or
less, a rate that is higher than the general population’s experience
hospitals, and 3% when accessing ambulances.
of very low household income (4%), and much lower than the full
sample (15%).

However, cross-dressers do experience a range of bias-related Housing

negative experiences in the workplace: 13% reported losing a job
Fifty-eight percent (58%) reported living in a home that they
because of bias, 34% reported harassment at work, 12% reported
own; this is nearly twice the rate of home ownership as the full
being denied a promotion, 18% were denied a job they applied
sample, and 9 percentage points under the national average.
for, 4% reported physical assault, and 6% reported sexual assault.
Twenty-seven percent (27%) reported living in a space that they
The rates of these negative workplace experiences are all lower
rented. Five percent (5%) reported living in a home that is owned
than the overall sample, except for sexual assault, which was
by a partner/spouse, 3% reported living with family or friends
approximately the same.
temporarily, and 1% reported living in campus housing.
Thirty percent (30%) reported that private information was
Twenty-three percent (23%) of respondents who are cross-
shared about them by coworkers or supervisors. Eighty percent
dressers reported having moved into a less expensive home/
(80%) reported that they have hidden their gender or gender
apartment because of being transgender or gender non-
transition and 56% have delayed transition. Twenty-seven percent
conforming, 7% had become homeless at some point because of
(27%) reported being underemployed. Seven percent (7%) have
bias, 4% reported eviction, 6% were denied an apartment/home,
participated in the underground economy for household income
14% had to ind diferent places to sleep for short periods of time,
(compared to 16% for the overall sample), including 4% doing
and 8% had sex in exchange for housing or a place to stay.
sex work and 3% in drug sales.
176 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Police/Jails Family Life

Cross-dressers reported a Of those who came out to family, 60% reported their family
Cross-dressers
substantial degree of police remained as strong as before they came out. Thirty-one (31%) of
disrespect and mistreatment.
reported a substantial those who were in a relationship reported that their relationship
Twenty percent (20%) of degree of police with their partner or spouse ended.
those interacting with police disrespect and Sixty-one percent (61%) of cross-dressers are parents. Eighty-one
as a transgender/gender non- mistreatment. percent (81%) reported that their children continued to speak
conforming person reported that
and spend time with them, while 19% reported that their children
they were generally treated with disrespect and 15% reported
limited contact. Sixteen percent (16%) stated that their former
harassment. Eight percent (8%) reported being physically
spouse limited or stopped their relationship with their children
attacked by a police oicer and 3% reported sexual assault.
and 5% reported that a court/judge did so.
Twenty-nine percent (29%) indicated they were comfortable
seeking police assistance and 46% indicated they were not Twelve percent (12%) reported they were victims of violence by a
comfortable seeking police assistance as a transgender or gender family member due to their gender identity/expression.
non-conforming person. Three percent (3%) reported being Thirty-nine (39%) reported losing a close friendship because of
arrested or held in a cell solely because of their gender identity/ their gender identity/expression.
expression.

Health Care “I am a private cross dresser (male-to-female).

Only my wife knows, and she does not approve.”
Eleven percent (11%) of respondents who cross-dress reported
postponing needed medical care when sick or injured due to bias
and 10% reported postponing preventive care due to bias.
“My ex-wife seemed to accept my cross-
Cross-dressers also report having accessed some transition-related dressing prior to marriage, then rejected it.”
health care. Counseling was the most accessed, followed by
hormone treatment. About half desire at least one type of surgery,
which is consistent with the inding that about half desired to
transition some day.

Respondents who identify as cross-dressers reported poorer

health outcomes than the general population but much better
health outcomes than those with other gender identities/
expressions in our sample.

Cross-dressers reported elevated rates of HIV infection at 1.01%,

not quite twice the rate of the general population (.6%), but
lower than the full sample (2.64%). Cross-dressers also reported
drinking or using drugs to cope with the mistreatment they face
as transgender/gender non-conforming persons: 6% reported
current use and 7% reported former use. By contrast, (8%)
of the full sample currently drinks or uses drugs to cope with
mistreatment due to bias and (18%) reported former use.

Smoking rates are the same as the full sample; 29% of cross-
dressers reported being current smokers compared to 30% of all
study participants.

Finally, 21% of cross-dressers reported a suicide attempt — about

half the rate of the overall sample (41%), but it is still many times
the general population rate of 1.6%.
 A SNAPSHOT OF THE EXPERIENCES OF CROSS-DRESSERS 177

Endnotes
Conclusions __________________________________________________________________________

Because cross-dressers may live as or express a gender diferent

1 We had a small number of cross-dressers in our sample who were female
than the one assigned to them at birth only part of the time, they
at birth, and, because of the difering levels of social stigma associated
have diferent experiences of discrimination. Because they can with wearing clothes of a diferent sex for men and women, we felt it was
often make choices about when and if to come out to others, they important to focus here on the experiences of those cross-dressers who
seemed to be shielded from some of the hostile environments were born male.
reported by our other respondents. Nonetheless, a sizable number 2 Those respondents who did not strongly identify with any of the terms
reported dealing with bias and violence in their lives. This may in Question 4 were then classiied based on their “somewhat” applies
well stem from the fact that they ofer no visual clues about their answers, so some of the cross-dressers in the sample only identiied
“somewhat” as a cross-dresser. If a respondent chose “strongly” cross-
gender identity when they are not cross-dressed, but may well be
dresser and “strongly” transsexual (or were both “somewhat”), they were
identiiable as gender diferent when they are dressed. It appears put in the transgender category.
that this group is highly vulnerable part of the time and much less
3 This may be in part because many deine cross-dresser as a term that only
vulnerable at other times. applies to heterosexuals, while the term drag queen or drag king is used
more by those who identify as gay, lesbian, or bisexual.
All of these factors deserve further study; statistically we know
relatively little about the lives of cross-dressers and additional 4 Kelly Ann Holder, U.S. Census Bureau, Housing and Household Economics
research would greatly enhance our knowledge. Statistics Division, “Comparison of ACS And ASEC Data on Veteran Status
and Period of Military Service: 2007” (Washington, DC: GPO, 2007):
http://www.census.gov/hhes/www/laborfor/veterans/comparison_report.
pdf.

“20 years in the Army, 2 in Vietnam, 2 Bronze

stars, a Purple Heart. I met my wife while
serving and told her that I was a transvestite.
I dressed at home. After the service, I got a
civil service job and stayed in the closet. Now I
am retired and I live in a town that is next to
a large Marine base. Dressing here would be
committing suicide. I dress up at home every day,
but never go outside in my feminine attire.”
178 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

POLICY PRIORITIES
We gave respondents a list of 13 policy areas and asked that they select the four that were most
important. The nature of this question allowed respondents to identify their own priorities from
this list, based on their individual experiences. The results show remarkable concurrence on
priorities, and they also reveal the breadth of concerns that individuals prioritize as being the
most essential to the improvement of their lives. It is also clear that priorities vary slightly by
race and gender, relecting particular vulnerabilities and unaddressed needs. It is not suggested
by this report that these ranked priorities are an appropriate or accurate way for advocacy
organizations or activists to prioritize work; rather, they are a relection of what individuals
identiied as the policy areas in which they wished to see work or change.
The following are the 13 policy areas ranked in order of the frequency that respondents marked each.

Policy Priorities

Protecting transgender/gender non-conforming people from discrimination in hiring and at work .............................................. 70%

Getting transgender-related health care covered by insurance .................................................................................................... 64%

Passing laws that address hate crimes against transgender/gender non-conforming people...................................................... 47%

Access to transgender-sensitive health care ................................................................................................................................. 43%

Better policies on gender and identity documents and other records ........................................................................................... 40%

Protecting transgender/gender non-conforming people from discrimination in housing .............................................................. 26%

The right to equal recognition of marriages involving transgender partners.................................................................................. 25%

Passing anti-bullying laws that make schools safer....................................................................................................................... 21%

Transgender/gender non-conforming prisoners’ rights.................................................................................................................. 15%

The right of transgender/gender non-conforming people to parent, including adoption .............................................................. 14%

HIV prevention, education and treatment....................................................................................................................................... 11%

Allowing transgender/gender non-conforming people to serve in the military ................................................................................ 7%

Immigration policy reform (such as asylum or partner recognition) ................................................................................................. 5%

Employment non-discrimination was the highest ranking priority for the sample overall as well
as for all races and genders except for transgender men. FTM respondents ranked “Getting
transgender-related health care covered by insurance” irst (72%), followed by “Protecting
transgender/non-conforming people from discrimination in hiring and at work” (67%).
Although their top priorities were the same as the overall sample, African American respondents
marked both “HIV prevention, education, and treatment” (43%) and “Transgender/gender non-
conforming prisoner’s rights” (23%) more often than the overall sample (11% and 15%). Also,
Latino/a respondents were three times more likely to have marked “Immigration policy reform
(such as asylum or partner recognition)” (15%) than the overall sample (5%).
 CONCLUSION 179

CONCLUSION
This report thoroughly documents the injustices that transgender and gender non-conforming people
face at every turn. In fact, study respondents were more likely to have experienced harassment at
work, at school, in the doctor’s oice, or on the street than to have escaped such mistreatment. Over
and over again, respondents were ired, evicted, denied medical care, faced dire poverty or were
bullied in school at rates far above the national average. People of color very clearly experienced the
compounding and devastating efects of racism, with far higher levels of discrimination and poorer
health outcomes than the sample as a whole.
Working on this report has been challenging for the researchers as we have catalogued the many
ways in which people are mistreated and abused, and we assume it has been challenging reading
as well. Tremendous damage results from institutional structures weighted against transgender
and gender non-conforming people and from blatant acts of personal prejudice perpetrated
against them just because they are diferent. Sometimes there are oicial policies in place that
make it acceptable to discriminate against transgender people; in other cases, social customs or
culture sanction bias and mistreatment.
We hope, however, that one thing stands out for you as it does for us: the remarkable resilience
of transgender and gender non-conforming people and their families. These are people who
continue to live and move forward in spite of the most daunting obstacles. They faced serious
barriers to health care, and yet were able to access necessary transition-related care. Teachers
and other school oicials physically and sexually assaulted transgender and gender non-
conforming students, and yet, although some were forced to leave school because of extreme
bullying, the sample as a whole achieved a high level of educational attainment. Despite
the stereotypes of broken families, and in light of all the stresses discrimination places on
relationships, respondents maintained relationships with their partners, children and families.
A quarter of respondents have endured multiple acts of discrimination, any one of which would
seriously impact a person’s life, and combined would be catastrophic, and yet they persevere.
It is in the spirit of transgender and gender non-conforming people everywhere who continue
to thrive and contribute to their communities, despite all of the injustices they sufer and the
barriers to their well-being that they face, that we present this report with the determination that
it will move us forward as a community. We recognize, too, that there are many, many people
we have lost along the way, who have been unable to survive the unremitting discrimination,
harassment and violence that they have encountered. We can honor them by working for a world
in which transgender and gender non-conforming people are free to live without fearing the
marginalization and abuse detailed here, in ways that respect every individual’s right to self-
determination and airm our collective humanity.

“Even had I known the inancial, legal, emotional, and physical obstacles that I
would face, I would still have chosen to transition and live as I do today.”
180 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

APPENDIX A: GLOSSARY

AG or Aggressive A masculine identiied woman; primarily used identities that our respondents identiied with, such as MTF, FTM,
in communities of color. transgender, genderqueer, etc.

Androgynous Refers to those whose appearance and identity do Gender Non-Conforming

not conform to conventional views of masculinity or femininity, A term for individuals whose gender expression is diferent from
and who either combine aspects of both femininity and societal expectations and/or stereotypes related to gender. For
masculinity or who present in a non-gendered way. the purposes of this report, we include individuals identiied
with a number of gender non-conforming identities in Question
Butch An identity term used by some masculine lesbian women. 4 (see the Portrait chapter for more information). Although it is
It is also used by others who have a masculine presentation, not often abbreviated to GNC, we have done so in this report for
regardless of their sexual orientation or gender. labeling charts.

Cross-Dresser A term for people who dress in clothing not Genderqueer

typically worn by their assigned birth sex, but who generally do not A term used by individuals who identify as neither entirely male
desire to live full-time as the other gender. For the purposes of this nor female, identify as a combination of both, or who present in a
study, the term cross-dresser refers to those who identiied with non-gendered way.
the term cross-dresser in Question 4 (for more information, see the
Portrait chapter). Gender Variant
A synonym for gender non-conforming.
Drag King A term generally used to refer to women who
occasionally dress as men or express female masculinity for GNC
personal satisfaction or for the purpose of entertaining others at See gender non-conforming.
bars, clubs or other venues. Some transgender men also use this
term to describe their identity. Hormone Therapy
The administration of hormones to facilitate the development
Drag Queen A term generally used to refer to men who of secondary sex characteristics as part of a medical transition
occasionally dress as women for personal satisfaction or for the process. Those medically transitioning from female to male may
purpose of entertaining others at bars, clubs or other venues. It is take testosterone while those transitioning from male to female
also used incorrectly, sometimes in a derogatory manner, to refer may take estrogen and androgen blockers.
to all transgender women.
Intersex
Drag Performer A term used to refer to Drag Kings and Drag Generally, a term used for people who have Diferences of
Queens who entertain others at bars, clubs or other venues. Some Sex Development, such as being born with external genitalia,
transgender people perform drag. chromosomes, or internal reproductive systems that are not
traditionally associated with typical medical deinitions of male
Feminine Male A person assigned male at birth who has a or female. In this survey, we inquired about whether respondents
feminine identity or prefers a feminine appearance, or who identiied with the term intersex, rather than asking about
otherwise express femininity. medical diagnoses.

FTM A person who transitions “from female to male,” meaning a MTF A person who transitions “from male to female,” meaning
person who was assigned female at birth, but identiies and lives a person who was assigned male at birth, but identiies and lives
as or hopes to live as a male. We also use the term “transgender as or hopes to live as a female. We also use the term “transgender
man” as a synonym. woman” as a synonym.

Gender Expression How a person presents or expresses his or Queer A term used to refer to lesbian, gay, bisexual and/or
her gender identity to others, often through manner, clothing, transgender people or the LGBT community. For some, the term is
hairstyles, voice or body characteristics. useful to assert a strong sense of identity and community across
sexual orientations and gender identities. For others, it refers
Gender Identity In general, this refers to an individual’s internal
to the lesbian/gay/bisexual part of the community. Used as a
sense of gender. Since gender identity is internal, one’s gender
reclaimed epithet for empowerment by many, it is still considered
identity is not necessarily perceived by or visible to others. In this
by some to be a derogatory term.
report, we use this term to refer generally to the full range of
 APPENDIX A: GLOSSARY 181

Sexual Orientation A term describing a person’s attraction to Transgender Woman A term for a transgender individual who,
members of the same gender and/or diferent gender. Usually assigned male at birth, currently identiies as a woman. In this
deined as lesbian, gay, bisexual, or heterosexual and can also report, we use transgender woman, male-to-female transgender
include queer, pansexual and asexual, among others. person, and MTF interchangeably.

Sex Reassignment Surgery A term that refers to various Transition The period during which a person begins to live
surgical procedures that change one’s body to align gender as a new gender, as opposed to living as the sex assigned at
identity and presentation. Contrary to popular belief, there birth. Transitioning may include changing one’s name, taking
is not one surgery; in fact there are many diferent surgeries. hormones, having surgery, or changing documents (e.g. driver’s
“Sex change surgery” is considered a derogatory term by some. license, Social Security record, birth certiicate) to relect one’s
Examples of sex reassignment surgery include: new gender.
• Breast Augmentation The surgical enlargement
Transsexual A term for people whose gender identity is diferent
of breast tissue as part of gender reassignment from their assigned sex at birth and who live in a gender diferent
for male-to-female patients when the breasts do from their birth sex, or desire to do so. Often, but not always,
not grow suiciently with hormone therapy. transsexual people alter or wish to alter their bodies through
• Chest Surgery The removal of breasts (mastectomy) hormones or surgery in order to align themselves physically with
in transgender men or the augmentation their gender identity.
of breasts for transgender women.
Two-Spirit A term that references historical multiple-gender
• Clitoral Release See metoidioplasty.
traditions in some of the native cultures of North America. Some
• Hysterectomy The surgical removal of the uterus. American Indian/Alaska Native people who are lesbian, gay,
bisexual, transgender, intersex or gender non-conforming identify
• Metoidioplasty A surgical procedure to create a neopenis
as Two-Spirit.
by releasing and extending the clitoris, often combined
with surgery to allow for urination through the penis. Underground Economy A term that refers to marginal or
• Oophorectomy The surgical removal of the ovaries. informal economies, such as those relating to drug sales,
sex work, panhandling and other street sales. Work in the
• Orchiectomy The surgical removal of the
underground economy may be the only income-generating option
testes (the scrotum and testicles).
for those who experience barriers to formal employment.
• Phalloplasty The surgical creation of a penis.
Visual Non-Conformer A term we developed to describe a
• Vaginoplasty The surgical creation of a vagina.
person whose gender presentation and/or gender identity are not
Third Gender A person whose gender identity is neither male nor aligned in the eyes of passing strangers or casual observers. For
female but a third option. example a transgender man who is perceived as female by a clerk
in a store; or a transgender woman who is seen as male by a front
Transgender Generally, a term for those whose gender identity desk person at a hotel. The opposite term is “visual conformer”
or expression is diferent than that typically associated with their which refers to people whose gender identity and presentation
assigned sex at birth, including transsexuals, androgynous people, match in casual situations; this is sometimes called “passing.”
cross-dressers, genderqueers, and other gender non-conforming
people who identify as transgender. Some, but not all, of these
individuals desire to transition gender; and some, but not all, Additional Note on Usage:
desire medical changes to their bodies as part of this process.
Throughout the report, we used the phrase “because they were
In this report, in order to see the experiences of diferent types
transgender or gender non-conforming” interchangeably with
of transgender people more clearly, cross-dressers and gender
“because of gender identity/expression.”
non-conforming people are not included in the term transgender
and are reported about separately. For more information, see
the Portrait and Methodology chapters and Appendix B: Survey
Instrument—Issues and Analysis.

Transgender Man A term for a transgender individual who,

assigned female at birth, currently identiies as a man. In this
report, we use transgender man, female-to-male transgender
person, and FTM interchangeably.
182 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

APPENDIX B:
THE SURVEY INSTRUMENT — ISSUES AND ANALYSIS
It was our intention to use this irst large national survey to broadly explore issues of
discrimination. As such, the questionnaire was quite lengthy, yet limited in the depth into each
topic we delved. We encourage other researchers to use this as a starting point to dig deeper into
areas of particular interest.
As we analyzed our data, we were able to get a better sense of the strengths and weaknesses of
our survey instrument. There are choices we made that were appropriate for our study that may
not be appropriate for others; some choices have made our work diicult, but may make others’
work more layered and interesting.1 We consider these possibilities here in the spirit of expanding
our collective learning.
We informally tested the questionnaire to attempt to identify and correct problems with speciic
questions before we ielded the survey. We would have liked more time and resources to test
questions more robustly.
Imperfections in the posing of questions emerged during our data analysis phase. Here, we
discuss each of the survey questions, provide any notable information about how we analyzed
the data that came from the question, and, when relevant, note what we would recommend be
changed or could be changed about the question.
 APPENDIX B: THE SURVEY INSTRUMENT — ISSUES AND ANALYSIS 183

Directions
The Questionnaire
Please read and answer each question carefully. For each answer, darken the appropriate oval completely. If you want to change an
answer, erase your first answer completely and darken the oval of your new answer. You may decline to answer specific questions.

