Enhanced Life Satisfaction: Transitioning Proven to Positively Impact Most Trans Adults.
According to an extensive survey conducted by The Washington Post and the Kaiser Family Foundation (KFF), transgender individuals in the United States face discrimination and systematic inequity in various areas of their lives, such as education, employment, and access to healthcare.
Transgender Americans encounter stigma and prejudice, enduring instances of harassment and verbal abuse. They often face eviction from their homes, are denied proper healthcare, and subjected to unwarranted confrontations in restroom facilities. Shockingly, a quarter of them have even experienced physical attacks, while approximately one in five have been terminated from their jobs or denied promotions due to their gender identity. Additionally, transgender individuals are more than twice as likely as the general population to grapple with severe mental health challenges like depression.
However, the majority of adult transgender individuals express that undergoing a transition has significantly improved their overall life satisfaction.
TC Caldwell, a 37-year-old Black nonbinary individual from Montgomery, Alabama, expressed their experience, stating, “The pain of existence has subsided. It is a liberating feeling to simply breathe and embrace my authentic self.”
The Washington Post-KFF poll, utilizing random sampling methods, stands as the most extensive non-governmental survey of transgender adults in the United States. Over 500 individuals who identify as transgender participated in the survey, providing insights into their childhood experiences, emotional well-being, and life after transitioning.
The survey expands upon an emerging yet restricted collection of research in this field. In 2015, the National Center for Transgender Equality conducted a survey involving 27,715 transgender individuals from the United States and its territories. Moreover, the organization is currently in the process of analyzing data from a considerably larger group of participants who voluntarily completed the survey last year. These initiatives, combined with two federal health surveys and a random-sample poll conducted by the Williams Institute, have provided valuable insights into the transgender community. However, transgender individuals emphasize the need for further data to better understand their experiences.
According to Josie Caballero, a trans woman and the director of the U.S. Trans Survey at the National Center for Transgender Equality, surveys such as the one conducted by the Post-KFF and their own U.S. Trans Survey are invaluable resources for researchers, policymakers, and advocates. These surveys offer essential tools to gain a deeper understanding of the transgender community’s needs and enable efforts to enhance their quality of life.
Additional research indicates that the transgender community has grown to an approximate count of 1.3 million adults. Surveys conducted by the Centers for Disease Control and Prevention (CDC) reveal that the transgender adult population tends to be younger compared to the overall cisgender adult population, with a majority of trans adults being under the age of 35.
The Washington Post-KFF survey unveils a wide range of perspectives within the transgender adult population regarding the concept of transitioning. While a significant number of trans individuals have undergone social transitioning, which involves changing their clothing, names, or pronouns, a smaller proportion has pursued medical transitioning. Specifically, less than one-third have utilized hormone treatments or puberty blockers, and roughly one in six have undergone gender-affirming surgery or other surgical procedures to modify their physical appearance.
Among transgender adults, a significant majority of 62 percent identify as “trans, gender non-conforming” or “trans, non-binary.” About 33 percent identify as a “trans man” or “trans woman.” Furthermore, nearly half of the respondents prefer the use of they/them pronouns, although many indicate occasional usage of she/her or he/him pronouns.
Josie Nixon, a 30-year-old nonbinary individual residing in Denver, expresses the sentiment that there is a growing resistance to the notion of fitting into traditional gender boxes. They state, “There is a push against the idea that we must conform to those rigid categories. While there are trans men and women who strongly identify within those boxes and find fulfillment, there is a trend, especially among younger individuals, to reject the limitations of these boxes. Many prefer to exist in between or outside of them, as these boxes fail to encompass the entirety of their identities.”
During their childhood, a majority of transgender adults recall having a realization that their gender identity differed from the sex assigned to them at birth. Approximately one-third (32 percent) report gaining an understanding of their gender identity at the age of 10 or even earlier, while another third (34 percent) reached this realization between the ages of 11 and 17.
