Gender-affirming care improves transgender lives, according to largest survey of trans people

Findings from the National Center for Transgender Equality’s 2022 U.S. Transgender Survey counter the right-wing narrative about “transition regret” by showing how gender-affirming care improves trans people’s lives, while the survey also documents the continued discrimination and marginalization trans Americans face.

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The NCTE released its "Early Insights" report of survey findings Wednesday. The survey includes data from 92,329 binary and nonbinary trans people across the U.S., the largest number of participants ever. “Early Insights” is the first in a series of reports to be released from the survey.

Ninety-four percent of respondents who lived at least some of the time in a gender other than the one they were assigned at birth reported that they were either “a lot more satisfied” (79 percent) or “a little more satisfied” (15 percent) with their life than before their transition. Nearly all of those who were undergoing hormone treatment or had received at least one form of gender-affirming surgery said this health care had improved their lives.

Respondents also reported substantial family support, with more than two-thirds of trans adults saying that their families were either supportive or highly supportive of their identity and gender expression.

“It’s impactful to see so many trans people report life satisfaction when they live according to their gender identity and get the health care they need, but we also see that trans people face substantial barriers to living full, healthy, and authentic lives,” Dr. Sandy E. James, co-principal investigator and lead researcher for the survey, said in a press release. “As the most comprehensive source of data about trans people in the U.S., these findings fill an important gap in our knowledge and serve as a critical resource for understanding and addressing the needs of trans people.”

Trans people still face discrimination and mistreatment at work, at school and elsewhere, according to the survey.

Eleven percent of respondents who had ever held a job said they had lost a job because of their gender identity or expression.

Eighty percent of adult respondents and 60 percent of 16- and 17-year-old respondents who were out or perceived as trans in elementary or secondary school said they went through one or more forms of mistreatment or negative experience.

Of those who had seen a health care provider within the previous 12 months, 48 percent reported having at least one negative experience because they were transgender, such as being refused health care, being misgendered, or being verbally or physically abused.

Most respondents reported being denied equal treatment due to their gender identity or being verbally harassed, physically harassed, or harassed online.

Respondents also faced economic challenges. Thirty-four percent were experiencing poverty. The unemployment rate among respondents was 18 percent. Nearly one-third had experienced homelessness in at some point.

Regarding the impact of discriminatory laws, 47 percent of respondents had thought about moving to another state because their state government considered or passed anti-trans laws and 5 percent had moved out of state because of this. The top 10 states from which respondents moved for this reason were Alabama, Arizona, Florida, Georgia, Missouri, North Carolina, Ohio, Tennessee, Texas, and Virginia.

“Trans people deserve equal access to the same societal benefits as everyone else — access to good jobs, affordable health care, stable housing and to feel safe in their communities,” said Josie Caballero, director of the survey. “The ‘Early Insights’ report highlights how much further the U.S. still needs to go to achieve trans equality.”

NCTE developed the survey in partnership with the National Black Trans Advocacy Coalition, the TransLatin@ Coalition, and the National Queer Asian Pacific Islander Alliance.

“Everyone deserves to be treated with dignity and fairness,” added Rodrigo Heng-Lehtinen, executive director of NCTE. “We need laws at the federal and state level that make sure all people — including trans people — are treated fairly. No one should ever face discrimination in employment, housing, health care, education, and other areas of life just because of who they are. Transgender people are here to stay, and we are proud of who we are.”