“Transgender/gender non-conforming” describes people whose gender identity or expression is different, at least part of the time,
from the sex assigned to them at birth.

1. Do you consider yourself to be transgender/gender non-conforming in any way?

Yes
No. If no, do NOT continue.
Directions
2. What sex were you assigned at birth, on your original birth certificate?
Anyone who answered Male
“No” to this irst question was excluded from our sample. Anyone who left this question blank was included
Please read and answer each question carefully. For each answer, darken the appropriate oval completely. If you want to change an
Female
or excluded answer,
based onerase youranswers
their first answer completely
to other and darken
questions. the oval of your included
We intentionally new answer. You may decline
respondents in thetosample
answer specific
who did questions.
not identify as
Directions
transgender3. What is your
because we primary gender
wanted
“Transgender/gender
to identity
include today?non-conforming people. We understood that by gathering data on gender identity/
gender
non-conforming” describes people whose gender identity or expression is different, at least part of the time,
Male/Man
Please aread
from the
expression across sex and answer
assigned
broad to each
spectrum, question
themand
at birth.
posing carefully. For each
questions in a answer,
mannerdarken the appropriate
that would make itoval completely.
possible If you wanttransgender
to distinguish to change an and
Female/Woman
answer, erase your first answer completely and darken the oval of your new answer. You may decline to answer specific questions.
gender non-conforming Part respondents
time as one gender,
for part timewe
analysis, as another
could discover and report on diferences across the spectrum when considerable or
1. Do you Aconsider
gender yourself
not listedtohere,
be transgender/gender non-conforming in any way?
please specify ___________________________________
relevant. “Transgender/gender
Yes non-conforming” describes people whose gender identity or expression is different, at least part of the time,
from the sex
No.assigned
If no, do to them
NOT at birth.
continue.
4. For each term listed, please select to what degree it applies to you.
1. What
2. Do you consider
sex were youyourself to beattransgender/gender
assigned non-conforming
birth, on your original in any way?
birth certificate?
Yes
Male

Somewhat
No. If no, do NOT continue.
Female

Not at all

Strongly
2. What
3. What is
sex were
your you assigned
primary at birth,today?
gender identity on your original birth certificate?
Male
See note after question 3.
Male/Man
Female
Female/Woman
Transgender
Part time as one gender, part time as another
3. What is Ayour
Transsexual primary gender identity today? Directions
gender not listed here, please specify ___________________________________
Male/Man
FTM (female to male)
Please
MTF read and answer
Female/Woman
(male each question carefully. For each answer, darken the appropriate oval completely. If you want to change an
4. For each termtolisted,
female)please select to what degree it applies to you.
answer, erase
IntersexPart your
time first
as oneanswer completely
gender, part timeandas darken
anotherthe oval of your new answer. You may decline to answer specific questions.
Gender A gender not listedor
non-conforming here, please
gender specify ___________________________________
variant
“Transgender/gender
Genderqueer non-conforming” describes people whose gender identity or expression is different, at least part of the time,

Somewhat Somewhat
from
4. Forthe sexterm
each
Androgynous assigned
listed,toplease
them at birth.to what degree it applies to you.
select

Not at all Not at all

Strongly
Anyone who chose Feminine male
one sex/gender for Question 2 and a diferent sex/gender for Question 3 was included in the sample as a
1. DoMasculine
you consider female yourself
or butchto be transgender/gender non-conforming in any way?
transgender person. Those
Yes
A.G. or Aggressive
who marked the same gender for both questions, or chose the “part-time” or “gender not listed here”
options in 3, wereThird No. If no, do NOT continue.
gender as transgender or gender non-conforming, depending on their answers to other questions.
classiied

Strongly
Transgender
Cross dresser
2. What sex
Transsexual were you
Drag performer assigned at birth, on your original birth certificate?
(King/Queen)
Going through the FTM Male to
(female
write-in
Two-spirit male) to Question 3 was time-consuming, but very helpful. We found hundreds of “genders-not-listed-
answers
MTF
Other, Female
(male
please to female)
specify _________________________________________________________
here” among our respondents.
Transgender We had anticipated that using the answers to Questions 2 and 3 would more easily help us categorize
Intersex
3. Transsexual
5. What
our respondents People is can
Gender
into your
MTF primary
non-conforming
tell gender
transgender, or identity
gender today?
variant
FTM transgender,
I’m transgender/gender andeven
non-conforming gender non-conforming
if I don’t tell them. categories. However, we had to rely heavily on
FTM (female
Male/Man to male)
questions 4 andGenderqueer
7
MTF to Always
better
(male determine
to female) how to it respondents into these constructs. This showed the value of asking more complicated,
Female/Woman
Androgynous
Most of the time
Intersex
Feminine
qualitative questions Part time
male
about as
genderone gender,
identity. part time as another
Sometimes
Gender A
Masculine non-conforming
gender
female notorlisted
butchor gender
here, pleasevariant
specify ___________________________________
Occasionally
Genderqueer
A.G. or Aggressive
Never
Androgynous
4. For each
Third term listed, please select to what degree it applies to you.
gender
Feminine
Cross dressermale
Masculine
Drag performer female or butch
(King/Queen)
A.G. or Aggressive
Two-spirit
Somewhat

Third
Other,gender
Not at all

please specify _________________________________________________________

Strongly

Cross dresser
Drag performer
5. People can tell I’m(King/Queen)
transgender/gender non-conforming even if I don’t tell them.
Two-spirit
Always
Other,Mostplease specify
of the time _________________________________________________________
Transgender
Sometimes
Transsexual
5. People Occasionally
can tell I’m transgender/gender non-conforming even if I don’t tell them.
FTM (female
Always to male)
Never
MTF (male
Most of to the
female)
time
IntersexSometimes
Gender non-conforming or gender variant
Occasionally
Genderqueer
Never
Androgynous
Feminine male
Masculine female or butch
A.G. or Aggressive
Third gender
Cross dresser
Drag performer (King/Queen)
Two-spirit
Other, please specify _________________________________________________________

5. People can tell I’m transgender/gender non-conforming even if I don’t tell them.
Always
Most of the time
Sometimes
Occasionally
 4. For each term listed, please select to what degree it applies to you.

184 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Somewhat
Not at all

Strongly
We used the answers to this question to better craft the categories of MTF and FTM, and transgender and gender non-conforming. In
Transgender
our analysis, weTranssexual
found it very valuable to have asked questions about cross-dressing and living in one’s gender part time (Question
FTM (female to male)
3) because the experiences of people living part-time in one gender and part-time in another, and those of cross-dressers, are often
MTF (male to female)
Intersex
trivialized and little studied.
Gender non-conforming or gender variant
Genderqueer
At the stage of analysis, these multilayered responses provided challenges but also a wealth of opportunities for interpretive work.
Androgynous
Feminineidentity
Asking more simpliied male questions would create more simpliied categories. As a project with limited staf resources and
Masculine female or butch
seemingly indefatigable volunteers,
A.G. or Aggressive we found our dedication to nuance and complexity extremely challenging and, in most cases, very
Third gender
worthwhile. We realize that within the LGBT movements, our two study partner organizations collectively have much larger resources
Cross dresser
to draw from thanDragmost state (King/Queen)
performer or local community-based organizations. We would caution others to consider these costs when choosing
between simple Two-spirit
and more complex ways of asking these questions.
Other, please specify _________________________________________________________

5. People can tell I’m transgender/gender non-conforming even if I don’t tell them.
Always
Most of the time
Sometimes
Occasionally
Never

We included this question so that people who are identiiable as transgender or gender non-conforming by strangers or acquaintances
because of how they look or sound could be tracked throughout the study. We used this question to develop the concept of “visual
conformers” and “visual non-conformers.” We grouped “never” and “occasionally” into the “conforming” category, and the other
answers into the “non-conforming” categories.

6. I tell people that I’m transgender/gender non-conforming. (Mark all that apply.)
Never
People who are close friends
Casual friends
Work colleagues
Family
Everyone
6. I tell people that I’m transgender/gender non-conforming. (Mark all that apply.)
7. How many Never
people know or believe you are transgender/gender non-conforming in each of the following settings? Mark all that
apply. People who are close friends
The inclusion of “everyone” as an answer choice left some ambiguity as to which people in the respondents’ lives they have actually
Casual friends
Work colleagues
told, because it is possible that a respondent did not have people of all the listed types in their lives at the time of the survey. See also
Family

applicable
the note after question 7.
Everyone
Some
A few
None

Most

Not
7. How many people know or believe you are transgender/gender non-conforming in each of the following settings? Mark all that
All

apply.
At home
On the job applicable
At school
In private social settings
Some
A few
None

Most

Not

In public social settings

All

When seeking medial care

8. ToAtthe
home
best of your ability, please estimate the following ages, if they apply to you. Mark “N.A.” if not applicable or if you have no
Ontothe
desire job
transition. Please mark each line.
At school
In private social settings
In public social settings
applicable

When seeking medial care

Age in
years

Not

We used the8.answers
To the best of your ability,
to Questions 6 please
and 7 estimate
to dividetherespondents
following ages, if they
into apply to you.
“generally out”Mark
and“N.A.” if not applicable
“generally closeted.”or ifPeople
you have
whono were out to
desire to transition. Please mark each line.
“most” or “all” on the job, at school, or “in public social settings,” (Question 7) or who said they tell casual friends, work colleagues, or
Age you first recognized that you were “different” in terms of your gender. ______
“everyone” theyAge
are you
transgender or gender
first recognized non-conforming (Question 6)identity
your transgender/gender-non-conforming were identiied as “generally out.” Everyone else was identiied
______
applicable

Age you began

as “generally closeted.” We only to live part time
found as a transgender/gender
a small number of respondentsnon-conforming
who wereperson.
only out to close friends ______
and family members.
Age in

Age you began to live full time as a transgender/gender non-conforming person. ______
years

Not

Age that you first got any kind of transgender-related medical treatment. ______
Your current
Our analysis indicated thatage _______complex.
the six answer options for each of the six settings in Question 7 was unnecessarily
Age you first recognized that you were “different” in terms of your gender. ______
We also used9. the
Do you or do you want to live full-time in a gender that is different from you gender at birth?
answers
Age you first
Yes,
in Question
recognized
I currently
7 to
liveyour
determine who was out whenidentity
transgender/gender-non-conforming
full-time in a gender different from my birth
seeking
gender.
medical care, on the job, and at home.
______
Age you
Notbegan to live
full-time yet, part time as a Itransgender/gender
but someday want to. non-conforming person. ______
Age you
In the questionnaire, No,began
I dowas
there to want
not live full
to time as a transgender/gender
live full-time.
a typographical non-conforming
error in the question person. care so that it reads
about “medical” ______
“medial.” We do not believe
Age that you first got any kind of transgender-related medical treatment. ______
this mistake10.
impacted
Your is
What
responses.
current agecode?
your zip _______
ZIP ___________
9. Do you or do you want to live full-time in a gender that is different from you gender at birth?
Yes,
11. What is yourI currently live full-time
race/ethnicity? (Mark inallathat
gender different from my birth gender.
apply.)
Not full-time yet, but someday I want to.
White
No, I do
Black or not wantAmerican
African to live full-time.
 6. I tell people that I’m transgender/gender non-conforming. (Mark all that apply.)

Al
M
N

N
A

a
Never
At home People who are close friends
On theCasual
job friends
Workthat colleagues APPENDIX B: THE SURVEY INSTRUMENT — ISSUES AND ANALYSIS 185
At school
6. I tell people I’m transgender/gender non-conforming. (Mark all that apply.)
Family
In private
Never social settings
In publicEveryone
social
People who settings
are close friends
WhenCasualseekingfriendsmedial care
7. How many Work people know or believe you are transgender/gender non-conforming in each of the following settings? Mark all that
colleagues
apply.
8. To the best Familyof your ability, please estimate the following ages, if they apply to you. Mark “N.A.” if not applicable or if you have no
6. I tell people that I’m transgender/gender non-conforming. (Mark all that apply.)
desire to transition.
Everyone Please mark each line.
Never
People who are close friends

applicable
7. How many people
Casual know or believe you are transgender/gender non-conforming in each of the following settings? Mark all that
friends

applicable
apply.

Some
A few
None
Work colleagues

Most

NotNot
Age in

All
Family

years
Everyone

applicable
At home
7. How many people know or believe you are transgender/gender non-conforming in each of the following settings? Mark all that

Some
A few
None
On
Agethe youjob

Most
first recognized that you were “different” in terms of your gender. ______

Not
apply.

All
At
Age school
you first recognized your transgender/gender-non-conforming identity ______
In
Age private social to
you began settings
live part time as a transgender/gender non-conforming person. ______
In
At public
Age social settings
you began
home to live full time as a transgender/gender non-conforming person. ______

applicable
When
Agethe
On seeking
that you first
job medial
got any carekind of transgender-related medical treatment. ______

Some
Your current age _______

A few
At school

None

Most
8. ToInthe best social
of yoursettings
ability, please estimate the following ages, if they apply to you. Mark “N.A.” if not applicable or if you have no

Not
private

All
desire
9. DoInyouto transition.
or do
public socialyouPlease
want tomark
settings each line.
live full-time in a gender that is different from you gender at birth?
When
We used this question Yes,
to Idetermine
seeking currently
mediallive care full-timeage.
current in a gender
We also different
used thefromage
my birth
thatgender.
a person “began to live full time” as the age that a person
At home
Not full-time yet, but someday I want to.
transitioned.8. ToOn the job

applicable
No, Iofdoyour not ability,
want toplease live full-time.
Atthe best
school estimate the following ages, if they apply to you. Mark “N.A.” if not applicable or if you have no

Age in
desire to transition.
socialPlease mark each line.

years
In private settings
The answer 10. What is yourbezip code?

Not
ield Inshould
public social limited
settingsto accept only numerical data with ages as choices, which was not done here so we needed to clean
ZIP ___________
When seeking
these data. In addition, it may medial
havecare been better to list current age at the beginning, to increase response rates.

applicable
Age you
11. What firstrace/ethnicity?
is your recognized that(Mark you were “different”
all that apply.)in terms of your gender. ______

Age in
8. ToAgethe you
bestfirst
of your ability, please estimate the following ages, if they identity apply to you. Mark “N.A.” if not applicable or if you have no

years
There is a veritable White recognized
treasure trove of your transgender/gender-non-conforming
information here for understanding the trajectory of coming into ______
one’s gender identity and

Not
desireAge to you
transition.
began Please
to live marktime
part each as line.
a transgender/gender non-conforming person. ______
Black or African American
living as one’s preferred
Age you gender
began
American to alongside
live
Indian full time as
or Alaska such issues as health
a transgender/gender
Native (enrolled outcomes,
non-conforming
or principal family acceptance and discrimination.
person.
tribe) ___________________________________ ______ For example, future
researchers could Age
Age that
use you recognized
Hispanic
you first
these first
or got
data toany
Latino kindyou
that
determine of transgender-related
were how “different”
recently medical
in terms treatment.
of your
respondents gender.
transitioned or when they transitioned ______
______ by decade.

applicable
Youryou
Age current
firstorage
Asian Pacific Islander
recognized your transgender/gender-non-conforming identity _______
______

Age in
Arab or Middle
to liveEastern

years
Age you began part time as a transgender/gender non-conforming person. ______
9. DoAgeyouyou or do you towant tofull
live full-time in a gender that is different from youperson.
gender at birth?

Not
Multiracial
began orlive
mixed race
time as a transgender/gender non-conforming ______
Age that Yes,you I currently
first got anylive full-time in a gender differentmedical
kind of transgender-related from my birth gender.
treatment. ______
Youryou Not
currentfull-time
age yet, but someday I want to. _______
Age No,first
I dorecognized
not want tothat liveyou were “different” in terms of your gender.
full-time. ______
Age you first recognized your transgender/gender-non-conforming identity ______
9. DoAgeyouyou or do
began you want
to to
live who live
part time full-time in a gender
astransitioned, that
a transgender/gender is different from
non-conforming you gender
person. at birth? ______
We used this10.
answer
What is to determine
your
Yes, zip code?
I currently
had who wanted to, and who did not want to. If they had transitioned, we put
AgeZIPyou began
___________ to livelivefull full-time
time as aintransgender/gender
a gender different from my birth gender.
non-conforming person. ______
them in the transgender Not full-time
category, yet, but
regardlesssomeday if I want
they to.
did
Age that you first got any kind of transgender-related medical treatment.not use that term to describe themselves in Question
______4.
Your is No, I doage
current not want to live full-time. _______
11. What your race/ethnicity? (Mark all that apply.)
10. What White
9. Do youis oryour
do you
Black
zip want
code?to live full-time in a gender that is different from you gender at birth?
or African American
ZIP Yes,
___________
American Indianlive
I currently full-timeNative
or Alaska in a gender different
(enrolled from my
or principal birth
tribe) gender.
___________________________________
Not full-time
Hispanic or yet,
Latino but someday I want to.
11. What is your
No, I do race/ethnicity? (Mark all that apply.)
Asian
White to or not wantIslander
Pacific to live full-time.
We used this information Arab or determine
Middle Eastern respondents’ state of residence and region, as well as whether they were “urban” or “rural” using
10. What Black
is your or
zipAfrican
code? American
the RUCA system. We Multiracial
did not or
use mixed
the race
rural/urban classiication to analyze our data but future researchers may do so.2
ZIP American
___________ Indian or Alaska Native (enrolled or principal tribe) ___________________________________
Hispanic or Latino
11. What is Asian
your or Pacific Islander
race/ethnicity? (Mark all that apply.)
Arab
Whiteor Middle Eastern
Multiracial
Black or African or mixed race
American
American Indian or Alaska Native (enrolled or principal tribe) ___________________________________
Hispanic or Latino
Asian or Pacific Islander
Arab or Middle Eastern
Multiracial or mixed race

We intentionally deviated from the Census-style race question here for the purpose of brevity. Thus, we don’t have exact Census
categories to match our sample with the nation as a whole, but we do have a set of categories we can align with Census data. It is
usually simpler for comparative purposes to draw on existing questions in federal surveys, but we continue to believe we made the right
decision.
186 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

