The Groundbreaking National Survey Explores Transgender Adults’ Diverse Identities and Experiences, Including Growing Up, Transitioning, and Facing Discrimination in Jobs, Housing and Health Care
A new KFF-Washington Post partnership survey provides a groundbreaking portrait of the diverse identities and experiences of transgender adults in the United States, including how they define themselves, childhood experiences, gender transitions, and the hostility and discrimination they face.
The project is the most in-depth representative survey of the life experiences of transgender adults living in the U.S., based on interviews with 515 trans individuals. KFF and The Washington Post also conducted a comparison survey of 823 adults who do not identify as transgender.
Findings from the survey – the 36th in the KFF-Post partnership dating back to 1995 – are featured in The Washington Post’s journalism and a KFF report. At 11 AM ET today, The Washington Post in partnership with KFF will hold a virtual event drawing on the survey findings and examining the realities that transgender Americans face.
Trans adults report widespread discrimination and harassment, including one in four (25%) who say they have been physically attacked because of their gender identity, gender expression, or sexual orientation. The share rises to three in ten among trans people of color (31%) and those who physically present as a gender different that their sex assigned at birth all or most of the time (30%). Even larger shares of trans adults report being verbally attacked (64%) and being harassed or feeling unsafe in a restroom or locker room because of their gender identity, gender expression, or sexual identity (41%).
Trans adults also report more difficulties in childhood, including feeling less safe and facing greater mental health struggles, than other adults. Despite this, nearly eight in ten (78%) of those who present as a gender different than the one assigned at birth say the transition has made them more satisfied with their lives.
Among trans people who have told at least one immediate family member about their identity, most (69%) say their family members are at least “somewhat supportive” of their trans identity, including one-fourth who say their family members are “very supportive.”
Trans individuals who had a trusted adult during their childhood (40% of trans adults) are less likely to report certain adverse childhood experiences. For example, two-thirds of trans adults (67%) who reported having a trusted adult to talk to say they had a happy childhood, compared to less than half (44%) of trans adults who didn’t have a trusted adult growing up.
The survey explores many different aspects of the experience of being trans in America, including some of the key insights cited below:
Growing up trans. Two thirds of trans adults (66%) say they began to understand their identify as a child or teenager, though most did not tell others at the time. A large majority (78%) say they experienced depression, anxiety, or other serious mental health challenges growing up. A minority felt safe participating in youth sports (44%), youth activities (41%) or religious gatherings (35%). Three in ten (29%) were kicked out of their homes or otherwise homeless.
Transitioning. What it means to “transition” differs widely among trans adults, and not all trans adults report feeling the need to transition in a specific way or seek gender-affirming care. Most say they’ve changed the clothes they wear (77%), changed their hair style or grooming (76%), gone by different pronouns (72%), or used a different name (57%). Fewer say they received counseling or therapy as part of their transition (38%), used hormone treatments or puberty blockers (31%), legally changed their name (24%), or underwent gender-affirming surgery or other surgical treatments (16%).
Difficulties accessing health care. Nearly half (47%) of trans adults say their health care providers know “not much” or “nothing” about how to provide care for trans people. About three in ten (31%) say they have had to teach their doctor or other provider about trans people to get appropriate care, and the same share (31%) say they’ve had a provider who refused to acknowledge their preferred gender identity. In addition, 17% say they’ve had a doctor refuse to provide gender-affirming care such as hormone treatments, and more than one in five (22%) say they have had health insurance that would not cover gender-affirming care or treatment.
Mental health. More than four in ten (43%) trans adults say they’ve had suicidal thoughts in the past year, a rate much higher than other adults (16%). A quarter (26%) also report having an eating disorder, and 17% say they engaged in self-harming behaviors in the past year – six times the rate among other adults (3%). Nearly half (47%) of trans adults say they did not get needed mental health care in the past year, often because of its costs.
Job and housing discrimination. One in five (21%) trans adults say they were fired, denied a job, or denied a promotion because of their gender identity, expression, or sexual identity. About half (49%) say they have been asked unnecessary or invasive questions at work. One in eight (13%) say they were evicted or denied housing because of their gender identity. More than a quarter (27%) say they moved to a different part of town, or a new city or state, because they thought it would be more accepting for someone who is trans.
The KFF/Washington Post Trans Survey was designed to reach a representative sample of adults in the U.S. who identify as transgender along with a comparison representative sample of the cisgender population in the U.S. The survey was conducted between Nov. 10 and Dec. 1, 2022, online and by telephone among a nationally representative sample of 515 U.S. adults who identify as trans and another 823 cisgender U.S. adults who do not identify as trans and their gender is the same as their sex assigned at birth. The margin of sampling error including the design effect for the trans adult sample is plus or minus 7 percentage points and plus or minus 4 percentage points for the non-trans adult sample. For results based on other subgroups, the margin of sampling error may be higher.