Alyssa Rogers, a 26-year-old White trans woman residing in Austin, shared her own experience, revealing that she first became aware of her gender identity at around 5 years old. During a difficult period in her life when her mother faced legal issues related to drug use, Rogers found herself living in an orphanage. It was there that she tried on a pink princess dress, an experience that immediately felt authentic and aligned with her true self.
“This was the first time I had the opportunity to do something like that,” Rogers explained. “It felt wonderful. I wanted to share it, but fear held me back because I knew it wouldn’t be accepted.”
After her time in the orphanage, Rogers eventually found a new home with her grandparents. Like many other transgender individuals surveyed in the Post-KFF study, she encountered challenges related to depression and loneliness during her childhood.
In comparison to the general American population, transgender adults are more than twice as likely to express that they faced significant mental health difficulties such as depression or anxiety while growing up. Specifically, 78 percent of trans adults report experiencing these struggles, whereas the figure stands at 32 percent for the overall U.S. population.
While slightly over half of transgender adults (53 percent) recall having a happy childhood, this percentage is notably lower than the 81 percent reported by the general population.
A significant majority of trans individuals (59 percent) indicate a lack of a trusted adult to confide in during their formative years, with this number rising to 64 percent among trans people of color. Those who did have a trusted adult to turn to were considerably more likely to feel safe in their childhood homes and report a happy childhood.
For transgender children, schools became a significant source of stress and anxiety. A survey conducted reveals that over 40 percent of trans children expressed feeling unsafe within the school environment. Additionally, one-quarter of them reported feeling unsafe when participating in sports or engaging in other youth activities.
According to Rogers, her experience at school was isolating as she felt like an “outcast.” Consequently, when she started cross-dressing as a teenager, she received little response from her classmates. However, her family reacted negatively. Rogers shared that her grandparents admitted her to a mental hospital and later subjected her to conversion therapy in Colorado. Although the state has now prohibited this practice, Rogers’s experience reflects a common narrative. Around 25 percent of transgender adults reveal attending religious services during their childhood or teenage years that attempted to change their sexual orientation or gender identity. Moreover, approximately 10 percent disclose attending conversion or reparative therapy.
The distressing circumstances Rogers faced took a toll on her mental health, leading her to contemplate suicide. She described her situation as terrible and unbearable.
For years, Rogers went to bed hungry, partly due to necessity and partly due to the belief that by restricting her food intake, she could prevent further physical growth. Her hope was that by not growing, she would have a better chance of presenting as a girl.
After enduring conversion therapy, Rogers made the decision to embark on estrogen hormone therapy. However, she was well aware that revealing her true identity as a woman would result in rejection from many members of her family.
While 69 percent of transgender individuals who have disclosed their gender identity to some of their immediate family members claim to receive at least “some degree of support,” approximately 30 percent report a lack of support from their families. This includes 13 percent who describe their families as “very unsupportive.” Moreover, around 29 percent of transgender adults state that they experienced homelessness or were expelled from their homes during their upbringing. This figure rises to 38 percent among trans people of color.
Rogers acknowledged the inevitable loss of some family members upon coming out. She expressed that it was not a matter of “if,” but rather a question of how many family members would reject her true self.
The poll findings indicate that there is no fixed timeline for transgender individuals when it comes to their transition. Roughly 30 percent of trans individuals started sharing their identity with others before the age of 18, while another third (32 percent) came out between the ages of 18 and 25. However, there are also those who came out later in life, and an additional 12 percent of trans adults have not disclosed their identity to anyone.
In the case of Nixon, a 30-year-old nonbinary individual residing in Denver, their journey towards self-realization began approximately six years ago. One significant moment stands out, where Nixon experienced an emotional release. They cried themselves to sleep, and upon waking up, they stood in front of the mirror and uttered the word that defined their identity for the first time.
“I simply said, ‘You’re trans’,” Nixon recollected. “Immediately after, I collapsed to the floor, overwhelmed with emotions, and I continued to cry for about a week.”