12. What is the highest degree or level of school you have completed? Mark ONE box. If you are currently enrolled, please mark the
previous grade or highest degree received.
Elementary and/or junior high
Some high school to 12th grade
High school graduate - high school Diploma or the equivalent (for example: GED)
Some college credit, but less than 1 year
Technical school degree (such as cosmetology or computer technician)
One or more years of college, no degree
Associate degree (for example: AA, AS)
Bachelor’s degree (for example: BA, AB, BS)
Master’s degree (for example: MA, MS, MEng, MEd, MSW, MBA)
12. What is the highest degree
Professional degree (for or level of school
example: MD,you
DDS,have
DVM,completed?
LLB, JD) Mark ONE box. If you are currently enrolled, please mark the
previous grade or highest
Doctorate degree degree received.PhD, EdD)
(for example:
Elementary and/or junior high
13. What is Some
your high school
current gross to annual
12th grade
household income (before taxes)?
We primarily used these High data
Less school after grouping
graduate
than $10,000
respondents
- high school Diplomainto categories.
or the We example:
equivalent (for developed the categories of “no high school diploma,”
GED)
“high school diploma,” Some
$10,000
“some college credit,
to college” but less than 1 year
$19,999 (which included Associate degrees and technical degrees) “college degree,” and “graduate/
Technicaltoschool
$20,000 $29,999 degree (such as cosmetology or computer technician)
professional degree.”$30,000
Fororother
One more surveys, it may no
years of college,
to $39,999
bedegree
simpler to ask about condensed categories like these. However, we opted for a
question that used more Associate
$40,000 todegree
speciic $49,999 (for example:
categories so thatAA,future
AS) researchers will be able to make more precise comparisons with general
Bachelor’s
$50,000 to degree
$59,999(for example: BA, AB, BS)
population data from$60,000
federal
Master’s to surveys.
degree
$69,999 (for example: MA, MS, MEng,future
We would encourage researchers
MEd, MSW, MBA) to design questions in such a way as to best meet their
Professional
$70,000
needs for comparative data. to degree
$79,999 (for example: MD, DDS, DVM, LLB, JD)
Doctoratetodegree
$80,000 $89,999 (for example: PhD, EdD)
$90,000 to $99,999
13. What is your current
$100,000 gross annual household income (before taxes)?
to $149,999
Less
$150,000than to $10,000
$ 199,999
$10,000
$200,000toto$19,999 $250,000
$20,000
More than to $250,000
$29,999
$30,000 to $39,999
14. How many$40,000peopleto $49,999
live in your household?
Number$50,000 to $59,999
_______
$60,000 to $69,999
15. How many$70,000 to $79,999
children currently rely on your income?
Number$80,000 to $89,999
_______
$90,000 to $99,999
16. What is $100,000 to $149,999
your relationship status?
12. What is $150,000
Single
the highest to $degree
199,999 or level of school you have completed? Mark ONE box. If you are currently enrolled, please mark the
$200,000
Partnered
previous grade to $250,000
or highest degree received.
More
Civil than $250,000
union
Elementary and/or junior high
Married
Some high school to 12th grade
14. How manyHigh people
school live
Separated in your
graduate household?
- high school Diploma or the equivalent (for example: GED)
Number
We asked respondents _______
only
Divorced
Some aboutcredit,
college householdbut lessincome,
than 1 year not individual income. Therefore, we do not know to what extent our respondents
had access to the Widowed
Technical
income they school
reported.degree (such
The as cosmetology
income ranges or computerintechnician)
presented the survey instrument vary slightly from increments
15. How manyOne children
or more years currently rely on your
of college, income?
no degree
commonly reported Number
Importantby Note: _______
the When
Associate U.S. Census
degree (for Bureau
we say: example:in
“Because tables
you
AA, and fact sheets created
are transgender/gender
AS) from the
non-conforming, American
has one or twoCommunity Survey
of these things happened (ACS)
to and the
you,” we Survey
Current Population do not mean
Bachelor’s that We
degree
(CPS). your
(forgender
example:
utilized identity
theBA,CPSor expression
AB, BS) useisdata
public causing
to bad or abusive
construct things
income to happen.
ranges that We are trying
matched to findreported
ranges out if on our
16. What
people areis your relationship
treating
Master’s you differently
degree (forstatus?
example:because you are
MA, MS, transgender
MEng, MEd, MSW, or gender
MBA) non-conforming.
Single
survey instrument, allowing us to compare our sample’s
Professional degree (for example: MD, DDS, DVM, LLB, JD) household income to that of the general population.
17. Because Partnered
I am transgender/gender
Doctorate degree (for example: non-conforming,
PhD, EdD) life in general is:
Civil
Much union
improved
This way of asking the question
Married did not allow us to say who was above or below the poverty line. Poverty lines are determined
13. What is Somewhat
your current improved
gross annual household income (before taxes)?
Separated
separately for individuals
The
Less and$10,000
same
than families of various sizes, but our questions did not capture household size nor did the survey ask about
Divorcedto worse
income with enoughSomewhat
$10,000
speciicity$19,999
Widowed for us to determine whether a given household was above or below the line. This would have been
Much
$20,000 worse
to $29,999
important data. In some ways
$30,000 better, in some ways worse
to $39,999
Important$40,000
Note: When we say: “Because you are transgender/gender non-conforming, has one or two of these things happened to
to $49,999
you,” we do not
$50,000 mean that
to $59,999 your gender identity or expression is causing bad or abusive things to happen. We are trying to find out if
Asking aboutpeople
household income
treating likely slightly compromised our ability to detect the efect of discrimination on income. For example, if
are$60,000 toyou differently
$69,999 because you are transgender or gender non-conforming.
a transgender person$70,000
who was to $79,999
ired from his or her job lives with a spouse who is working, all we can look at is their joint income. Or,
17. Because I am transgender/gender
$80,000 to $89,999 non-conforming, life in general is:
if a gender non-conforming
Much improvedperson was ired, and has moved back in with parents, the parents’ income might be included, which would
$90,000 to $99,999
Somewhattoimproved
also be misleading. $100,000 $149,999
The sameto $ 199,999
$150,000
Somewhat worse
$200,000 to $250,000
Future research would Much getworse
a clearer picture by looking at both individual and household income.
More than $250,000
In some ways better, in some ways worse
14. How many people live in your household?
Number _______

15. How many children currently rely on your income?

Number _______
These data were unusable because we did not clarify whether the person should include his or herself in the answer (thus, an answer of
1 might mean they live alone or it might mean they live with one other person).
16. What is your relationship status?
Single
Partnered
Civil union
Married
Separated
Divorced
Widowed
 Technical
Doctoratetoschool
$80,000 degree
$89,999 degree (such as
(for example: cosmetology
PhD, EdD) or computer technician)
One or more
$90,000 years of college, no degree
to $99,999
Associate
13. What is your current
$100,000 degree
to gross(forannual
$149,999 example: AA, AS) income (before taxes)?
household
Bachelor’s
Less
$150,000than to degree
$10,000 (for example: BA, AB, BS)
$ 199,999
Master’s to
$10,000
$200,000 degree
to$19,999 (for example: MA, MS, MEng, MEd, MSW, MBA)
$250,000
12. What is the highest degree or level of school you have completed? Mark ONE box. If you are currently enrolled, please mark the
Professional
$20,000
More than degree (for example: MD, DDS, DVM, LLB, JD) APPENDIX B: THE SURVEY INSTRUMENT — ISSUES AND ANALYSIS 187
to $250,000
$29,999
previous grade or highest degree received.
Doctoratetodegree
$30,000 $39,999 (for example: PhD, EdD)
Elementary and/or junior high
$40,000
14. How many
Somepeople to $49,999
high live in to
school your household?
12th grade
13. What is
Numberyour current
$50,000 gross annual household income (before taxes)?
to $59,999
High_______
school graduate - high school Diploma or the equivalent (for example: GED)
Less
$60,000 than $10,000
to $69,999
Some college credit, but less than 1 year
$10,000
$70,000
15. How many to $19,999
children $79,999
currently rely on your income?
Technical school degree (such as cosmetology or computer technician)
$20,000
$80,000
Number to $29,999
$89,999
One _______
or more years of college, no degree
$30,000
$90,000 to $39,999
$99,999
Associate degree (for example: AA, AS)
16.was
This question What $40,000
$100,000
is attobest.
$49,999
todegree
your relationship
inartful $149,999status?
First, because BA, of the
Bachelor’s (for example: AB,phrase
BS) “rely on your income,” this question did not gauge how many children
$50,000
$150,000
Single toto$59,999
$ 199,999
Master’s
our respondents were$60,000
raising degree
or had(for example:
raised in MA,past.
the MS, MEng,
Second, MEd, it MSW, MBA) doesn’t even refer to any parental status — children
technically
$200,000
Partnered to $69,999
to $250,000
Professional degree (for example: MD, DDS, DVM, LLB, JD)
$70,000
More
Civil
relying on income could union
refer to $79,999
than degree
$250,000
to a grandchild orPhD,
niece/nephew or anyone. Simpler, standard questions relating to parental status,
Doctorate (for example: EdD)
$80,000
Married to $89,999
number of children
14. and child-rearing
$90,000 to $99,999 responsibilities should be used. It might also be helpful include a question about adult
13. How
Whatmany people
Separated
is your current live in your
gross household?
annual household income (before taxes)?
$100,000
Number
dependants, such as Less _______
Divorced
elderly to $149,999
thanparents.
$10,000
$150,000
Widowedtoto$19,999 $ 199,999
$10,000
$200,000
15. How many children to $250,000
currently rely on your income?
See note on Important
Question $20,000
20_______
for to
how$29,999
we determined parental status.
More
Number
Note: than
When $250,000
we say: “Because you are transgender/gender non-conforming, has one or two of these things happened to
$30,000 to $39,999
you,” we do not mean
$40,000 to $49,999 that your gender identity or expression is causing bad or abusive things to happen. We are trying to find out if
14.
16. How
What many
is your people
treating livedifferently
relationship in your household?
status?
people are$50,000 toyou
$59,999 because you are transgender or gender non-conforming.
Number
Single_______
$60,000 to $69,999
Partnered
17. Because I am transgender/gender
$70,000 to $79,999 non-conforming, life in general is:
15. How many
Muchchildren
Civil union
improved currently rely on your income?
$80,000 to $89,999
Number _______
Married
Somewhat
$90,000 to improved
$99,999
Separated
The sameto $149,999
$100,000
16. What is your relationship
Divorced
Somewhat status?
$150,000 toworse
$ 199,999
Single
Widowed
Much worse
$200,000 to $250,000
Partnered
In some ways better, in some ways worse
More than $250,000
Important
This question met ourCivil
Note: union
analytic Whenneeds we say: “Because
because weyou are transgender/gender
grouped together all ofnon-conforming, has one or two
those in a relationship. of these
Other things happened
researchers to to
may desire
you,” Married
we many
do notpeople
mean that your gender identity or expression is causing bad or abusive things to happen. We are trying to find out if
14.
further specify How
“domestic live in
partnership.” your household?
Others may also be interested in whether marriages were performed with a marriage license,
areSeparated
treating
peopleNumber _______ you differently because you are transgender or gender non-conforming.
Divorced
which is not made clear with the question as written.
17. How Widowed
Because I am transgender/gender
15. many children currently rely onnon-conforming,
your income? life in general is:
Much_______
Number improved
ImportantSomewhat
Note: When we say: “Because you are transgender/gender non-conforming, has one or two of these things happened to
improved
you,” we do
The mean that your gender identity or expression is causing bad or abusive things to happen. We are trying to find out if
notsame
16. What is your relationship status?
treating you
people areSomewhat worse differently because you are transgender or gender non-conforming.
Single
Much
Partnered worse
Notes in the17. Because
text I am transgender/gender
In some
of questionnaires
Civil union ways better,are in somenon-conforming,
generally ways
to worse
be avoided.life inWe
general
addedis: this note after receiving feedback during testing of the
Much improved
questionnaire that theMarried
phrase, improved“because you are transgender/gender non-conforming,” was distressing to some respondents because
Somewhat
Separated
The same
its meaning and implication
Divorced was unclear and could be interpreted as blaming a person’s gender identity and expression for societal
Somewhat worse
reactions. We used theWidowed
phrase
Much worsethroughout the survey so that we could report with conidence on the connection between the
discrimination In some
reported and ways better, in some
a respondent beingways worse based on gender identity or expression. Thus we added this note to clarify our
targeted
Important Note: When we say: “Because you are transgender/gender non-conforming, has one or two of these things happened to
you,”
intended meaning. we do not mean that your gender identity or expression is causing bad or abusive things to happen. We are trying to find out if
people are treating you differently because you are transgender or gender non-conforming.

17. Because I am transgender/gender non-conforming, life in general is:

Much improved
Somewhat improved
The same
Somewhat worse
Much worse
In some ways better, in some ways worse

18. Because I am transgender/gender non-conforming, my housing situation is:

Much improved
Somewhat improved
The same
18. BecauseSomewhat worse
I am transgender/gender non-conforming, my housing situation is:
worse
Much improved
In some ways
Somewhat better, in some ways worse
improved
The same
This question19.could
If you have
are orbeen
were worse
Somewhat employed,
improvedhow has the factathat
by including notyou are transgender/
applicable optiongender non-conforming
for those who have changed your
not come outemployment
as transgender/gender
situation? Much worse
non-conforming. Much improved
In some ways better, in some ways worse
Somewhat improved
Stayed
19. If you are the same
or were employed, how has the fact that you are transgender/ gender non-conforming changed your employment
situation? Somewhat worse
worse
Much improved
In some ways
Somewhat better, in some ways worse
improved
Not applicable.
Stayed the sameI was never employed
Somewhat worse
20. Because youworse
Much are transgender/gender non-conforming, how has your situation changed as a parent?
Much
In someimproved
ways better, in some ways worse
Somewhat
Not improved
applicable. I was never employed
Stayed the same
20. Because
The not applicable Somewhat
you could
answer worse
are transgender/gender
have been improvednon-conforming, how hasthat
by also noting yourthe
situation changed
question mayasnot
a parent?
apply to people who have never come
worse
out to their employer.Much improved
In some ways better, in some ways worse
Somewhat improved
Not Applicable.
Stayed the same I am not a parent.
Somewhat worse
21. What are
Muchyour current living arrangements?
worse
Homeless
In some ways better, in some ways worse
Living
Not in a shelter
Applicable. I am not a parent.
 worse
situation? Much improved
In some
Somewhat
Much ways
improved better, in some ways worse
improved
The same improved
Somewhat
19. If you are
Stayedor were
Somewhat employed, how has the fact that you are transgender/ gender non-conforming changed your employment
the worse
same
188 NATIONAL situation? Much
Somewhat
TRANSGENDER worse worse
DISCRIMINATION SURVEY
Much
In some
Much improved
ways better, in some ways worse
worse
Somewhat improved
In some ways better, in some ways worse
Stayed
19. If you are
Not or the same
were
applicable. employed, how has
I was never the fact that you are transgender/ gender non-conforming changed your employment
employed
situation? Somewhat worse
20. BecauseMuch worse
youimproved
are transgender/gender non-conforming, how has your situation changed as a parent?
In some
Somewhat
Much ways
improved better, in some ways worse
improved
Not
Stayedapplicable.
Somewhat I was never employed
the improved
same
Somewhat
Stayed the worse
same
20. BecauseMuchyouworse
Somewhat are transgender/gender
worse non-conforming, how has your situation changed as a parent?
Much
In some
Much improved
ways better, in some ways worse
worse
Somewhat
Not
In applicable.
some improved
ways I was in
better, never
someemployed
ways worse
Stayed
Not the same
Applicable. I am not a parent.
20. BecauseSomewhat worse
you are transgender/gender non-conforming, how has your situation changed as a parent?
We used “Not Much
21.Applicable,
What are your worse
Iimproved
am notliving
current a parent,” from this question to determine parental status. Those who marked other answers were
arrangements?
In some ways
Somewhat
Homeless better, in some ways worse
improved
presumed to be a parent. See
Not Applicable.
Stayed note I in
amQuestion
not a parent. 15 for why this was helpful.
Living inthe same
a shelter
Somewhat worse
Living in a group home facility or other foster care situation
21. What are
Much your
Living in current
worse living arrangements?
a nursing/adult care facility
Homeless
In some
Living in ways better, in some
campus/university ways worse
housing
Living in a shelter
Still living with parents orafamily
Not Applicable. I am not parent. you grew up with
Living inwith
Staying a group
friendshome facilitytemporarily
or family or other foster care situation
Living
21. What are your
Living in a nursing/adult
current
with care facility
living spouse
a partner, arrangements?
or other person who pays for the housing
Living
Homeless
Living in house/apartment/condo
in campus/university housing I RENT alone or with others
Still
Living
Livingliving awith parents or family you
in house/apartment/condo
in shelter grewalone
I OWN up with
or with others
Staying
Living inwith friends
a group or family
home facilitytemporarily
or other foster care situation
Living with
in a a partner,
nursing/adult spouse
care or other
facility
22. Because you are transgender/gender non-conforming, have person who paysyou
for experienced
the housing any of the following housing situations? Please mark
Living ifinyou
"Not applicable" house/apartment/condo
campus/university
were never in ahousing I RENT
position alone or with
to experience suchothers
a housing situation. For example, if you have always owned your
home as aLiving
Still in house/apartment/condo
living with parentsnon-conforming
transgender/gender or family you I OWN
grew alone or with
up with
person, you others
could not have been evicted.
Staying with friends or family temporarily
Although this22.question
Because you
Living
worked are a
with transgender/gender
partner,
for our spouse
analysis, or non-conforming,
other
others person behave
maywho paysyou
for experienced
interested the in what any
housing typeof of
theshelter
following housing
people situations?
were in whenPlease
theymark
chose the
“Living in a "Not applicable"
Living ifinyou were never in a position
house/apartment/condo to experience
I RENT suchothers
alone or with a housing situation. For example, if you have always owned your

applicable applicable applicable

shelter” option.
home as aLiving
transgender/gender non-conforming
in house/apartment/condo I OWN person,
aloneyou could
or with not have been evicted.
others

Yes

Not
No
22. Because you are transgender/gender non-conforming, have you experienced any of the following housing situations? Please mark
"Not applicable" if you were never in a position to experience such a housing situation. For example, if you have always owned your
home as a transgender/gender
I moved into a less expensive non-conforming person, you could not have been evicted.
home/apartment.

Yes

Not
I became homeless.

No
I have been evicted.
I was denied a home/apartment.
II moved into a back
had to move less expensive home/apartment.
in with family members or friends.
II became homeless.

Yes

Not
had to find different places to sleep for short periods of time, such as on a friend’s couch.

No
II have been evicted.
have had sex with people to sleep in their bed/at their homes or to pay rent.
II was denied
had to a home/apartment.
use equity in my home to pay for living expenses.
had to move
I moved into a back in with family
less expensive members or friends.
home/apartment.
had to find
I became different places to sleep for short periods of time, such as on a friend’s couch.
homeless.
had sex
I have been with people to sleep in their bed/at their homes or to pay rent.
evicted.
had to
I was use equity
denied in my home to pay for living expenses.
a home/apartment.
I had to move back in with family members or friends.
I had to find different places to sleep for short periods of time, such as on a friend’s couch.
I have had sex with people to sleep in their bed/at their homes or to pay rent.
I had to use equity in my home to pay for living expenses.

Given the high rates of youth homelessness due to parental rejection, it would have been helpful if we had added options like “I was
kicked out of my family home before the age of 18” and “I was kicked out of my family home over the age of 18.”

We also believe we should have asked if respondents had ever been homeless for any reason (not necessarily because they were
transgender or gender non-conforming).

Additionally, we could have diferentiated between those who were denied a rental home/apartment and those who encountered bias
when they attempted to buy a house.

23. If you have experienced homelessness, did you go to a shelter?

Yes
No [Go to Question 25]
Not applicable, I never experienced homelessness [Go to Question 25]

24. Because you are transgender/gender non-conforming, did you experience any of the following when you went to a shelter?
Yes

No

I was denied access to a shelter.

