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New findings from the 2022 U.S. Transgender Survey

New state-level bills targeting transgender, nonbinary, and intersex Americans add to these individuals' concerns.

- February 27, 2024
Banner at a rally for trans rights, in Eugene, Oregon.
Banner supporting trans rights, in Eugene, Oregon (cc) David Geitgey Sierralupe, via Flickr

The National Center for Transgender Equality recently released the preliminary findings from its 2022 U.S. Transgender Survey. This updates findings from a similar survey the organization fielded in 2011 to assess the status of transgender, nonbinary, and intersex people. 

With over 92,000 transgender, nonbinary, and intersex respondents, the survey is one of the most wide-reaching snapshots available of what life is like for these groups. The survey captures that status at a moment when states across the U.S. are introducing hundreds of bills that will have severely negative consequences for transgender, nonbinary, and intersex people. These include prohibitions against accessing healthcare, bans on updating state-issued documentation, and exclusions of transgender women and girls from sports

Here’s a closer look at the survey’s findings on each of these issues. 

Health

To capture the effects of these developments, survey questions asked respondents to rate psychological distress using the Kessler Psychological Distress Scale. Nearly half of respondents (44%) reported experiencing serious psychological distress in the last 30 days. 

Only 87% of respondents have health insurance. Of those, approximately a quarter report having at least one issue with their insurance company over the past year, including being denied coverage for hormone therapy, surgery, or another type of gender-affirming medical care. More than one-quarter reported not seeing a doctor during the past year due to high costs. This compares to just under 10% of the general population who did not see a doctor due to cost during the same time frame. 

Of those who saw a health care provider within the past year, close to half (48%) reported having had at least one negative experience due to being transgender. These included being refused health care, being misgendered, having a provider use harsh or abusive language, or having the provider be physically rough or abusive during treatment.

These findings are significant. Of those who said they had accessed gender-affirming care, close to all (94%) reported being more satisfied with their life. This suggests that although accessing care leads to better life outcomes and satisfaction, accessing that care is dangerous and potentially more so as these legislative attacks gain traction.

These findings corroborate those of a Washington Post/KFF survey fielded last year that reported that 78% of adults living in a gender different than the one corresponding to their sex assigned at birth made them a lot more satisfied. 

Education

In the 2022 U.S. Transgender Survey, 60% of 16- to 17-year-old respondents reported mistreatment at school, including verbal harassment, physical violence, and online bullying, as well as being barred from using their chosen names, pronouns, or the bathroom/locker room matching their gender identity. 

Just this past week, Nex Benedict, a nonbinary Oklahoma high school student, was severely beaten by three students in a school restroom. Benedict died the following day, reportedly from those injuries. The school had punished Benedict, the victim of the attack, with a two-week suspension. This response reflects the overly punitive approach to trans and nonbinary youth that makes surviving and thriving difficult and, in Benedict’s case, impossible. 

Among this group of teenage respondents, a little over a quarter (27%) reported having supportive family members. The survey revealed 17% reported having unsupportive family members and 5% reported that a family member in their household was violent towards them due to their transgender identity. Within this age group, 1% reported being kicked out of their home for being transgender. 

Employment and housing

Almost a fifth (18%) of respondents in the survey were unemployed, which is higher than the national rate. One-third reported being unhoused at some point in their lives. 

Documentation

Research suggests that employment difficulties stem from issues accessing correct state documents. These include birth certificates, passports, Social Security cards, and driver’s licenses that accurately reflect a person’s gender and name. Almost half the respondents reported not having correct documentation. Of those, 22% report being verbally harassed, assaulted, or asked to leave a location when presenting the identification that did not list their correct gender. 

Safety

Nearly one-third of survey respondents said they had been verbally harassed in the previous year, either in person and/or online, and 3% of respondents said they were physically attacked in the last year because of their gender identity. 

Nearly half (47%) of the 2022 survey respondents said that they had considered moving in the previous year because of restrictive bills passed or introduced in their state; 5% said they had moved. These numbers might be higher today due to the rapid proliferation of these bills in 2023 and in the first few months of 2024. 

Political science scholarship on policy diffusion is split on why states might choose to enact laws that will drive people from their states. This research explores how policies made into law in one state, for instance, tend to influence lawmakers elsewhere. While many state lawmakers see incentives to attracting workers and do so through tax and labor laws, others might enact policies that make their states unattractive to groups they view as undesirable. This seems to be the case in states like Florida and Ohio, where lawmakers have gone on the record stating that transgender people do not exist.