The nature of a transgender person’s transition varies greatly, and there is a growing trend among younger individuals to deviate from a traditional binary gender path. The survey findings highlight that the majority of adults identifying as trans or transgender prefer terms such as “nonbinary” (40 percent) or “gender non-conforming” (22 percent). Additionally, 22 percent identify as a “trans woman,” while 12 percent identify as a “trans man.”
When Nixon made the decision to transition, they resided in Grand Rapids, Michigan. However, due to the conservative atmosphere of the town and the desire to avoid being known solely as a male, Nixon chose to relocate. It is worth noting that about 27 percent of trans adults state that they have moved to a different location because they believed it would be more accepting. Urban areas have a higher proportion of trans adults who have relocated (35 percent).
“I literally searched online for ‘Where do trans people live’,” Nixon shared. “That’s how I discovered Colorado.”
Initially, Nixon relocated to Boulder, where they embarked on their transition journey. They underwent significant changes, including legally changing their name, growing out their hair, and commencing hormone therapy by taking estrogen.
Large majorities of trans adults have changed their physical appearance in ways that reflect their gender identity, with 77 percent changing the types of clothes they wear and 76 percent changing their hairstyle or grooming habits. Fewer have used hormone treatments (31 percent), legally changed their names (24 percent), or undergone gender-affirming surgery or other surgical treatments to change their physical appearance (16 percent).
Trans adults who identify as either a “trans man” or a “trans woman” are more than three times as likely as those who identify as nonbinary or gender non-conforming to say they have used hormone treatments (60 percent) or undergone gender-affirming surgery (31 percent).
Despite encountering ongoing discrimination, including within Colorado, Nixon gradually discovered a sense of happiness that had eluded them in the past. Throughout their youth, Nixon struggled to establish genuine connections with others, suspecting that hiding a significant part of their identity played a significant role in their difficulty. Children have a keen ability to detect inauthenticity. However, as Nixon’s hair grew and their body underwent changes, they faced instances of harassment in restrooms and even had a roommate who revealed transphobic views. Nevertheless, Nixon experienced a newfound sense of relief.
Nixon expressed, “Even on the worst day I’ve ever had as a trans person, it is still better than the best days I experienced before transitioning. It’s not that I don’t cherish the memories from my past, but living authentically outweighs the hardships of concealing a version of myself just to appease strangers.”
According to the Post-KFF survey, a significant majority of individuals who present themselves differently from their assigned gender at birth experience increased satisfaction with their lives. Specifically, 78 percent of respondents express that living as a different gender has brought them greater contentment, with over 40 percent indicating that they are “a lot” more satisfied.
It is important to note that not all transgender individuals present as a gender different from their assigned birth sex consistently.
Among trans individuals, 30 percent physically present as a different gender at all times, while 20 percent do so “most of the time.” An additional 34 percent present as a different gender on occasion, while a notable portion (16 percent) state that they “never” physically present as a gender different from their assigned birth sex.
Nixon, specifically in Colorado, reveals that they are visibly transgender on a daily basis, yet strangers may perceive them in various ways.
Nixon shared their experiences, stating, “Every time I answer the phone, I am addressed as ‘Hello, sir.’ However, when I visit the grocery store, I receive a mix of ‘he,’ ‘she,’ and ‘they’ on a daily basis. I have made a personal decision to embrace this androgynous space as where I want to exist.”
Although 57 percent of transgender adults express overall satisfaction with their lives, this percentage is lower than that of the general U.S. adult population, where 73 percent report being satisfied.
Transgender adults experience higher rates of anxiety compared to cisgender adults, with 56 percent stating they have felt anxious “often” in the past year. In comparison, 31 percent of cisgender adults reported the same. Moreover, transgender individuals are more than twice as likely as cisgender individuals to report feeling depressed (48 percent compared to 21 percent) or lonely (45 percent compared to 21 percent) in the past year.