I was thrown out after they learned I was transgender.
I was harassed by residents or staff.
I was physically assaulted/attacked by residents or staff.
I was sexually assaulted/attacked by residents or staff.
I was forced to live as the wrong gender in order to be allowed to stay in a shelter.
I was forced to live as the wrong gender in order to be/feel safe in a shelter.
I decided to leave a shelter even though I had no place to go because of poor treatment/unsafe
conditions.
 APPENDIX B: THE SURVEY INSTRUMENT — ISSUES AND ANALYSIS 189
23. If you have experienced homelessness, did you go to a shelter?
Yes
No [Go to Question 25]
Not applicable, I never experienced homelessness [Go to Question 25]

24. If
23. Because you
you have are transgender/gender
experienced homelessness,non-conforming,
did you go to adid you experience any of the following when you went to a shelter?
shelter?
Yes
No [Go to Question 25]

Yes

No
Not applicable, I never experienced homelessness [Go to Question 25]

24. Because you are transgender/gender non-conforming, did you experience any of the following when you went to a shelter?
I was denied access to a shelter.
I was thrown out after they learned I was transgender.
I was harassed by residents or staff.

Yes

No
I was physically assaulted/attacked by residents or staff.
I was sexually assaulted/attacked by residents or staff.
II was
was denied
forced to live astothe
access wrong gender in order to be allowed to stay in a shelter.
a shelter.
II was
was thrown
forced to live
out as they
after the wrong
learnedgender
I wasintransgender.
order to be/feel safe in a shelter.
II was
decided to leave
harassed by aresidents
shelter even though I had no place to go because of poor treatment/unsafe
or staff.
Iconditions.
was physically assaulted/attacked by residents or staff.
I was sexually assaulted/attacked by residents or staff.
I wastoforced
The phrase “forced live as to live
theas the wrong
wrong gender
gender” in order
used to be
above is allowed
somewhat to stay in a shelter.Those marking “yes” could mean either “shelter
ambiguous.
25. What
I wasisforced
your current
to live asemployment status? in
the wrong gender (Mark
orderall
to that apply.)
be/feel safe in a shelter.
staf required me I decidedFull-time
to dress
to or livea shelter
leave as the even
wrong gender
though I hadin
noorder
place to stay”
to go or “Iofdressed/lived
because as the wrong gender so that I could stay at
poor treatment/unsafe
the shelter because IPart-time
conditions.
felt it was
More than one job
necessary.” We suggest future researchers clarify which is desired.
Self-employed, own your business
25. What is Self-employed, contract worker
your current employment status? (Mark all that apply.)
Unemployed but looking
Full-time
Unemployed and stopped looking
Part-time
On
Moredisability
than one job
Student
Self-employed, own your business
Retired
Self-employed, contract worker
Homemaker
Unemployed or butfull-time
lookingparent
Other, pleaseand
Unemployed specify ___________________________________
stopped looking
On disability
26. Have you done any of the following to avoid discrimination because you are transgender or gender non-conforming? If you
Student
are/were not employed, mark not applicable.
Retired
Homemaker or full-time parent
Other, please specify ___________________________________

applicable
26. Have you
Our set of responses done any
deviated of the
from following
those usedtoinavoid discrimination
surveys becausepopulation,
of the general you are transgender or gender
so we did non-conforming?
our best If you
to develop categories that

Yes

Not
are/were not employed, mark not applicable.

No
matched available data and met our difering analytic needs. For the purposes of this report, we developed the following categories:

Stayed in a job I’d prefer

bothto part-
leave and full-time workers (because the U.S. Department of Labor does so in their data), and

applicable
“Employed,” which included
Didn’t seek a promotion or a raise
Changed
also included those jobs
who checked “more than one job.” This also included both self-employed categories if respondents did not also
Yes

Not
No
Delayed my
check “unemployed gender
but transition
looking.”
Hid my gender or gender transition
I have not
Stayed in adone anything
job I’d to leave
prefer to avoid discrimination
“Unemployed,”
Didn’twhich
seek a included
promotion those who said they were “unemployed but looking” and contract workers, students, retirees,
or a raise
Changed jobs
people on disability, and homemakers if they also checked “unemployed but looking.” To calculate unemployment rates, those
Delayed my gender transition
who checkedHid“unemployed and stopped
my gender or gender transitionlooking” were not considered unemployed (and were considered “Out of the Workforce”
I have not done anything
instead) but for purposes of evaluatingto avoidharassment
discriminationand discrimination elsewhere in the study, those who checked “unemployed
and stopped looking” were kept in the unemployed category.

“Out of the Workforce,” which included students, retirees, people on disability, and homemakers who did not check “unemployed
but looking.” Those who checked “unemployed and stopped looking” were in this category if they also checked student, retiree,
on disability, or homemaker. When calculating unemployment rates, those who checked “unemployed and stopped looking” were
included in this category.

We also classiied those who answered “Other” into the appropriate category above based on their write-in answers. For example,
respondents who said they had any kind of job, such as seasonal, part time, under-employment or periodic contract work, or were
about to start a job, were categorized as “employed.” Respondents who said they had been ired, were looking, or said they were doing
street work were categorized as “unemployed.” Respondents who indicated they were care-giving, were on disability, were waiting for
disability, had chronic illnesses, were students with no other evidence of paid work, had inherited wealth or trusts, or were in unpaid
intern or volunteer positions were categorized as “out of the workforce.”

We do not have a speciic recommendation about how this question should be worded for future research, and we suggest looking at
Department of Labor surveys for question design.

We also recommend considering a question about union membership.

 Self-employed, own your business
Self-employed, contract worker
Unemployed but looking
Unemployed and stopped looking
On disability
190 NATIONAL TRANSGENDER DISCRIMINATION SURVEY
Student
Retired
Homemaker or full-time parent
Other, please specify ___________________________________

26. Have you done any of the following to avoid discrimination because you are transgender or gender non-conforming? If you
are/were not employed, mark not applicable.

applicable
Yes

Not
No
Stayed in a job I’d prefer to leave
Didn’t seek a promotion or a raise
Changed jobs
Delayed my gender transition
Hid my gender or gender transition
I have not done anything to avoid discrimination

27. Because of being transgender/gender non-conforming, which of the following experiences have you had at work? Please mark
each row.

applicable
Yes

Not
No
I feel more comfortable and my performance has improved.
I did not get a job I applied for because of being transgender or gender non-
conforming.
I am or have been under-employed, that is working in the field I should not be in or a
position for which I am over-qualified.
I was removed from direct contact with clients, customers or patients.
I was denied a promotion.
I lost my job.
I was harassed by someone at work.
I was the victim of physical violence by someone at work.
I was the victim of sexual assault by someone at work.
I was forced to present in the wrong gender to keep my job.
I was not able to work out a suitable bathroom situation with my employer
I was denied access to appropriate bathrooms.
I was asked inappropriate questions about my transgender or surgical status.
I was referred to by the wrong pronoun, repeatedly and on purpose.
Supervisors or coworkers shared information about me that they should not have.

28. Because of being transgender or gender non-conforming, have any of the following people close to you faced any kind of job
discrimination?
Generally, this question yielded extremely important results.

We could have included, “I was ired from my job” as an additional query, because “lost my job,” although very informative, also
included layofs that were targeted toward an employee because of bias. This left us unable to directly answer the question of how applicable
Yes

Not
No

many people were “ired.” We do believe that the vast majority of those who “lost their job” were ired. However, especially because this
survey was conducted just as the economic downturn of 2008-2009 was starting, it would have been helpful to have asked respondents
Spouse or partner
to diferentiate between, “I was ired” and “I was laid of due to bias.” If drawing these distinctions, we do believe it is important to still
Children or other family member
ask about job loss, overall, because other bias-related job losses may not fall neatly into those two categories.
29. If you have ever worked for pay in the street economy, please check all activities in which you have engaged.
Sex work/sex industry
We could have askedDrug
more directly about demotions, which could be implied by the “removed from contact” selection but was not
sales
entirely captured. Other, please specify ___________________________________
Not applicable. I have never worked for pay in the street economy.
For the irst query, “I feel more comfortable and my performance has improved” may have provided us with more speciic information
if it had been limited to people who had transitioned while in the workforce. It might have been worded “Since I transitioned
gender, I feel more comfortable and my performance has improved at work.” (Those for whom it did not apply would then choose
“not applicable.”). This could include more speciic questions about how respondents’ performance or comfort has improved, such as
“morale has improved,” “less distracted,” “less worried about being ired,” etc. One might even ask an open-ended question in which
respondents are given the opportunity to describe how their situation has improved for the purpose of qualitative analysis rather
than quantitative indings. In addition, future researchers may be interested in asking a series of questions about the experience of
transitioning on the job.

The query “forced to present in the wrong gender to keep my job” is also somewhat ambiguous. Those marking “yes” could mean either
“my boss required me to present as the wrong gender when I told him I intended to transition” or “I presented as the wrong gender at
 each row.
I feel more comfortable and my performance has improved.
I did not get a job I applied for because of being transgender or gender non-

applicable
conforming.
I am or have been under-employed, that is working in the field I should not be in or a
position for which I am over-qualified. APPENDIX B: THE SURVEY INSTRUMENT — ISSUES AND ANALYSIS 191

Yes

Not
No
I was removed from direct contact with clients, customers or patients.
I was denied a promotion.
feel my
I lost more comfortable and my performance has improved.
job.
I did
wasnot get a job
harassed byI someone
applied foratbecause
work. of being transgender or gender non-
work so as to avoid
I waspotential
the victim iring.”
conforming. of physical Because
violencethe irst is what
by someone we meant, and the second meaning was covered by options in Question
at work.
26, we recommend I am orthe
wasthat have been
victim
future under-employed,
of researchers
sexual by that
assaultalter theis wording
someone working in of
at work. thethis
fieldquery.
I should not be in or a
position
I was forcedfor which I am over-qualified.
to present in the wrong gender to keep my job.
I was removed
not able tofromwork direct
out acontact with
suitable clients, situation
bathroom customers or my
with patients.
employer
Last, the “not applicable”
I was deniedoption a could
promotion.
access have been
to appropriate clariied, like most of our other n/a options in the survey, to indicate that the person
bathrooms.
had not been out I lost
as my
was askedjob.inappropriate questions
transgender/gender about my transgender
non-conforming on the job, or surgical
orhad status.
not applied for a job, or had not ever been a part of the
I was harassed
referred toby bysomeone
the wrong atpronoun,
work. repeatedly and on purpose.
workforce. ISupervisors
was the victim of physicalshared
or coworkers violence by someone
information at work.
about me that they should not have.
I was the victim of sexual assault by someone at work.
I was forced
28. Because to present
of being in the wrong
transgender gender
or gender to keep my job.
non-conforming, have any of the following people close to you faced any kind of job
I was not able to work out a suitable bathroom situation with my employer
discrimination?
I was denied access to appropriate bathrooms.
I was asked inappropriate questions about my transgender or surgical status.
I was referred to by the wrong pronoun, repeatedly and on purpose.

applicable
Supervisors or coworkers shared information about me that they should not have.

Yes

Not
No
28. Because of being transgender or gender non-conforming, have any of the following people close to you faced any kind of job
discrimination?
Spouse or partner
Children or other family member

applicable
29. If you have ever worked for pay in the street economy, please check all activities in which you have engaged.
Sex work/sex industry

Yes

Not
The wording of this question could be improved by clarifying that we were referring to the respondent’s transgender or gender non-

No
Drug sales
conforming status, not thatplease
Other, of thespecify
partner or child. The current wording could be interpreted to mean that we were asking if the
___________________________________
Spouse
respondent’s partner ororchild
Not partner
applicable.
was Itransgender
have never worked for paynon-conforming
or gender in the street economy.
and experienced discrimination on that basis.
Children or other family member

29. If you have ever worked for pay in the street economy, please check all activities in which you have engaged.
Sex work/sex industry
Drug sales
Other, please specify ___________________________________
Not applicable. I have never worked for pay in the street economy.

We wanted to know how many of our respondents were forced into the underground economy that leaves them at risk for arrest and
other negative outcomes. Although we believe that the majority of respondents understood the question, the phrase “street economy”
may not be the best phrasing. An untested alternative might be “work for money on the street.” We avoided using the terms “illegal”
or “criminal,” and “prostitution” in this question because they might cause discomfort for those respondents to whom it applied; we
believed that the “street economy” phrase implied that this question was about such activities.

Furthermore, in the irst answer choice, “sex industry,” was included next to “sex work.” The term “sex industry” especially, but also the
term “sex work,” was potentially interpreted by respondents to include work at strip clubs or in the adult entertainment industry that
might not correlate with the same vulnerabilities of criminalized work. This type of legal employment may come with its own risks and
could be the subject of another question or could be included in this question as a separate answer choice from the choice more clearly
about prostitution, such as “Prostitution” or “sex for pay” or “sex for pay or food.”

Other activities that could have been included are busking (performing on the street for money) and panhandling.
192 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

30. Based on being transgender/gender non-conforming, please check whether you have experienced any of the following in these
public spaces. (Mark all that apply.)

do not present
to access this.
have not tried
Denied equal

disrespected
treatment or

applicable. I

applicable. I

applicable. I
transgender
harassed or

attacked or

experience

outcomes.
Physically

assaulted

negative
Verbally
service

did not

these
here.
Not

Not

Not
as
Retail store
Hotel or restaurant
Bus, train, or taxi
Airplane or airport staff/TSA
Doctor's office or hospital
Emergency Room
Rape crisis center
Domestic violence shelter/program
Mental health clinic
Drug treatment program
Ambulance or EMT
Govt. agency/official
Police officer
Judge or court official
Legal services clinic

We used the31. Have you

answers to ever
theseinteracted withfor
questions theaccess
police as
toahealth
transgender/gender
care, publicnon-conforming person?
accommodations, and to develop our data on bias-motivated
Yes [Go to Question 32]
violence. In retrospect, it would have
No [Go to Question 33]
been more valuable to diferentiate between being “denied service” and being denied “equal
treatment or service.” For the vast majority of these categories, we do not have data on refusal to serve altogether. (Later in the health
32. Because of being transgender/gender non-conforming, which of the following experiences have you had in your interaction with
section, withthe
Question 33, we
(Mark
police?on
do ask about denial of treatment by doctors and other medical providers, so we do have data for that
alltransgender/gender
that apply.)
30. Based being non-conforming, please check whether you have experienced any of the following in these
public spaces. (Mark all thathave
category alone.) Officers generally treated me with respect
apply.)
Officers generally have treated me with disrespect
Officers have harassed me
Our category, “Ambulance
Officersand EMT,” could have been
me “Ambulance/EMT/Medics” in order to designate a wider range of possible

do not present
to access this.
have physically assaulted have not tried
Denied equal

disrespected
treatment or

applicable. I

applicable. I

applicable. I
transgender
harassed or

Officers have sexually assaulted me

attacked or

experience
responders.

outcomes.
Physically

assaulted

negative
Verbally
service

did not
33. As a transgender/gender non-conforming person, how comfortable do you feel seeking help from the police?

these
here.
Not

Not

Not
Also, our inclusion ofVerythree “not applicable” options may have been confusing. This is important because when calculating our results,
comfortable

as
we generally removed Somewhat
respondentscomfortable
for whom a question was not applicable from the analysis of that question. For this question, the
Neutral
Retail store
second “not applicable” option, “Not applicable, I did not experience these negative outcomes,” should have simply been about facing no
Hotel Somewhat
or restaurant uncomfortable
negative outcomes Very
Bus,without uncomfortable
a “not applicable” label in front of it. It should also have been placed before, “Not applicable, I have not tried
train, or taxi
34. Because of being transgender/gender non-conforming, have you ever been arrested or held in a cell?
Airplane or airport
to access this.” Additionally, thestaff/TSA
two remaining “not applicable” responses could have been combined.
Yes
Doctor's office or hospital
No Room
Emergency
This question also
Rapedidcrisis
notcenter
ask (nor did any other question) about harassment/assault that may have happened as the respondents
35. Have you ever
Domestic beenshelter/program
violence sent to jail or prison for any reason?
were spending time in public togenerally, as opposed to in one of the speciic places. Had we done so, we would have been able to have
MentalYes [Go clinic
health Question 36]
a better overall Drug No
of [Go
sensetreatment to Question
harassment 38]
program and hate crimes. Also, hate crimes can be broader than harassment and violence — for example,
vandalism. When Ambulance
the survey or EMT
wasindesigned, wetotal?
made the decision not to ask a series of questions on hate crimes and instead limited
36. How
Govt.long were you
agency/official jail or prison,
the questionnaire to Under
broader six months
instances of discrimination. Therefore, the survey data do not give a full picture of hate crimes committed
Police officer
Judge Six
or months
court to a year
official
against transgender and gender non-conforming people, which is unfortunate given the paucity of data on this severe problem.
Legal One to three
services clinicyears
Three to five years
31. Have youFiveever
to ten years with the police as a transgender/gender non-conforming person?
interacted
Ten
Yes or
[Gomore years 32]
to Question
No [Go to Question 33]

32. Because of being transgender/gender non-conforming, which of the following experiences have you had in your interaction with
Depending onthethe
police? (Mark of
purpose all additional
that apply.) research, researchers may want to diferentiate between interactions where the respondent was
Officers generally have treated me with respect
a crime victim, an alleged
Officersperpetrator or treated
generally have some other interaction.
me with disrespect
Officers have harassed me
Officers have physically assaulted me
Officers have sexually assaulted me

33. As a transgender/gender non-conforming person, how comfortable do you feel seeking help from the police?
Very comfortable
Somewhat comfortable
Neutral
Somewhat uncomfortable
Very uncomfortable
34. Because of being transgender/gender non-conforming, have you ever been arrested or held in a cell?
Yes
No

