KFF/The Washington Post Trans Survey
These findings were published on May 5, 2023.
In the U.S., views towards trans people and gender identity are sharply divided by partisanship and whether cisgender adults personally know someone who is trans. More than four in ten cisgender adults (43%) say they personally know someone who is trans, including one in ten who say they have a close friend who is trans and one in ten who say they have a trans family member.
Just over half of adults (57%) say whether someone is a man or woman is determined by the sex they were assigned at birth, with about four in ten adults saying that someone can be a man or woman even if that is different from the sex they were assigned at birth. However, cisgender adults who say they personally know someone who is trans are much more likely than those who do not know anyone who is trans to say that a person’s gender can be different from the sex they were assigned at birth (53% v. 35%). In addition, eight in ten (82%) of Republicans say that whether a person is a man or woman is determined by their sex assigned at birth, compared to far fewer Democrats (35%) and independents (54%) who say the same.
Access to Gender-Affirming Care For Young Trans People
Gender-affirming care is a model of care which includes a range of behavioral and medical interventions aimed at affirming an individual’s gender identity. Most major U.S. medical associations, including those in the fields of pediatrics, endocrinology, and mental health recognize the medical necessity and appropriateness of gender affirming care for transgender and gender diverse youth, often describing the harmful effects denying such care can have.
Majorities of transgender adults and cisgender adults support trans children and teenagers having access to gender-affirming counseling. Eight in ten trans adults (79%) and six in ten cisgender adults (62%) support trans children between the ages of 10 and 14 having accessing gender-affirming counseling, similar to the share of trans adults (79%) and cisgender adults (66%) who say the same about trans teenagers, ages 15 through 17. At least two-thirds of trans adults also support trans children between the ages of 10 and 14 to have access to puberty-blocking medications (69%) and three-fourths support trans teenagers (between the ages of 15 and 17) have access to hormonal treatments. However, less than half of cisgender adults support trans children or teenagers having access to either of these gender-affirming treatments.
Overall, views towards trans children and teenagers having access to gender-affirming health care vary sharply by partisanship. While most Democrats or independents support trans children having access to gender-affirming therapy or counseling under medical supervision, fewer than half of Republicans say they support this. However, Republicans are almost five times more likely to support access to gender-affirming therapy than they are to support access to puberty-blocking medication under medical supervision. About half of Democrats (51%) and a third of independents (36%) support trans children ages 10-14 having access to puberty-blocking medication, compared to just one in ten Republicans (9%). A majority of Democrats (64%) and about half of independents (48%) support teenagers ages 15-17 having access to hormonal treatments, compared to 16% of Republicans who say the same.
Partisanship and geography are strongly connected, and this applies to views of trans issues as well. While about half of rural residents and majorities of suburban and urban residents support trans children ages 10 to 14, and trans teenagers having access to gender-affirming counseling or therapy under medical supervision, support for access to medications vary sharply depending on where people live. Urban residents are about twice as likely as rural residents to support trans children ages ten to fourteen having access to puberty-blocking medication (38% v. 19%), with suburban residents falling in between (29%). When it comes to trans teenagers, at least four in ten urban residents (46%) and suburban residents (42%) support access to hormonal treatments compared to 29% of rural residents. Support for trans teenagers having access to hormonal treatments is also slightly lower in states with Medicaid policies that exclude trans care compared to states without these exclusions.
Support for Laws Protecting Trans Adults Against Discrimination
A majority of the U.S. public supports laws that protect trans adults against discrimination in several areas, from housing to health care. Support for these policies also holds across party lines. While a majority of Republicans support laws prohibiting discrimination against trans people in all cases except in the U.S. military, a larger share of Republicans compared to Democrats oppose laws that prohibit discrimination against trans people. Majorities of both cisgender and trans Americans say they support laws that prohibit discrimination against trans people in all the areas asked about.
Teaching Gender Identity In Schools
Large shares of adults say they think it is “inappropriate” to discuss trans identity in public schools with students before grade 6 including three-fourths of adults who say it is “inappropriate” to discuss trans identity with students in kindergarteners through third grade and seven in ten who say the same about students in grades 4 and 5. About half of adults say it is “appropriate” to discuss trans identity with students in middle school and most (64%) adults say it is “appropriate” to have these discussions with high school students. Trans adults are much more supportive of discussing trans identity in schools compared to cisgender adults, with support increasing among older grades. A majority of trans adults say they think it is “appropriate” to discuss trans identity with students in grades kindergarten to third grade (64%), elementary school grades four and five (71%), middle school (82%), and high school (87%). Trans adults are more than twice as likely as cisgender adults to say they think it is “appropriate” to discuss trans identity with the youngest students (kindergarten through third grade and grades four and five).
While a majority of Democrats, independents and Republicans say it is inappropriate to discuss gender identity with the youngest students in kindergarten through third grade, most Democrats say it is “appropriate” to have these discussions with students at every other grade level. Republicans, on the other hand, stand out in their near-universal opposition to discussing trans identity with younger students, with well over 9 in 10 saying it is “inappropriate” to discuss with students in kindergarten through third grade and in fourth and fifth grade. Two-thirds of Republicans say it is “inappropriate” for teachers to discuss trans identity with high school students.
Trans Athletes’ Participation in Sports
With the recent attention on the participation of trans athletes in sports, the survey finds a majority of adults in the U.S. are opposed to trans women and girls competing in sports at every level with other women and girls; however, notable divisions exist among partisans, trans and cisgender adults and among cisgender adults who personally know someone who is trans. Majorities of trans adults as well as Democrats say trans women and girls should be allowed to compete with cisgender women and girls in sports at each level. About four in ten cisgender adults who personally know someone who is trans say trans women and girls should be allowed to compete with other women and girls at all levels.
While most adults say that trans women and girls should not be allowed to compete in various levels of sports, just over half (54%) of cisgender adults and about three-fourths (73%) of trans adults say they are either “very concerned” or “somewhat concerned” the mental health of trans girls will suffer if they are not allowed to compete with other girls in youth sports.