Tim McCoy, a 72-year-old White trans man residing in Syracuse, New York, shares his personal struggles with chronic depression and anxiety that have been present since his younger years. However, he mentions that these feelings initially eased after he started testosterone treatment.
McCoy reflects on his experience, sharing that initially, he felt euphoric and believed transitioning was the solution to all his problems. The early years of his transition brought him a sense of wonder and positivity. However, after approximately five years, the depression resurfaced. McCoy acknowledges that while transitioning has improved his overall quality of life, it is not a panacea for every challenge he faces.
He attributes a significant portion of this ongoing struggle to the discrimination faced by transgender individuals, which has intensified due to the increasingly hostile political climate towards the trans community. McCoy expresses the constant fear and anxiety associated with disclosing his transgender identity, particularly in the present times. The persistent concern about the reactions and potential consequences significantly impacts his well-being, creating a perpetual source of stress.
Disturbingly, the poll data reveals that one in four transgender adults report experiencing physical attacks based on their gender identity, gender expression, or sexual identity. Additionally, more than six in ten (64 percent) report having faced verbal attacks. These alarming statistics underscore the pervasive discrimination and hostility faced by the transgender community.
Tessa Jelani, a 26-year-old Black transgender woman residing in Washington, D.C., recalls facing frequent harassment before discovering effective ways to feminize her appearance.
“At the beginning of my transition, I was attacked with a bat to the head,” Jelani recounted. “I remember the assailant saying, ‘I won’t hit a woman, but I’ll hit you.'”
The Post-KFF poll highlights the widespread discrimination experienced by transgender adults in various aspects of their daily lives. Approximately half (49 percent) report being subjected to unnecessary or invasive questioning in their workplace, while 21 percent have been terminated, denied employment, or passed over for a promotion due to their gender identity, expression, or sexual identity.
Discrimination extends beyond the workplace, as 17 percent of respondents state that their transgender identity has resulted in being denied service by healthcare providers. Additionally, 13 percent report instances of eviction or housing denial, with this number rising to 21 percent among transgender individuals of color.
Caldwell, the nonbinary individual from Montgomery, Alabama, recounts an experience where their quality of care was negatively affected after healthcare providers discovered their transgender identity. During a routine checkup last year, Caldwell underwent a coronavirus test and a chest X-ray. However, the treatment shifted once the providers realized Caldwell was transgender.
“They switched my nurse to a male nurse, and nobody would communicate with me,” Caldwell shared. “It was an all-Black clinic, and it was disheartening to experience this sense of being treated as ‘other’ even within your own community. In hindsight, I believe it was largely due to ignorance. They might have even thought they were being helpful.”
Despite facing such challenges, both Caldwell and Jelani express a growing acceptance they have encountered in recent years. While Alabama has passed several anti-trans bills, Caldwell acknowledges that their fellow Alabamians often surprise them with their support. Caldwell recalls feeling nervous when picking up their prescription for testosterone for the first time, but their anxiety subsided upon meeting the pharmacist, who provided understanding and acceptance.
Caldwell vividly recalls their initial apprehension when picking up their testosterone prescription, describing how they felt nervous and shaking. However, they were pleasantly surprised by the pharmacist’s compassionate and affirming response. The pharmacist, a Black woman, showed genuine concern and guided Caldwell through the process, offering step-by-step instructions on using the syringe, measuring the dosage, and distinguishing between the drawing needle and injection.
A majority of transgender individuals hold the belief that people’s perceptions and acceptance of them have improved over time. Fifty-five percent express that people in the United States are more accepting of transgender individuals compared to a decade ago. Jelani is optimistic that this positive trend will continue as more individuals have the opportunity to know and understand members of the transgender community.
“The younger generation is exemplifying acceptance,” Jelani emphasizes. “They are open to embracing and celebrating differences, which is influencing the older generation to be more open-minded. Not everything needs to be explained for it to be accepted. We, as transgender individuals, have always existed, and we will continue to exist. Nothing can impede that reality.”