35. Have you ever been sent to jail or prison for any reason?
Yes [Go to Question 36]
 Ambulance
Doctor's
Drug office
treatment or EMTor hospital
program

transgen
have not

outcome
experien
disrespe

attacked

negative
applicab

to acces

applicab

applicab
assaulte
Physical

do not p
Verbally
Govt. agency/official

harasse
Emergency
Ambulance Room
or EMT

treatme
service
Denied

did not

these
Police officercenter

here.
Rape agency/official
Govt. crisis

Not

Not

Not
as
Judge
Domestic
Police or court
violence
officer official
shelter/program
Legal
Mentalservices
Judge health
or courtclinic clinic
official
APPENDIX B: THE SURVEY INSTRUMENT — ISSUES AND ANALYSIS 193
Drug
Retailtreatment
Legal services
store program
clinic
31. Have
Hotelyou
Ambulance ever or interacted
or restaurant EMT with the police as a transgender/gender non-conforming person?
31. Have
Govt. Yes
you [Go
ever
agency/official
Bus, train, or taxito Questionwith
interacted 32]the police as a transgender/gender non-conforming person?
Police No
Yes
Airplane [Go[Go
officer
or totoQuestion
airport Question
staff/TSA 33]
32]
Judge No
Doctor's or office
courttoor
[Go official
Question
hospital 33]
32. Because
Legal of being
services
Emergency Room transgender/gender non-conforming, which of the following experiences have you had in your interaction with
clinic
the Because
32. police? (Mark
Rape crisis of being all that
center apply.)
transgender/gender non-conforming, which of the following experiences have you had in your interaction with
31.
the Have
police? Officers
you
Domestic ever
(Mark
violencegenerally
interacted
all that have
with treated
apply.)
shelter/program meas
the police with respect
a transgender/gender non-conforming person?
MentalYes
Officers[Go generally
health to Question
clinic have disrespect
32]treated me with respect
No [Go to
Officers
Drug treatment have
generally
programharassed
Question me
33] treated
have me with disrespect
Officers
Ambulance or have physically me
EMT harassed assaulted me
32. Because of being
Govt. Officers have
agency/official sexually assaulted
transgender/gender
physically assaulted me
non-conforming,
me which of the following experiences have you had in your interaction with
the police? (Mark all
PoliceOfficers
officer have that apply.)assaulted me
sexually
33. As a transgender/gender
Judge Officers
or courtgenerally
official have non-conforming person,
treated me with how comfortable do you feel seeking help from the police?
respect
33. As Very
Officers comfortable
generally
a transgender/gender
Legal services clinic have treated me with
non-conforming disrespect
person, how comfortable do you feel seeking help from the police?
Somewhat
Officers
Very have comfortable
comfortable harassed me
31. Have youNeutral
Officers
ever have
Somewhat physically
comfortable
interacted with theassaulted mea transgender/gender non-conforming person?
police as
Somewhat
Officers
Neutral
Yes [Go have uncomfortable
sexually32]
to Question assaulted me
Very
Somewhat
No [Go uncomfortable
uncomfortable
to Question 33]
34. As
33. Because of uncomfortable
being transgender/gender
a transgender/gender
Very non-conforming non-conforming, have you ever
person, how comfortable do been arrested
you feel or help
seeking held from
in a cell?
the police?
34. Because
32. Because Yesof
Very of comfortable
being transgender/gender
being transgender/gender non-conforming,
non-conforming, which
have you ever
of the been arrested
following or held
experiences in ayou
have cell?
had in your interaction with
No
Yes
the police?Somewhat
(Mark all that comfortable
apply.)
Neutral
No
Officers generally have treated me with respect
35. Have you ever generally
Somewhat
Officers been senthave
to jailtreated
uncomfortable or prison
me for any
with reason?
disrespect
35. Have youYes
Very [Go
ever to
beenQuestion
uncomfortable
Officers have sent to36]
harassed jailmeor prison for any reason?
This question34.could
Because No
be of[Go
Officers being
Yesclariied
[Go to
to Question
have to allow 38]
transgender/gender
Question 36]respondents
physically assaultednon-conforming,
me to indicate have you ever
if they were been
notarrested or heldaincrime
committing a cell?and were arrested/held anyway, or
No [Go have
Yes
Officers to Question
sexually 38]assaulted me
if they were 36.
targeted
How long
for additional scrutiny by police because they were transgender or gender non-conforming.
No were you in jail or prison, total?
36. How Under
long were six months
you in jail or prison, total?
33. As a transgender/gender non-conforming person, how comfortable do you feel seeking help from the police?
35. Have youSix
Under
Very months
ever sixbeen to asent
months
comfortable yearto jail or prison for any reason?
One
Yes to three
[Go
Six months
Somewhat toyears
to comfortable
Question
a year 36]
Three
No
One[Go
Neutral totothree
tofive years 38]
Question
Five
Threetototen
Somewhat years
five years
uncomfortable
36. How longTen
Fivewere
Very or
to more
ten you years
in jail or prison, total?
years
uncomfortable
34. Because
In this question, we didUnder
Tenofnot six
orbeing
more months
exploreyearsa) why respondents
transgender/gender non-conforming, have
were in you
jail, b)ever
when been
inarrested or held
the course of intheir
a cell?
transgender journey it happened
Six months to a year
Yes
and c) whether it was One related
to three toyears
their being transgender or gender non-conforming. This is an area ripe for additional research.
No
Three to five years
35. data
To have better Have forFivecomparison
you to ten
ever beenyearssenttotogeneral
jail or prison for any reason?
population incarceration rates, it would be helpful to break out jail and prison. Prison
Ten [Go
Yes or more years 36]
to Question
data for the general population
No [Go to Question 38]
is much more readily available for comparison.

36. How long were you in jail or prison, total?

Under six months
Six months to a year
One to three years
Three to five years
Five to ten years
Ten or more years

37. If you were jailed or in prison, have you ever experienced any of the following because of being transgender/gender non-
conforming? (Mark all that apply in each category.)
or attacked

or attacked

hormones
Physically
assaulted

assaulted
Harassed

Sexually

medical
Denied

Denied
regular

care

From other inmates

From correctional officers or staff

38. Have you attended school at any level (elementary school or higher) as a transgender/gender non-conforming person?
Yes [Go to Question 39]
No [Go to Question 41]

39. Because you are transgender/gender non-conforming, have you been a target of harassment, discrimination or violence at
We used thisschool? (Mark
question to all that apply.)
determine whether or not a respondent was out as transgender or was openly expressing gender non-
conforming appearance or behavior at school. If the respondent indicated “no” but still answered question 39, we excluded their
Not applicable.
transgender or

these negative

answers.
Did not attend

thrown out, or
such a school

conforming at

Harassed or

Harassed or

assaulted or

assaulted or

assaulted or

assaulted or
gender non-

attacked by

attacked by

attacked by

attacked by
teachers or

teachers or

teachers or

experience
enrollment

outcomes.
Not out as

Physically

Physically
bullied by

bullied by
that point

Expelled,
students

students

students
Sexually

Sexually

I did not

When it came time to analyze the data, we realized that we could not distinguish whether respondents were self-reporting a
denied
staff

staff

staff

transgender identity at school, or whether they were gender non-conforming, regardless of their identity today. Furthermore, it is
possible that some answered “yes” even though they were not out or expressing any gender non-conformity at all. While some nuances
Elementary
were lost, these school
data nonetheless provided valuable information about school-based discrimination our respondents faced. An untested
alternative wouldJunior
be, “While attending school, did you (a) openly identify as transgender, (b) express gender non-conformity, or (c) did
high/middle
not openly identify as transgender or express gender non-conformity.”
school
High School
College
Graduate or
professional
 H

D
P

S
a
o

a
o

c
r
From other inmates
From correctional officers or staff
194 NATIONAL TRANSGENDER DISCRIMINATION SURVEY
38. Have you attended school at any level (elementary school or higher) as a transgender/gender non-conforming person?
Yes [Go to Question 39]
No [Go to Question 41]

39. Because you are transgender/gender non-conforming, have you been a target of harassment, discrimination or violence at
school? (Mark all that apply.)

Not applicable.
transgender or

these negative
Did not attend

thrown out, or
such a school

conforming at

Harassed or

Harassed or

assaulted or

assaulted or

assaulted assaulted or

Sexually assaulted or
gender non-

attacked by

Harassed attacked by

or attackedattacked by

assaulted attacked by
teachers or

teachers or

or attackedteachers or
37. If you were jailed or in prison, have you ever experienced any of the following because of being transgender/gender non-

experience
enrollment

outcomes.
Not out as

Physically

Physically
bullied by

bullied by
that point

Expelled,
students

students

students
Physically Sexually

Sexually
conforming? (Mark all that apply in each category.)

I did not
hormones denied
staff

staff

staff

medical
Denied

Denied
regular
Elementary

care
school
Junior
high/middle
From other inmates
school
From
High correctional officers or staff
School
College
38. Have you attended
Graduate or school at any level (elementary school or higher) as a transgender/gender non-conforming person?
Yes [Go to Question 39]
professional
schoolNo [Go to Question 41]
Technical school
39. Because you are transgender/gender non-conforming, have you been a target of harassment, discrimination or violence at
school?
40. (Mark
Because all that transgender/gender
I am/was apply.) non-conforming, which of the following statements are true?
The data generated by this chart was extremely valuable and very complex to analyze. It may have been easier to have used simpliied

Not applicable.
transgender or

negative
applicable
Did not attend

categories. Also, to determine whether respondents were openly transgender versus gender non-conforming at each school level, a more

thrown out, or
such a school

conforming at

Harassed or

Harassed or

assaulted or

assaulted or

assaulted or

assaulted or
gender non-

attacked by

attacked by

attacked by

Yes by
teachers or

teachers or

teachers or

experience
enrollment

outcomes.
Not out as

Physically

Physically
complex set of responses would need to be developed.
bullied by

bullied by
that point

Expelled,
students

students

students

attacked
Sexually

Sexually

I did not
Not
No
denied

these
staff

staff

staff
Like Question 30, the “not applicable” responses here may have been confusing. We treated “did not attend such a school” and “not
I had to leave school because the harassment was so bad.
outas transgender or gender non-conforming at that point,”as the true “not applicable” responses, taking those who marked them out
IElementary
had to leave school for financial reasons related to my transition.
Ischool
of the analysis for lost or could
that part not get financial
of the question aidaltogether,
or scholarships.
but factored in (counted as “no” responses) those who marked “Not Applicable, I
IJunior
was not allowed to have any housing on campus.
did not experience these
Ihigh/middle
negative outcomes.” Also, the physical positions of these two response options on the printed page (and online
was not allowed gender appropriate housing on campus.
version) should Ischool
was not
have beenallowed to use—
switched thewith
appropriate bathrooms
“did not attend or other
such a facilities.
school” being labeled “not applicable” and with “not applicable”
removed from “IHigh did School
not experience these negative outcomes.”
College
Graduate or
Last, it may have been clearer to change the words “you are” in the beginning of the question to “I am/was”) because some people are
professional
school
thinking of past experiences to answer this question.
Technical school

40. Because I am/was transgender/gender non-conforming, which of the following statements are true?

applicable
Yes

Not
No

I had to leave school because the harassment was so bad.

I had to leave school for financial reasons related to my transition.
I lost or could not get financial aid or scholarships.
I was not allowed to have any housing on campus.
I was not allowed gender appropriate housing on campus.
I was not allowed to use the appropriate bathrooms or other facilities.

This question was very valuable. However, it did not distinguish between K-12 and college/technical/graduate school, though some
questions like housing and scholarships are more applicable to higher education. For simplicity, it might have been better to separate
these questions by school level.

We should have included a question about whether or not “teachers or professors, repeatedly and on purpose, failed to call me by my
chosen name or pronouns” and one that asked “I was required to wear clothing that did not match my gender identity.”
 APPENDIX B: THE SURVEY INSTRUMENT — ISSUES AND ANALYSIS 195

41. What type of health insurance do you have? If you have more than one type of coverage, check the ONE that you usually use to
cover doctor and hospital bills.
I have NO health insurance coverage
Insurance through a current or former employer (employee health plan, COBRA, retiree benefits)
Insurance through someone else’s employer (spouse, partner, parents, etc.)
41. What type Insurance
of healthyouinsurance
or someone in your
do you family
have? purchased
If you have more than one type of coverage, check the ONE that you usually use to
cover doctor Medicare
and hospital bills.
Medicaid
I have NO health insurance coverage
Military
Insurance health care/Champus/Veterans
through a current or former employer Administration/Tri-Care
(employee health plan, COBRA, retiree benefits)
Student
Insurance insurance
through through
someonecollegeelse’s or university
employer (spouse, partner, parents, etc.)
Other
Insurance publicyou (such as state in
or someone or your
county levelpurchased
family health plans, etc.)
Other,
Medicare please specify ___________________________________
41. What type of health insurance do you have? If you have more than one type of coverage, check the ONE that you usually use to
Medicaid
cover
42. What doctor
kind and hospital
of place
Military bills.
healthdocare/Champus/Veterans
you go to most often when you are sick or need advice about your health? (check one)
Administration/Tri-Care
We believe it might have IEmergency
havebeen
Student NO health
room insurance
insurance
helpful through
to have coverage
college or university
clariied the Medicaid choice as “medicaid/public insurance you get from your state”
Insurance
Doctor’s
Other through
office
public (such a ascurrent orcounty
state or formerlevel
employer
health(employee health plan, COBRA, retiree benefits)
plans, etc.)
Insurance
since in many states,Other, people
Health through
may
clinic
please know someone
orspecify
health it by aelse’s
center employer
state-speciic
that I or (spouse,
name,
my insurance
___________________________________ partner,
for as parents,
such
pays MediCal. etc.)
Insurance
Free healthyou or someone in your family purchased
clinic
42. What kind Medicare
V.A.of (veteran’s)
place do you clinicgoortohospital
most often when you are sick or need advice about your health? (check one)
Medicaid
Alternative medicine
Emergency room provider (acupuncture, herbalist)
Military health
Not applicable.
Doctor’s care/Champus/Veterans
office I do not use any health care Administration/Tri-Care
providers
Student insurance
Health clinic through
or health centercollege or my
that I or university
insurance pays for
43. Because Other
Freeyou public (such as state or county
are transgender/gender
health clinic level healthhave
non-conforming, plans, etc.)
you had any of the following experiences? (Please check an answer
for each row. Other, please
havespecify
V.A.If (veteran’s)
you NEVER
clinic or___________________________________
needed
hospitalmedical care, please check "Not applicable")
Alternative medicine provider (acupuncture, herbalist)
42. What kind of place do Iyou
Not applicable. go to
do not usemost
anyoften
healthwhen
careyou are sick or need advice about your health? (check one)
providers
Emergency room

applicable
43. Because Doctor’s
you are office
transgender/gender non-conforming, have you had any of the following experiences? (Please check an answer
Health clinic toorthis
health center that I or primarily
mycare,
insurance pays for "Not

Yes
for eachthe row. If you have NEVER needed medical please check applicable")

Not
For our purposes, answers question were important in terms of those who answered “Emergency room,” because

No
Free health clinic
we lacked comparable V.A.information
(veteran’s) clinicabout the general population for most other answer choices. Future researchers may look more
or hospital
I have Alternative
postponedmedicineor not tried provider
to get (acupuncture,
needed medical herbalist)
care when I was sick or injured

applicable
deeply into these data.
because NotI applicable.
could not affordI do notit. use any health care providers
I have postponed or not tried to get checkups or other preventive medical care because I

Yes

Not
No
43. Because
could notyou areit.transgender/gender non-conforming, have you had any of the following experiences? (Please check an answer
afford
for each
I have row. If you have
postponed NEVER
or not tried needed medical
to get needed care, please
medical check
care when "Notsick
I was applicable")
or injured
Ibecause of disrespect
have postponed or not ortried
discrimination
to get neededfrommedical
doctorscareor other
when healthcare
I was sickproviders.
or injured
I have postponed
because I could not or afford
not triedit. to get checkups or other preventive medical care because of

applicable
Idisrespect
have postponedor discrimination
or not triedfrom doctors
to get or other
checkups healthcare
or other providers.
preventive medical care because I
A doctor
could notor otherit.provider refused to treat me because I am transgender/gender non-
afford

Yes
Iconforming.

Not
have postponed or not tried to get needed medical care when I was sick or injured

No
I had to teach
because my doctor
of disrespect or or other provider
discrimination about
from transgender/gender
doctors non-conforming
or other healthcare providers.
people in order to or
I have postponed getnot
appropriate
tried to getcare.
checkups or other preventive medical care because of
Idisrespect
have postponed or not triedfrom
or discrimination to get needed
doctors medical
or other care when
healthcare I was sick or injured
providers.
because
A doctor or I could
othernot afford refused
provider it. to treat me because I am transgender/gender non-
Iconforming.
have postponed or not tried to get checkups or other preventive medical care because I
could
I had tonotteach
affordmy it.doctor or other provider about transgender/gender non-conforming
Ipeople
have postponed
in order to or getnot tried to getcare.
appropriate needed medical care when I was sick or injured
because of disrespect or discrimination from doctors or other healthcare providers.
I have postponed or not tried to get checkups or other preventive medical care because of
disrespect or discrimination from doctors or other healthcare providers.
A doctor or other provider refused to treat me because I am transgender/gender non-
conforming.
I had to teach my doctor or other provider about transgender/gender non-conforming
people in order to get appropriate care.
196 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

44. Please mark below if you received health care related to being transgender/ gender non-conforming.

Have had it

applicable
someday
Want it
Do not
want it

Not
Counseling
Hormone treatment
Top/chest/breast surgery (chest reduction, enlargement, or reconstruction)
Male-to-female removal of the testes
Male-to-female genital surgery (removal of penis and creation of a vagina,
labia, etc.)
Female-to-male hysterectomy (removal of the uterus and/or ovaries)
Female-to-male genital surgery (clitoral release/metoidioplasty/creation of
testes)
Female-to-male phalloplasty (creation of a penis)

45. Please tell us how much the following procedures have cost if you have had them, or mark the box that says I have NOT had this
In this question, we tried to balance medically precise and politically acceptable terms with language that would be accessible to all.
procedure.
Although our inal questions were not always consistent, we still believe that the inclusion of medical terms along with more general

and my out

Don't know
some or all

pay for this

of this and
descriptions of the various surgeries was valuable. In retrospect, the terms vaginoplasty and orchiectomy should have been included.

procedure
insurance

insurance
cost was:

cost was:
my out of

of pocket

NOT had
did NOT
paid for

pocket

I have
We also used the term “genital surgery” in conjunction with clitoral release and creation of testes, which may have implied that other

this
My

My
surgeries we listed, including the creation of a penis, the removal of ovaries, and the reduction or enlargement of breasts, are not also
genital surgeries.
Hormone treatment , average MONTHLY cost _________ _________
Visits to the doctor to monitor hormone levels, average
_________ _________
We should have YEARLY cost facial feminization surgery in this question. There are also a range of other procedures that we also should
asked about
44. Please mark below if you received health care related to being transgender/ gender non-conforming.
Chest/breast/top surgeries and
have asked about, such as “laser hair removal or electrolysis” and “surgery_________ _________
to create a more feminine or masculine shape elsewhere on
reconstructions/reductions/enhancements TOTAL cost
the body.” Genital/bottom surgeries TOTAL cost _________ _________

Have had it

applicable
someday
Facial surgeries TOTAL cost _________ _________

Want it
Do not
Other transition-related health care TOTAL cost. Please want it
We did not diferentiate between respondents who acquired hormones without a prescription_________
(such as purchasing them online or on

Not
describe type of care here. _________
the street) and those Other
who _____________________________________
did, and it would be helpful to know this information. (This could have been done by having two hormone
categories: “hormone treatment, from a doctor” and “hormone treatment, from online street or other sources.”)
46. Counseling
Have you ever received a gender-related mental health diagnosis?
Hormone
No treatment
Top/chest/breast
We didn’t ask about medical surgery (chest
Yes. My diagnosis:
treatments reduction,
are notenlargement,
supervisedorbyreconstruction)
___________________________________
that licensed/trained medical professionals, another question that would
Male-to-female removal of the testes
Male-to-female
have been valuable. These genital
queries surgery
could (removal
have beenof penis
made and
in creation
this of a have
question,
47. Not including any gender-related mental health diagnosis, do you vagina,
ora could have
disability been made
(physical, inmental
learning, a diferent
health)question
that that centered
labia, etc.)
substantially
around non-medically affects a major
supervised life activity?
care, such as the following untested question: “I have acquired the following care NOT supervised by
Female-to-male
Yes hysterectomy (removal of the uterus and/or ovaries)
doctors, such asFemale-to-male
onlineNo or togenital
buying
[Go itsurgery
Question the(clitoral
on49] street:release/metoidioplasty/creation of
1) hormones, 2) silicone injections, 3) chest/breast (top) surgeries, 4) lower/bottom
surgeries.” testes)
48. Female-to-male phalloplasty
What is your disability? (Mark(creation
all that of a penis)
apply.)
Physical condition
45. PleaseLearning
tell us how much the following procedures have cost if you have had them, or mark the box that says I have NOT had this
disability
procedure.Mental health condition

49. What is your HIV status?

and my out

Don't know
some or all

pay for this

of this and

procedure
insurance

insurance
cost was:

cost was:
my out of

of pocket

NOT had

HIV negative
did NOT
paid for

pocket

HIV positive
I have

this

Don’t know
My

My

Hormone treatment , average MONTHLY cost _________ _________

Visits to the doctor to monitor hormone levels, average
_________ _________
YEARLY cost
Chest/breast/top surgeries and
_________ _________
reconstructions/reductions/enhancements TOTAL cost
Genital/bottom surgeries TOTAL cost _________ _________
Facial surgeries TOTAL cost _________ _________
Other transition-related health care TOTAL cost. Please
describe type of care here. _________ _________
Other _____________________________________

46. Have you ever received a gender-related mental health diagnosis?

This question was confusing
No for respondents and for analysts alike. At this point, we have not attempted to tabulate the data for it,
although we do thinkYes. My is
there diagnosis: ___________________________________
usable data that could be gleaned from it. We recommend that future researchers develop a diferent way
of capturing47.
these data andany
Not including test the question
gender-related extensively
mental before putting
health diagnosis, it inathe
do you have ield.(physical,
disability Also, a simpler
learning,question meant
mental health) thatonly to determine
substantially
whether insurance affects a were
companies major covering
life activity?
transition-related care could have been utilized.
Yes
No [Go to Question 49]

48. What is your disability? (Mark all that apply.)

Physical condition
 Visits to the doctor to monitor hormone levels, average
procedure. _________ _________

Have had it
YEARLY cost

Don't applicable
someday
Chest/breast/top surgeries and

out it
_________ _________

Do not
My want it

know
some or all

pay for this

reconstructions/reductions/enhancements TOTAL cost

Want
of this and

procedure
insurance

insurance
cost was:

cost was:
my out of

of pocket

NOT had

Not
did NOT
Genital/bottom surgeries TOTAL cost _________ _________

paid for

and my
pocket

I have
APPENDIX B: THE SURVEY INSTRUMENT — ISSUES AND ANALYSIS 197
Facial surgeries TOTAL cost _________ _________

this
My
Other transition-related health care TOTAL cost. Please
Counseling
describe treatment
Hormone type of care here. _________ _________
Other treatment
Hormone _____________________________________
Top/chest/breast , average
surgery (chestMONTHLY
reduction, cost _________
enlargement, or reconstruction) _________
Visits to the doctor
Male-to-female to monitor
removal hormone levels, average
of the testes
46. Male-to-female
Have you ever _________ _________
YEARLY cost received a gender-related
genital surgery (removal ofmental health
penis and diagnosis?
creation of a vagina,
labia, No
Chest/breast/top
etc.) surgeries and
Yes. My diagnosis: ___________________________________ _________ _________
reconstructions/reductions/enhancements
Female-to-male hysterectomy (removal of the TOTAL
uteruscost
and/or ovaries)
Genital/bottom surgeries
Female-to-male TOTAL
genital surgery cost release/metoidioplasty/creation
(clitoral _________
of _________
47. testes)
Not including
Facial anyTOTAL
surgeries gender-related
cost mental health diagnosis, do you have a disability (physical,_________
_________ learning, mental health) that
Those interested in deeper
substantially affectsanalysis
a major around
life gender-related mental health diagnoses
activity? may want to capture whether respondents’ desired
Other transition-related
Female-to-male health
phalloplasty care TOTAL
(creation cost. Please
of a penis)
to receive a diagnosis Yes
describe ortype
why of they sought it out (for example, because some
care here. doctors and surgeons
_________ provide care only to patients who
_________
45.aPlease No
Other [Go to Question
tellidentity
us how much the49]
_____________________________________
following procedures have
have received gender diagnosis after evaluation by a cost if youhealth
mental have had them, or markThese
professional). the boxpatients
that saysmay
I have NOT had
request this
a diagnosis
procedure.
from a mental48. What
health is your disability?
provider, and (Mark
may all that
receive apply.)
it, without
46. Have you ever received a gender-related mental health diagnosis?the clinician or patient truly seeing it as a mental health diagnosis. The
Physical condition
No
perceived stigma attachedLearning with mental health diagnoses may impact the treatment patients seek and their response to this question.
disability

and my out

Don't know
some or all

pay for this

of this and
Yes. My diagnosis: ___________________________________

procedure
insurance

insurance
cost was:

cost was:
my out of

of pocket

NOT had
did NOT
Mental health condition

paid for

pocket

I have
47. Not including any gender-related mental health diagnosis, do you have a disability (physical, learning, mental health) that

this
My

My
49. What is your
substantially HIVastatus?
affects major life activity?
HIV
Yes negative
HormoneHIV
No [Gopositive
to Question
treatment 49] MONTHLY cost
, average _________ _________
Visits Don’t
to theknow
doctor to monitor hormone levels, average
48. What is your disability? (Mark all that apply.) _________ _________
YEARLY cost
Physical condition
Chest/breast/top surgeries and
Learning disability _________ _________
reconstructions/reductions/enhancements TOTAL cost
Mental health
Genital/bottom condition
surgeries TOTAL cost _________ _________
Facial surgeries TOTAL cost _________ _________
49. What
Otheristransition-related
your HIV status?health care TOTAL cost. Please
Questions 47 and 48HIV
describewere not
negative
type standard
of care here. questions used on federal surveys_________
and we suggest future researchers investigate questions used
_________
more widely. HIV positive
Other _____________________________________
Don’t know
46. Have you ever received a gender-related mental health diagnosis?
Future researchers may No also want to add another question series to diferentiate between disabilities that might be a result of, or
Yes. My diagnosis:
aggravated by, discrimination ___________________________________
(e.g. depression, anxiety, HIV, etc.) For example, it may be useful to ask a question along these lines
(although we 47.are
Notnot suggesting
including this particular
any gender-related wording):
mental “Do you
health diagnosis, dohave or did
you have you have
a disability any oflearning,
(physical, these health
mental or mental
health) that health conditions
substantially affects a major because
because of discrimination/rejection life activity?
you are transgender or gender non-conforming, or stress from that discrimination/
Yes
rejection: 1) anxiety, No
2) clinical or severe
[Go to Question 49] depression, 3) alcohol abuse, 4) drug abuse, 5) heart conditions, 6) weight problems, 7)
anorexia, 8) auto-immune problems, 9) smoking, 10) HIV.”
48. What is your disability? (Mark all that apply.)
Physical condition
Learning
We also could have asked disability
about a range of health, including mental health, conditions NOT necessarily connected to discrimination.
Mental health condition

49. What is your HIV status?

HIV negative
HIV positive
Don’t know

Note that we did not ask how people knew of their HIV status, for example, whether or not they have been tested.

50. I drink or misuse drugs to cope with the mistreatment I face or faced as a transgender or gender non-conforming person.
Yes
Yes, but not currently
No
Not applicable. I face no mistreatment.

51. Have you ever smoked 100 cigarettes in your life?

Yes be interested in asking about general usage of alcohol and drugs that was not connected to discrimination
Future researchers may
No
that respondents face in order to better compare with general population data. Also, we could have asked separately about alcohol and
drugs. 52. Do you now smoke daily, occasionally, or not at all?
50. I drink Daily
or misuse drugs to cope with the mistreatment I face or faced as a transgender or gender non-conforming person.
Occasionally
Yes
Furthermore, those who Yes,atare
Not interested
allnot
but currently in delving deeper into this topic may ask whether drinking (or using drugs) increased or
No
decreased after transition, or if it was connected to a major life event, such as losing a job, getting divorced, etc.
53. If you now smoke, would
Not applicable. younolike
I face to quit?
mistreatment.
Yes
51. Have youNo ever smoked 100 cigarettes in your life?
Not
Yes applicable, I do not smoke now
No
54. Have you ever attempted suicide?
52. Do youYesnow smoke daily, occasionally, or not at all?
We selected these and Nothe following standard smoking-related questions, working with the Network for LGBT Tobacco Control,
Daily
replicating questions Occasionally
on federaltransgender/gender
and state tobacco surveys and allowing us to compare the prevalence of smoking in our sample with
55. Because Notofatbeing
all non-conforming, have you lived through any of the following family issues? If a situation
does not apply to you, please mark “Not applicable.”
the general population.
53. If you now smoke, would you like to quit?
Yes
applicable

No
Not applicable, I do not smoke now
Yes

Not
No
 50. I drink or misuse drugs to cope with the mistreatment I face or faced as a transgender or gender non-conforming person.
Yes
Yes, but not currently
No
Not applicable. I face no mistreatment.
198 NATIONAL TRANSGENDER DISCRIMINATION SURVEY
51. Have you ever smoked 100 cigarettes in your life?
Yes
No

52. Do you now smoke daily, occasionally, or not at all?

Daily
Occasionally
Not at all

53. If you now smoke, would you like to quit?

Yes
No
Not applicable, I do not smoke now
50. I drink or misuse drugs to cope with the mistreatment I face or faced as a transgender or gender non-conforming person.
54. Have you
Yesever attempted suicide?
Yes
Yes, but not currently
No
No
Not applicable. I face no mistreatment.
55. Because of being transgender/gender non-conforming, have you lived through any of the following family issues? If a situation
Some of thedoes
mostnotdevastating
apply and
to you, most
please important
mark results from the survey came from this question, which was almost not included
“Not applicable.”
51. Have you ever smoked 100 cigarettes in your life?
because we knew weYes could not delve deeply enough into the topic and because it made the institutional review process more diicult
because the questionNo conceivably could trigger or retrigger thoughts of suicide among respondents. Thus, we included, at the beginning

applicable
52.a Do
of the survey, you now
suicide smoke daily,
resource, The occasionally, or notwhich
Trevor Project, at all? agreed to serve both adult and youth callers. And, in fact, we did receive two

Yes

Not
Daily

No
calls from respondents who were distressed from illing out the survey and were able to appropriately refer them; we are not sure how
Occasionally
many may have called NotThe
at allTrevor Project.
My family is as strong today as before I came out.
53. IfMyyoufamily
now relationships
smoke, wouldare youslowly
like toimproving
quit? after coming out.
We are incredibly Mygrateful that
relationship
Yes
wemy
with included
spouse orthis question.
partner ended. We recommend that future researchers carefully consider how to construct
a more complexMy setexof
Nolimited or stopped
questions about mysuicidality
relationshipby with my children.
looking at federal and other surveys. We recommend that future questions
A court/judge limited or
Not applicable, stopped
I do my relationship
not smoke now with my children.
diferentiate between attempts
My children choseat notdiferent stages
to speak with me of
or a respondent’s
spend life. Additionally future studies might diferentiate between attempts
time with me.
Myopposed
54. Have
in the last year as parents
you everorto
family
overchose
attempted not to speak
suicide?
a person’s with me
life span or spend time
to compare withmany
to the me. studies that only ask about the last year. Furthermore, it
I was Yes
a victim of domestic violence by a family member.
would be helpfulI haveto ask
Nolostabout ideation and connection with depressive episodes or other mental health conditions.
close friends.

56. Because
55. Please mark the appropriate
of being response non-conforming,
transgender/gender about adoption and foster
have parenting
you lived as aany
through transgender/gender non-conforming
of the following family issues? If a person.
situation
does not apply to you, please mark “Not applicable.”

Not No, I have

No previously
Yesrelated to

unknown
partner's
Yes, my

not tried
children
child or

A child

Yes, a

applicable
to me
child
me
I have successfully adopted or fostered a child.
IMy
tried to adopt
family is as or fostertoday
strong a child
as and wasI came
before rejected.
out.
My family relationships are slowly improving after coming out.
My relationship with my spouse or partner ended.
My ex limited or stopped my relationship with my children.
A court/judge limited or stopped my relationship with my children.
My children chose not to speak with me or spend time with me.
My parents or family chose not to speak with me or spend time with me.
I was a victim of domestic violence by a family member.
I have lost close friends.

56. Please mark the appropriate response about adoption and foster parenting as a transgender/gender non-conforming person.
As mentioned in relation to Question 22, we didn’t ask whether respondents’ parents or guardians forced them to leave the family
home for being transgender or gender non-conforming. This question could be included in this batch of question as opposed to in the
No, I have
previously
related to

unknown
partner's
Yes, my

not tried
children
child or

A child

housing question.
Yes, a

to me
child
me

The statement “my relationship with my spouse or partner ended” could have been clariied to indicate “when I came out to them or
I have successfully adopted or fostered a child.
when I transitioned.”
I tried to adopt or foster a child and was rejected.
The statement “I was a victim of domestic violence by a family member” did not distinguish between violence at the hands of parents,
siblings and other family members, and intimate partners. Nor did it ask about violence not motivated by bias. If the ability to compare
to general population data is desired, this question needs to be further divided.

In a couple of these questions, respondents might be confused whether or not they should mark “no” or “not applicable.” For example,
for “A court/judge limited or stopped my relationship with my children” a respondent might indicate “no” when they were divorced by
mutual agreement with their spouse, which included agreement about custody of children, but never went in front of a judge to decide
custody. We would want them to choose “not applicable” in that scenario but they may have chosen “no.” Thus, redoing the entire
structure of this question might better assist respondents to select the appropriate answer choices.
 My family relationships are slowly improving after coming out.
My relationship with my spouse or partner ended.
My ex limited or stopped my relationship with my children.
A court/judge limited or stopped my relationship with my children.
My children chose not to speak with me or spend time with me. APPENDIX B: THE SURVEY INSTRUMENT — ISSUES AND ANALYSIS 199
My parents or family chose not to speak with me or spend time with me.
I was a victim of domestic violence by a family member.
I have lost close friends.

56. Please mark the appropriate response about adoption and foster parenting as a transgender/gender non-conforming person.

No, I have
previously
related to

unknown
partner's
Yes, my

not tried
children
child or

A child

Yes, a

to me
child
me
I have successfully adopted or fostered a child.
I tried to adopt or foster a child and was rejected.

This question could be improved by specifying whether respondents are to report only oicial adoptions and foster care placements
or unoicial assumption of the parental role. Furthermore, we suspect that those who adopted or fostered a child before they came
out as transgender or gender non-conforming may have answered yes. Altering the wording of this question should be able to capture
whether the adoption or placement happened before or after coming out and/or transition. Also, the question did not distinguish
between adoptions arranged by agencies versus those prompted through changing family circumstances. For these reasons, we made
the diicult decision to not report on the results of this question because we believe our respondents misunderstood what turned out to
be a poorly-worded question.

57. For each of the following documents, please check whether or not you have been able (allowed) to change the documents or
records to reflect your current gender. Mark “Not applicable” if you have no desire to change the gender on the document listed.

applicable
changes

changes

Not tried
allowed

denied
Yes,

No,

Not
Birth certificate
Drivers license and/or state issued non-driver ID
Social Security records
Passport
Work ID
Military discharge papers (DD214 or DD215)
57. ForHealth
each ofinsurance records
the following documents, please check whether or not you have been able (allowed) to change the documents or
recordsStudent records
to reflect your current gender. Mark “Not applicable” if you have no desire to change the gender on the document listed.
Professional licenses or credentials

58. Have you or your employer ever received notice that the gender your employer has listed for you does not match the gender the

applicable
changes

changes

Not tried
From examining the data,
government we suspect
has listed for you?that many respondents chose “not tried” when likely they did not have that particular document
allowed

denied

and “not applicable” Yes

Yes,

would have been a more accurate choice. Part of this could be due to our instructions asking respondents to “mark
No,

Not
No
‘not applicable’ if youNothave no desire to change the gender on the document listed.” We should also have said to mark “not applicable”
applicable
Birth certificate
if they did not have such documents as passports or military discharge papers. However, we also suspect that many may have simply
59. Have you ever
Drivers received
license and/ornotice from your
state issued state motor
non-driver ID vehicle agency that the gender on your driver’s license does not match the
checked the gender
sameSocial
box (yes
the federal on everything,
records has no
government
Security onforeverything,
listed etc.)
you with Social due to the form of this question, which lends itself to repetitive
Security?
answers as opposed Yescarefully considered ones for each line.
Passport
to
Work NoID
Not discharge
Military applicable papers (DD214 or DD215)
Those able to do deeper analysisrecords
Health insurance may be interested in whether or not respondents were able to update names on these IDs and records
and may want60. to
Thinking
Student
expand about
thealllist
records of your IDs andcredit
to include records, which of the
reporting following
agencies statements
and name on is most true?
credit card.
All of my IDs
Professional and records
licenses list the gender I prefer.
or credentials
Some of my IDs and records list the gender I prefer.
58. Have you None or of
yourmyemployer
IDs and records list the notice
ever received genderthatI prefer.
the gender your employer has listed for you does not match the gender the
government has listed for you?
61. When Yes I present documents with my name and gender (like a driver’s license or a passport) that do not match the gender I present
as: (Mark No all that apply.)
I have
Not been harassed.
applicable
I have been assaulted/attacked.
59. Have you I have
everbeen askednotice
received to leave.
from your state motor vehicle agency that the gender on your driver’s license does not match the
The relevancy
gender theI question
of this have
federalhad no
in problems.
futurehas
government studies
listed fordepends
you withon whether
Social the Social Security Administration continues or ceases such
Security?
Not applicable. I have only presented documents that match.
Yes
notiications to employers.
No
62. PleaseNot check what you believe are the four most important policy priorities affecting transgender/gender non-conforming people in
applicable
the U.S.
60. Thinking HIVabout
prevention, education
all of your IDs andand treatment
records, which of the following statements is most true?
Better
All of mypolicies
IDs andon records
gender and identity
list the documents
gender I prefer. and other records
Passing
Some of anti-bullying laws thatlist
my IDs and records make schoolsI safer
the gender prefer.
Transgender/gender
None non-conforming
of my IDs and records prisoner’s
list the gender rights
I prefer.
Immigration policy reform (such as asylum or partner recognition)
61. When Allowing
I present transgender/gender
documents with my non-conforming
name and gender people
(like atodriver’s
serve inlicense
the military
or a passport) that do not match the gender I present
as: (Mark Access
all that to transgender-sensitive health care
apply.)
IGetting
have beentransgender-related
harassed. health care covered by insurance
IProtecting
have beentrans/gender non-conforming people from discrimination in hiring and at work
assaulted/attacked.
IProtecting
have beentransgender/gender
asked to leave. non-conforming people from discrimination in housing
 Health insurance
Military dischargerecordspapers (DD214 or DD215)
Studentinsurance
Health records records
Professional
Student records licenses or credentials
Professional licenses or credentials
58. Have you or your employer ever received notice that the gender your employer has listed for you does not match the gender the
200 NATIONAL TRANSGENDER DISCRIMINATION SURVEY
government
58. Have youhas listedemployer
or your for you? ever received notice that the gender your employer has listed for you does not match the gender the
government Yeshas listed for you?
No
Yes
Not
No applicable
Not applicable
59. Have you ever received notice from your state motor vehicle agency that the gender on your driver’s license does not match the
gender
59. Havetheyou federal
ever government
received notice hasfrom
listedyour for you
statewith
motorSocial Security?
vehicle agency that the gender on your driver’s license does not match the
gender theYes federal government has listed for you with Social Security?
No
Yes
Not
No applicable
Not applicable
60. Thinking about all of your IDs and records, which of the following statements is most true?
60. ThinkingAll about
of my allIDsofandyourrecords
IDs andlistrecords,
the gender I prefer.
which of the following statements is most true?
Some
All of myof my
IDsIDs andand records
records list the
list the gender
gender I prefer.
I prefer.
None
Some of of my
my IDsIDs and
and records
records list
list the
the gender
gender II prefer.
prefer.
None of my IDs and records list the gender I prefer.
61. When I present documents with my name and gender (like a driver’s license or a passport) that do not match the gender I present
61. (Mark
as: When all that apply.)
I present documents with my name and gender (like a driver’s license or a passport) that do not match the gender I present
as: (Mark Iall have
thatbeen
apply.) harassed.
II have
have been
been assaulted/attacked.
harassed.
II have
have been
been assaulted/attacked.
asked to leave.
II have
have had
beenno problems.
asked to leave.
Not applicable.
I have I have only presented documents that match.
had no problems.
Not applicable. I have only presented documents that match.
62. Please check what you believe are the four most important policy priorities affecting transgender/gender non-conforming people in
the U.S.
62. Please check what you believe are the four most important policy priorities affecting transgender/gender non-conforming people in
the U.S. HIV prevention, education and treatment
Better
HIV policies oneducation
prevention, gender and andidentity
treatmentdocuments and other records
Passing anti-bullying
Better policies on gender lawsand
thatidentity
make schools
documentssaferand other records
Transgender/gender
Passing anti-bullying non-conforming
laws that make schoolsprisoner’s rights
safer
Immigration
Transgender/gender policy reform (such as asylum
non-conforming or partner
prisoner’s rightsrecognition)
Allowing transgender/gender
Immigration policy reform (such non-conforming people to
as asylum or partner serve in the military
recognition)
Access totransgender/gender
Allowing transgender-sensitive health care people to serve in the military
non-conforming
Getting to
Access transgender-related
transgender-sensitive health carecare
health covered by insurance
Protecting trans/gender non-conforming
Getting transgender-related people from
health care covered discrimination in hiring and at work
by insurance
Protecting trans/gender
Protecting transgender/gender non-conforming
non-conforming people people from discrimination
from discrimination in hiringinand
housing
at work
Passing laws
Protecting that address hatenon-conforming
transgender/gender crimes against transgender/gender non-conforming
people from discrimination in housingpeople
The right of transgender/gender non-conforming people to parent,
Passing laws that address hate crimes against transgender/gender non-conforming people including adoption
The
The right
right to
of equal recognition of marriages
transgender/gender involving
non-conforming transgender
people to parent,partners
including adoption
The right to equal recognition of marriages involving transgender partners

This question was added as a way to at least supericially gauge respondents’ policy priorities. Because there was only one question
on this topic, the indings to this question are interesting, but cannot be considered to be an accurate representation of community or
individual priorities. It might also be helpful in future studies to allow participants to rank their choices or write in other options.

63. What is your U.S. citizenship status?

U.S. citizen
Documented non-citizen
Undocumented non-citizen
63. What is your U.S. citizenship status?
U.S.
64. Are you citizen to vote?
registered
Documented
Yes non-citizen
Undocumented
No non-citizen

64.
65. Are
Haveyou registered
you ever beentoavote?
member of the armed forces?
Yes
Yesexpanded
This question could be [Go to Question 66] to ask about participation in the last presidential election or last election.
or altered
No
No [Go to Question 67]
I was denied entry because I am transgender/gender non-conforming [Go to Question 67]
65. Have you ever been a member of the armed forces?
Yesdischarged
66. Were you [Go to Question 66] service because of being transgender/gender non-conforming?
from the
No [Go to Question 67]
Yes
I was
No or denied entry
still in the because I am transgender/gender non-conforming [Go to Question 67]
military
66. What
67. Were are
you your
discharged from the
household’s service
current because
sources of being(Mark
of income? transgender/gender
all that apply.)non-conforming?
Yes
Paycheck from a your or your partner’s job
No or still
Money fromin the military fees, dividends or rental income
a business,
Aid such as TANF; welfare; WIC; public assistance; general assistance; food stamps or SSI
67. What are your household’s
Unemployment current sources of income? (Mark all that apply.)
benefits
Paycheck
The answer choices for this
Child fromoraalimony
question
support your or your
could havepartner’s job out “no” and “still in the military.”
separated
Moneysecurity,
Social from a business, fees, dividends
workers comp, disability,or rental income
veteran’s benefits or pensions
Aid such as
Inherited TANF; welfare; WIC; public assistance; general assistance; food stamps or SSI
wealth
Unemployment benefits
Pay from street economies (sex work, other sales)
Child support
Other, please or alimony
specify ___________________________________
Social security, workers comp, disability, veteran’s benefits or pensions
Inherited
69. What is wealth
your sexual orientation?
Pay from street economies (sex
Gay/Lesbian/Same-gender work, other sales)
attraction
Other, please specify ___________________________________
Bisexual
Queer
69. What is your sexual orientation?
Heterosexual
Gay/Lesbian/Same-gender attraction
Asexual
Bisexual
Other, please specify ___________________________________
Queer
Heterosexual
70. Anything else you’d like to tell us about your experiences of acceptance or discrimination as a transgender/gender non-conforming
person? Asexual
Other, please specify ___________________________________
 U.S. citizen
65. Have you ever been a member of the armed forces?
Documented non-citizen
Yes [Go to Question 66]
Undocumented non-citizen
No [Go to Question 67]
I was denied entry because I am transgender/gender non-conforming [GoB:toTHE
Question 67]INSTRUMENT — ISSUES AND ANALYSIS 201
64. Are you registered to vote? APPENDIX SURVEY
Yes
66.
63. Were you
What is discharged from the service because of being transgender/gender non-conforming?
Noyour U.S. citizenship status?
Yes
U.S. citizen
No or still in the
Documented military
65. Have you ever beennon-citizen
a member of the armed forces?
Undocumented
Yes [Go to Question non-citizen
66]
67. What are your household’s current sources of income? (Mark all that apply.)
No [Go to Question 67]
64. Are youPaycheck
registered from a your or your partner’s job
I was deniedto vote?
entry because I am transgender/gender non-conforming [Go to Question 67]
Money
Yes from a business, fees, dividends or rental income
Aid such as TANF; welfare; WIC; public assistance; general assistance; food stamps or SSI
No discharged
66. Were you from the service because of being transgender/gender non-conforming?
Unemployment benefits
Yes
Child
65. Have you support
ever been or
a alimony of the armed forces?
member
No or still in the military
Social
Yes [Go security, workers
to Question 66] comp, disability, veteran’s benefits or pensions
Inherited
No your
[Go to wealth
Question 67]
67. What are household’s current sources of income? (Mark all that apply.)
Pay
I wasfrom street
denied economies
entry because (sex
I am work, other sales) non-conforming [Go to Question 67]
transgender/gender
Paycheck from a your or your partner’s job
Other, please specify ___________________________________
Money from a business, fees, dividends or rental income
66. Were you
Aid discharged
such as TANF; fromwelfare;
the service
WIC;because of being transgender/gender
public assistance; general assistance;non-conforming?
food stamps or SSI
69. What is your sexual orientation?
Yes
Unemployment benefits
Gay/Lesbian/Same-gender
We did not report onChildthe results
No or support of
still in the this attraction
question but future researchers may ind these data useful. If we were constructing a shorter
or military
alimony
Bisexual
survey, this question Social
would
Queer
security,
be a workers comp,
candidate for disability, veteran’s benefits or pensions
deletion.
67. What are your household’s
Inherited wealth current sources of income? (Mark all that apply.)
Heterosexual
Paycheck from aeconomies
your or your partner’s job sales)
Pay from street (sex work, other
Asexual
Money
Note that we did not Other, from
have aplease a specify
questionbusiness, fees, dividends
numbered 68. or rental income
___________________________________
Other,
Aid suchplease specify
as TANF; ___________________________________
welfare; WIC; public assistance; general assistance; food stamps or SSI
69. What isUnemployment benefits
your sexual orientation?
70. Anything else
Child you’d like
support to tell us about your experiences of acceptance or discrimination as a transgender/gender non-conforming
or alimony
Gay/Lesbian/Same-gender attraction
person? Social security, workers comp, disability, veteran’s benefits or pensions
Bisexual
______________________________________________________________
Inherited
Queer wealth
______________________________________________________________
Pay from street economies (sex work, other sales)
Heterosexual
______________________________________________________________
Other, please specify ___________________________________
Asexual
______________________________________________________________
Other, please specify ___________________________________
______________________________________________________________
69. What is your sexual orientation?
______________________________________________________________
Gay/Lesbian/Same-gender attraction
70. Anything else you’d like to tell us about your experiences of acceptance or discrimination as a transgender/gender non-conforming
Having the “other, Bisexual
person?please specify” option cost resources to be spent re-categorizing certain people based on their response which future
Queer
______________________________________________________________
researchers may want to avoid. There were very few true “others” that didn’t approximate the concepts that were listed. On the other
Heterosexual
______________________________________________________________
Asexual
hand, this option______________________________________________________________
allowed us to capture a sense of diversity in respondents’ sexual orientations and the language used to describe them.
Other, please specify ___________________________________
______________________________________________________________
______________________________________________________________
70. Anything else you’d like to tell us about your experiences of acceptance or discrimination as a transgender/gender non-conforming
______________________________________________________________
person?
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________

This question generated over 200 pages of text. Excerpted quotes were included throughout the report. We believe these narratives
brought the data to life in a way that was invaluable.
202 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Other Questions
There were a few other questions, other than those in the survey instrument and suggested above, that we believe should be considered
by future researchers. We will not go into the long list of questions that ended up not being used, but instead ofer a few other areas for
potential research:
• Religion We wish we had asked about what religion (if any) respondents were raised and what their current religious
ailiation (if any) was. We especially wanted to know how this question correlated with or had a protective afect
against suicidality, family rejection, and poor health outcomes. Those who are interested in delving deeper may want
to ask about being out in and acceptance in religious communities as well as rejection by religious communities,
potentially both in the communities respondents were raised in or those they participate(d) in since then.
• Child abuse, including sexual abuse Future researchers might ask about these traumatic childhood
experiences, separate from and/or motivated by a child’s transgender identity or gender non-conformity.
• Physical and sexual assault We asked about physical and sexual assault in a variety of contexts (in high school, in medical
settings, etc.), but not in general, so we do not have overall rates of physical and sexual assault. We also did not ask about
assault not motivated by a person’s transgender or gender non-conforming status. Future researchers may want to do so.

Endnotes
__________________________________________________________________________

1 We plan to provide the dataset to additional researchers to perform deeper or diferent analysis.

2 For more information about the RUCA system, see http://depts.washington.edu/uwruca/.

204 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

APPENDIX C:
THE SURVEY INSTRUMENT (PAPER COPY)
Before using questions from the survey instrument, please read Appendix B: Survey Instrument – Issues and Analysis.
 APPENDIX C: THE SURVEY INSTRUMENT 205

National Survey on Transgender Experiences

of Discrimination in the U.S.
Purpose
You are invited to participate in a research project regarding transgender and gender non-conforming people in the United
States. Your responses will be part of an important report on transgender people’s experiences of discrimination in
housing, employment, health care and education.

Procedures

You will be asked to complete the attached survey. Your participation and responses are confidential. Please answer the
questions as openly and honestly as possible. You may skip questions. The survey will take about 20 minutes to
complete. You must be 18 years of age or older to participate. When you have completed the survey, please return it in
the enclosed envelope directly to:

Susan Rankin, Ph.D

Research Associate, Center for the Study of Higher Education
Pennsylvania State University
University Park, PA 16802
814-863-2655

Comments provided will be analyzed using content analysis and submitted as an appendix to the survey report. Quotes
from submitted comments will also be used throughout the report to give “voice” to the quantitative data.

Discomforts and Risks

There are no risks in participating in this research beyond those experienced in everyday life. Some of the questions are
personal and might cause discomfort. In the event that any questions asked are disturbing, you may stop responding to
the survey at any time. Participants who experience discomfort are encouraged to contact:

The Trevor Project

866-4-U-TREVOR
The Trevor Helpline is the only national crisis and suicide prevention helpline for gay, lesbian, bisexual, transgender and
questioning youth; the Helpline can also help transgender and gender non-conforming adults. The Helpline is a free and
confidential service that offers hope and someone to talk to, 24/7. Trained counselors listen and understand without
judgment.

Benefits
The results of the survey will be part of an important report on discrimination against transgender people by the National
Center for Transgender Equality and the National Gay and Lesbian Task Force to help create better opportunities for
transgender and gender non-conforming people. We are grateful to Penn State University’s Center for the Study of
Higher Education for hosting the survey and maintaining the integrity of our data.

Statement of Confidentiality
You will not be asked to provide any identifying information, such as your name, and information you provide on the
survey will remain confidential. In the event of any publication or presentation resulting from the research, no personally
identifiable information will be shared. Please also remember that you do not have to answer any question or questions
about which you are uncomfortable.

Voluntary Participation
Participation in this research is voluntary. If you decide to participate, you do not have to answer any questions on the
survey that you do not wish to answer. Individuals will not be identified and only group data will be reported (e.g.,
the analysis will include only aggregate data). By completing the survey, your informed consent will be implied. Please
note that you can choose to withdraw your responses at any time before you submit your answers. Refusal to take part in
this research study will involve no consequences.
206 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

Right to Ask Questions

You can ask questions about this research.

Questions concerning this project should be directed to:

Justin Tanis
National Center for Transgender Equality
1325 Massachusetts Avenue, NW Suite 700
Washington, DC 20005
202-903-0112
[email protected]

OR

Susan Rankin, Ph.D

Research Associate, Center for the Study of Higher Education
Pennsylvania State University
University Park, PA 16802
814-863-2655
[email protected]

Completion of the survey indicates your consent to participate in this study. It is recommended that you keep this
statement for your records.
 APPENDIX C: THE SURVEY INSTRUMENT (PAPER COPY) 207

Directions

Please read and answer each question carefully. For each answer, darken the appropriate oval completely. If you want to change an
answer, erase your first answer completely and darken the oval of your new answer. You may decline to answer specific questions.

“Transgender/gender non-conforming” describes people whose gender identity or expression is different, at least part of the time,
from the sex assigned to them at birth.

1. Do you consider yourself to be transgender/gender non-conforming in any way?

Yes
No. If no, do NOT continue.

2. What sex were you assigned at birth, on your original birth certificate?
Male
Female

3. What is your primary gender identity today?

Male/Man
Female/Woman
Part time as one gender, part time as another
A gender not listed here, please specify ___________________________________

4. For each term listed, please select to what degree it applies to you.

Somewhat
Not at all

Strongly
Transgender
Transsexual
FTM (female to male)
MTF (male to female)
Intersex
Gender non-conforming or gender variant
Genderqueer
Androgynous
Feminine male
Masculine female or butch
A.G. or Aggressive
Third gender
Cross dresser
Drag performer (King/Queen)
Two-spirit
Other, please specify _________________________________________________________

5. People can tell I’m transgender/gender non-conforming even if I don’t tell them.
Always
Most of the time
Sometimes
Occasionally
Never
208 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

6. I tell people that I’m transgender/gender non-conforming. (Mark all that apply.)
Never
People who are close friends
Casual friends
Work colleagues
Family
Everyone

7. How many people know or believe you are transgender/gender non-conforming in each of the following settings? Mark all that
apply.

applicable
Some
A few
None

Most

Not
All
At home
On the job
At school
In private social settings
In public social settings
When seeking medial care

8. To the best of your ability, please estimate the following ages, if they apply to you. Mark “N.A.” if not applicable or if you have no
desire to transition. Please mark each line.

applicable
Age in
years

Not
Age you first recognized that you were “different” in terms of your gender. ______
Age you first recognized your transgender/gender-non-conforming identity ______
Age you began to live part time as a transgender/gender non-conforming person. ______
Age you began to live full time as a transgender/gender non-conforming person. ______
Age that you first got any kind of transgender-related medical treatment. ______
Your current age _______

9. Do you or do you want to live full-time in a gender that is different from you gender at birth?
Yes, I currently live full-time in a gender different from my birth gender.
Not full-time yet, but someday I want to.
No, I do not want to live full-time.

10. What is your zip code?

ZIP ___________

11. What is your race/ethnicity? (Mark all that apply.)

White
Black or African American
American Indian or Alaska Native (enrolled or principal tribe) ___________________________________
Hispanic or Latino
Asian or Pacific Islander
Arab or Middle Eastern
Multiracial or mixed race
 APPENDIX C: THE SURVEY INSTRUMENT (PAPER COPY) 209

12. What is the highest degree or level of school you have completed? Mark ONE box. If you are currently enrolled, please mark the
previous grade or highest degree received.
Elementary and/or junior high
Some high school to 12th grade
High school graduate - high school Diploma or the equivalent (for example: GED)
Some college credit, but less than 1 year
Technical school degree (such as cosmetology or computer technician)
One or more years of college, no degree
Associate degree (for example: AA, AS)
Bachelor’s degree (for example: BA, AB, BS)
Master’s degree (for example: MA, MS, MEng, MEd, MSW, MBA)
Professional degree (for example: MD, DDS, DVM, LLB, JD)
Doctorate degree (for example: PhD, EdD)

13. What is your current gross annual household income (before taxes)?
Less than $10,000
$10,000 to $19,999
$20,000 to $29,999
$30,000 to $39,999
$40,000 to $49,999
$50,000 to $59,999
$60,000 to $69,999
$70,000 to $79,999
$80,000 to $89,999
$90,000 to $99,999
$100,000 to $149,999
$150,000 to $ 199,999
$200,000 to $250,000
More than $250,000

14. How many people live in your household?

Number _______

15. How many children currently rely on your income?

Number _______

16. What is your relationship status?

Single
Partnered
Civil union
Married
Separated
Divorced
Widowed

Important Note: When we say: “Because you are transgender/gender non-conforming, has one or two of these things happened to
you,” we do not mean that your gender identity or expression is causing bad or abusive things to happen. We are trying to find out if
people are treating you differently because you are transgender or gender non-conforming.

17. Because I am transgender/gender non-conforming, life in general is:

Much improved
Somewhat improved
The same
Somewhat worse
Much worse
In some ways better, in some ways worse
210 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

18. Because I am transgender/gender non-conforming, my housing situation is:

Much improved
Somewhat improved
The same
Somewhat worse
Much worse
In some ways better, in some ways worse

19. If you are or were employed, how has the fact that you are transgender/ gender non-conforming changed your employment
situation?
Much improved
Somewhat improved
Stayed the same
Somewhat worse
Much worse
In some ways better, in some ways worse
Not applicable. I was never employed

20. Because you are transgender/gender non-conforming, how has your situation changed as a parent?
Much improved
Somewhat improved
Stayed the same
Somewhat worse
Much worse
In some ways better, in some ways worse
Not Applicable. I am not a parent.

21. What are your current living arrangements?

Homeless
Living in a shelter
Living in a group home facility or other foster care situation
Living in a nursing/adult care facility
Living in campus/university housing
Still living with parents or family you grew up with
Staying with friends or family temporarily
Living with a partner, spouse or other person who pays for the housing
Living in house/apartment/condo I RENT alone or with others
Living in house/apartment/condo I OWN alone or with others

22. Because you are transgender/gender non-conforming, have you experienced any of the following housing situations? Please mark
"Not applicable" if you were never in a position to experience such a housing situation. For example, if you have always owned your
home as a transgender/gender non-conforming person, you could not have been evicted.
applicable
Yes

Not
No

I moved into a less expensive home/apartment.

I became homeless.
I have been evicted.
I was denied a home/apartment.
I had to move back in with family members or friends.
I had to find different places to sleep for short periods of time, such as on a friend’s couch.
I have had sex with people to sleep in their bed/at their homes or to pay rent.
I had to use equity in my home to pay for living expenses.
 APPENDIX C: THE SURVEY INSTRUMENT (PAPER COPY) 211

23. If you have experienced homelessness, did you go to a shelter?

Yes
No [Go to Question 25]
Not applicable, I never experienced homelessness [Go to Question 25]

24. Because you are transgender/gender non-conforming, did you experience any of the following when you went to a shelter?

Yes

No
I was denied access to a shelter.
I was thrown out after they learned I was transgender.
I was harassed by residents or staff.
I was physically assaulted/attacked by residents or staff.
I was sexually assaulted/attacked by residents or staff.
I was forced to live as the wrong gender in order to be allowed to stay in a shelter.
I was forced to live as the wrong gender in order to be/feel safe in a shelter.
I decided to leave a shelter even though I had no place to go because of poor treatment/unsafe
conditions.

25. What is your current employment status? (Mark all that apply.)
Full-time
Part-time
More than one job
Self-employed, own your business
Self-employed, contract worker
Unemployed but looking
Unemployed and stopped looking
On disability
Student
Retired
Homemaker or full-time parent
Other, please specify ___________________________________

26. Have you done any of the following to avoid discrimination because you are transgender or gender non-conforming? If you
are/were not employed, mark not applicable.
applicable
Yes

Not
No

Stayed in a job I’d prefer to leave

Didn’t seek a promotion or a raise
Changed jobs
Delayed my gender transition
Hid my gender or gender transition
I have not done anything to avoid discrimination
212 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

27. Because of being transgender/gender non-conforming, which of the following experiences have you had at work? Please mark
each row.

applicable
Yes

Not
No
I feel more comfortable and my performance has improved.
I did not get a job I applied for because of being transgender or gender non-
conforming.
I am or have been under-employed, that is working in the field I should not be in or a
position for which I am over-qualified.
I was removed from direct contact with clients, customers or patients.
I was denied a promotion.
I lost my job.
I was harassed by someone at work.
I was the victim of physical violence by someone at work.
I was the victim of sexual assault by someone at work.
I was forced to present in the wrong gender to keep my job.
I was not able to work out a suitable bathroom situation with my employer
I was denied access to appropriate bathrooms.
I was asked inappropriate questions about my transgender or surgical status.
I was referred to by the wrong pronoun, repeatedly and on purpose.
Supervisors or coworkers shared information about me that they should not have.

28. Because of being transgender or gender non-conforming, have any of the following people close to you faced any kind of job
discrimination?

applicable
Yes

Not
No

Spouse or partner
Children or other family member

29. If you have ever worked for pay in the street economy, please check all activities in which you have engaged.
Sex work/sex industry
Drug sales
Other, please specify ___________________________________
Not applicable. I have never worked for pay in the street economy.
 APPENDIX C: THE SURVEY INSTRUMENT (PAPER COPY) 213

30. Based on being transgender/gender non-conforming, please check whether you have experienced any of the following in these
public spaces. (Mark all that apply.)

do not present
to access this.
have not tried
Denied equal

disrespected
treatment or

applicable. I

applicable. I

applicable. I
transgender
harassed or

attacked or

experience

outcomes.
Physically

assaulted

negative
Verbally
service

did not

these
here.
Not

Not

Not
as
Retail store
Hotel or restaurant
Bus, train, or taxi
Airplane or airport staff/TSA
Doctor's office or hospital
Emergency Room
Rape crisis center
Domestic violence shelter/program
Mental health clinic
Drug treatment program
Ambulance or EMT
Govt. agency/official
Police officer
Judge or court official
Legal services clinic

31. Have you ever interacted with the police as a transgender/gender non-conforming person?
Yes [Go to Question 32]
No [Go to Question 33]

32. Because of being transgender/gender non-conforming, which of the following experiences have you had in your interaction with
the police? (Mark all that apply.)
Officers generally have treated me with respect
Officers generally have treated me with disrespect
Officers have harassed me
Officers have physically assaulted me
Officers have sexually assaulted me

33. As a transgender/gender non-conforming person, how comfortable do you feel seeking help from the police?
Very comfortable
Somewhat comfortable
Neutral
Somewhat uncomfortable
Very uncomfortable
34. Because of being transgender/gender non-conforming, have you ever been arrested or held in a cell?
Yes
No

35. Have you ever been sent to jail or prison for any reason?
Yes [Go to Question 36]
No [Go to Question 38]

36. How long were you in jail or prison, total?

Under six months
Six months to a year
One to three years
Three to five years
Five to ten years
Ten or more years
214 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

37. If you were jailed or in prison, have you ever experienced any of the following because of being transgender/gender non-
conforming? (Mark all that apply in each category.)

or attacked

or attacked

hormones
Physically
assaulted

assaulted
Harassed

Sexually

medical
Denied

Denied
regular

care
From other inmates
From correctional officers or staff

38. Have you attended school at any level (elementary school or higher) as a transgender/gender non-conforming person?
Yes [Go to Question 39]
No [Go to Question 41]

39. Because you are transgender/gender non-conforming, have you been a target of harassment, discrimination or violence at
school? (Mark all that apply.)

Not applicable.
transgender or

these negative
Did not attend

thrown out, or
such a school

conforming at

Harassed or

Harassed or

assaulted or

assaulted or

assaulted or

assaulted or
gender non-

attacked by

attacked by

attacked by

attacked by
teachers or

teachers or

teachers or

experience
enrollment

outcomes.
Not out as

Physically

Physically
bullied by

bullied by
that point

Expelled,
students

students

students
Sexually

Sexually

I did not
denied
staff

staff

staff
Elementary
school
Junior
high/middle
school
High School
College
Graduate or
professional
school
Technical school

40. Because I am/was transgender/gender non-conforming, which of the following statements are true? applicable
Yes

Not
No

I had to leave school because the harassment was so bad.

I had to leave school for financial reasons related to my transition.
I lost or could not get financial aid or scholarships.
I was not allowed to have any housing on campus.
I was not allowed gender appropriate housing on campus.
I was not allowed to use the appropriate bathrooms or other facilities.
 APPENDIX C: THE SURVEY INSTRUMENT (PAPER COPY) 215

41. What type of health insurance do you have? If you have more than one type of coverage, check the ONE that you usually use to
cover doctor and hospital bills.
I have NO health insurance coverage
Insurance through a current or former employer (employee health plan, COBRA, retiree benefits)
Insurance through someone else’s employer (spouse, partner, parents, etc.)
Insurance you or someone in your family purchased
Medicare
Medicaid
Military health care/Champus/Veterans Administration/Tri-Care
Student insurance through college or university
Other public (such as state or county level health plans, etc.)
Other, please specify ___________________________________

42. What kind of place do you go to most often when you are sick or need advice about your health? (check one)
Emergency room
Doctor’s office
Health clinic or health center that I or my insurance pays for
Free health clinic
V.A. (veteran’s) clinic or hospital
Alternative medicine provider (acupuncture, herbalist)
Not applicable. I do not use any health care providers

43. Because you are transgender/gender non-conforming, have you had any of the following experiences? (Please check an answer
for each row. If you have NEVER needed medical care, please check "Not applicable")

applicable
Yes

Not
No
I have postponed or not tried to get needed medical care when I was sick or injured
because I could not afford it.
I have postponed or not tried to get checkups or other preventive medical care because I
could not afford it.
I have postponed or not tried to get needed medical care when I was sick or injured
because of disrespect or discrimination from doctors or other healthcare providers.
I have postponed or not tried to get checkups or other preventive medical care because of
disrespect or discrimination from doctors or other healthcare providers.
A doctor or other provider refused to treat me because I am transgender/gender non-
conforming.
I had to teach my doctor or other provider about transgender/gender non-conforming
people in order to get appropriate care.
216 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

44. Please mark below if you received health care related to being transgender/ gender non-conforming.

Have had it

applicable
someday
Want it
Do not
want it

Not
Counseling
Hormone treatment
Top/chest/breast surgery (chest reduction, enlargement, or reconstruction)
Male-to-female removal of the testes
Male-to-female genital surgery (removal of penis and creation of a vagina,
labia, etc.)
Female-to-male hysterectomy (removal of the uterus and/or ovaries)
Female-to-male genital surgery (clitoral release/metoidioplasty/creation of
testes)
Female-to-male phalloplasty (creation of a penis)

45. Please tell us how much the following procedures have cost if you have had them, or mark the box that says I have NOT had this
procedure.

and my out

Don't know
some or all

pay for this

of this and

procedure
insurance

insurance
cost was:

cost was:
my out of

of pocket

NOT had
did NOT
paid for

pocket

I have

this
My

My

Hormone treatment , average MONTHLY cost _________ _________

Visits to the doctor to monitor hormone levels, average
_________ _________
YEARLY cost
Chest/breast/top surgeries and
_________ _________
reconstructions/reductions/enhancements TOTAL cost
Genital/bottom surgeries TOTAL cost _________ _________
Facial surgeries TOTAL cost _________ _________
Other transition-related health care TOTAL cost. Please
describe type of care here. _________ _________
Other _____________________________________

46. Have you ever received a gender-related mental health diagnosis?

No
Yes. My diagnosis: ___________________________________

47. Not including any gender-related mental health diagnosis, do you have a disability (physical, learning, mental health) that
substantially affects a major life activity?
Yes
No [Go to Question 49]

48. What is your disability? (Mark all that apply.)

Physical condition
Learning disability
Mental health condition

49. What is your HIV status?

HIV negative
HIV positive
Don’t know
 APPENDIX C: THE SURVEY INSTRUMENT (PAPER COPY) 217

50. I drink or misuse drugs to cope with the mistreatment I face or faced as a transgender or gender non-conforming person.
Yes
Yes, but not currently
No
Not applicable. I face no mistreatment.

51. Have you ever smoked 100 cigarettes in your life?

Yes
No

52. Do you now smoke daily, occasionally, or not at all?

Daily
Occasionally
Not at all

53. If you now smoke, would you like to quit?

Yes
No
Not applicable, I do not smoke now

54. Have you ever attempted suicide?

Yes
No

55. Because of being transgender/gender non-conforming, have you lived through any of the following family issues? If a situation
does not apply to you, please mark “Not applicable.”

applicable
Yes

Not
No
My family is as strong today as before I came out.
My family relationships are slowly improving after coming out.
My relationship with my spouse or partner ended.
My ex limited or stopped my relationship with my children.
A court/judge limited or stopped my relationship with my children.
My children chose not to speak with me or spend time with me.
My parents or family chose not to speak with me or spend time with me.
I was a victim of domestic violence by a family member.
I have lost close friends.

56. Please mark the appropriate response about adoption and foster parenting as a transgender/gender non-conforming person.
No, I have
previously
related to

unknown
partner's
Yes, my

not tried
children
child or

A child

Yes, a

to me
child
me

I have successfully adopted or fostered a child.

I tried to adopt or foster a child and was rejected.
218 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

57. For each of the following documents, please check whether or not you have been able (allowed) to change the documents or
records to reflect your current gender. Mark “Not applicable” if you have no desire to change the gender on the document listed.

applicable
changes

changes

Not tried
allowed

denied
Yes,

No,

Not
Birth certificate
Drivers license and/or state issued non-driver ID
Social Security records
Passport
Work ID
Military discharge papers (DD214 or DD215)
Health insurance records
Student records
Professional licenses or credentials

58. Have you or your employer ever received notice that the gender your employer has listed for you does not match the gender the
government has listed for you?
Yes
No
Not applicable

59. Have you ever received notice from your state motor vehicle agency that the gender on your driver’s license does not match the
gender the federal government has listed for you with Social Security?
Yes
No
Not applicable

60. Thinking about all of your IDs and records, which of the following statements is most true?
All of my IDs and records list the gender I prefer.
Some of my IDs and records list the gender I prefer.
None of my IDs and records list the gender I prefer.

61. When I present documents with my name and gender (like a driver’s license or a passport) that do not match the gender I present
as: (Mark all that apply.)
I have been harassed.
I have been assaulted/attacked.
I have been asked to leave.
I have had no problems.
Not applicable. I have only presented documents that match.

62. Please check what you believe are the four most important policy priorities affecting transgender/gender non-conforming people in
the U.S.
HIV prevention, education and treatment
Better policies on gender and identity documents and other records
Passing anti-bullying laws that make schools safer
Transgender/gender non-conforming prisoner’s rights
Immigration policy reform (such as asylum or partner recognition)
Allowing transgender/gender non-conforming people to serve in the military
Access to transgender-sensitive health care
Getting transgender-related health care covered by insurance
Protecting trans/gender non-conforming people from discrimination in hiring and at work
Protecting transgender/gender non-conforming people from discrimination in housing
Passing laws that address hate crimes against transgender/gender non-conforming people
The right of transgender/gender non-conforming people to parent, including adoption
The right to equal recognition of marriages involving transgender partners
 APPENDIX C: THE SURVEY INSTRUMENT (PAPER COPY) 219

63. What is your U.S. citizenship status?

U.S. citizen
Documented non-citizen
Undocumented non-citizen

64. Are you registered to vote?

Yes
No

65. Have you ever been a member of the armed forces?

Yes [Go to Question 66]
No [Go to Question 67]
I was denied entry because I am transgender/gender non-conforming [Go to Question 67]

66. Were you discharged from the service because of being transgender/gender non-conforming?
Yes
No or still in the military

67. What are your household’s current sources of income? (Mark all that apply.)
Paycheck from a your or your partner’s job
Money from a business, fees, dividends or rental income
Aid such as TANF; welfare; WIC; public assistance; general assistance; food stamps or SSI
Unemployment benefits
Child support or alimony
Social security, workers comp, disability, veteran’s benefits or pensions
Inherited wealth
Pay from street economies (sex work, other sales)
Other, please specify ___________________________________

69. What is your sexual orientation?

Gay/Lesbian/Same-gender attraction
Bisexual
Queer
Heterosexual
Asexual
Other, please specify ___________________________________

70. Anything else you’d like to tell us about your experiences of acceptance or discrimination as a transgender/gender non-conforming
person?
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
220 NATIONAL TRANSGENDER DISCRIMINATION SURVEY

ABOUT THE AUTHORS

Dr. Jaime M. Grant is the founding Executive Director of the Jack Harrison is a Vaid Fellow at the National Gay and Lesbian
Arcus Center for Social Justice Leadership (ACSJL) at Kalamazoo Task Force Policy Institute, where he has served since 2009. Prior
College, where she also serves as an Assistant Professor. ACSJL to this report, he contributed to the Task Force publication, Outing
aims to invigorate social justice scholarship and activism in the Age 2010: Public Policy Issues Afecting Lesbian, Gay, Bisexual and
academy while nurturing social justice leaders and projects Transgender Elders by Dr. Jaime M. Grant. Jack graduated from
around the globe. Prior to her work in Kalamazoo, she served as Georgetown University in December of 2008 and is now pursuing
director of the Policy Institute at the National Gay and Lesbian an M.A. in Communication, Culture, and Technology from the
Task Force where she spearheaded a Census advocacy campaign, same university. He has previously interned for the National
deepened the Task Force’s sexual liberation work, and authored Center for Transgender Equality and Khemara, a women’s
its recent contribution to the ield of LGBT aging, Outing Age organization in Phnom Penh, Cambodia.
2010. Grant holds a B.A. from Wesleyan University and a Ph. D. in
Dr. Jody L. Herman is a consulting researcher for the National
Women’s Studies from the Union Institute. Her scholarly work has
Gay and Lesbian Task Force. She graduated from Illinois State
appeared in Signs, a feminist journal of culture and society and in
University and now holds a Ph.D. in Public Policy and Public
Diana E. H. Russell’s landmark anthology, Femicide. Her critique
Administration in the ield of Gender and Social Policy from The
of racism in the women’s and queer movements has appeared in
George Washington University, where she also earned her M.A.
The Reader’s Companion to U.S. Women’s History and the journal
in Public Policy with a concentration in Women’s Studies. She
of the National Women’s Studies Association.
currently serves as the Peter J. Cooper Public Policy Fellow at the
Lisa Mottet, Esq. is the Director of the Transgender Civil Rights Williams Institute at the UCLA School of Law.
Project at the National Gay and Lesbian Task Force, which
Mara Keisling is the founding Executive Director of the National
she has led since 2001. The Project’s primary focus is to assist
Center for Transgender Equality. She is considered one of the
LGBT activists and allies with passing and implementing non-
foremost authorities on discrimination against transgender
discrimination laws and policies from the local to the federal
people in the United States and has almost twenty-ive years of
level, with a secondary focus of enacting transgender-friendly
professional experience in social marketing and opinion research.
policies such as those related to driver’s licenses, birth certiicates,
A Pennsylvania native and a transgender woman, Mara completed
and health care. Mottet co-authored Transitioning Our Shelters:
her undergraduate studies at Penn State University and did her
A Guide to Making Homeless Shelters Safe for Transgender People,
graduate work at Harvard University in American Government.
working with the National Coalition for the Homeless. She also
co-authored Opening the Door to the Inclusion of Transgender
People: The Nine Keys to Making Lesbian, Gay, Bisexual and
Transgender Organizations Fully Transgender-Inclusive. Lisa
graduated from the University of Washington in 1998 and
received her J.D. from the Georgetown University Law Center in
2001.

Dr. Justin E. Tanis is on the staf of the National Center

for Transgender Equality (NCTE) and has worked in LGBT
organizations for close to 25 years as a community organizer,
leader, educator and program specialist. He is the author of Trans-
Gendered: Theology, Ministry, and Communities of Faith (Pilgrim
Press, 2003), which was the result of his doctoral research into
the experiences of transgender people in communities of faith.
Among his other writing credits, he and Lisa Mottet collaborated
on Opening the Door to the Inclusion of Transgender People: The
Nine Keys to Making Lesbian, Gay, Bisexual and Transgender
Organizations Fully Transgender-Inclusive. He holds a bachelor’s
degree from Mount Holyoke College, a Master’s degree from
Harvard University, and a doctorate from San Francisco
Theological Seminary.
“My mother disowned me. I was ired from my job after 18 years of loyal employment.
I was forced onto public assistance to survive. But still I have pressed forward, started
a new career, and rebuilt my immediate family. You are deined not by falling, but
how well you rise after falling. I’m a licensed practical nurse now and am studying
to become an RN. I have walked these streets and been harassed nearly every day,
but I will not change. I am back out there the next day with my head up.”

—Survey Respondent

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