HEALTH OUTCOMES IN TRANSGENDER COMMUNITIES: RESULTS FROM THE 2015 U. S HEALTH OUTCOMES IN TRANSGENDER COMMUNITIES: RESULTS FROM THE 2015 U.S. TRANSGENDER SURVEY Sandy E. James, Survey Project Manager, NCTE February 17, 2017

USTS Project Overview U.S. Trans Survey (USTS) conducted in the summer of 2015 Follow up to the 2008-09 National Transgender Discrimination Survey (NTDS). NTDS had over 6,400 respondents Wide range of topics in USTS: Health, education, employment, family life, housing, identity documents, harassment and violence, police interactions, and more

USTS Project Overview 27,715 respondents 50 states, DC, American Samoa, Guam, Puerto Rico, and U.S. military bases overseas Adults 18+ English and Spanish, online 1/3 non-binary

Results

Pervasive Mistreatment & Violence Because they were transgender ... 46% verbally harassed in past year 9% physically attacked in past year Sexually assaulted: 10% past year and 47% in lifetime

3X higher unemployment than U.S. population Severe Economic Hardship & Instability 3X higher unemployment than U.S. population 15% versus 5% 2X higher poverty than U.S. population 29% versus 14%

Severe Economic Hardship & Instability Homelessness 12% homeless in the past year 30% homeless in lifetime

1.4% of all respondents were living with HIV— Compounding Impact of Other Forms of Discrimination Among people of color, poverty was 3X higher than the U.S. population 1.4% of all respondents were living with HIV— 5X higher than the U.S. population Among Black trans women, the rate was 19%

Compounding Impact of Other Forms of Discrimination People with disabilities 24% unemployed 45% living in poverty Undocumented 50% experienced homelessness 24% physically attacked in the past year

Key Health Findings

8X serious psychological distress than U.S. population Harmful Effects On Physical & Mental Health 8X serious psychological distress than U.S. population 39% versus 5% 9X attempted suicide in lifetime than U.S. population 40% versus 4.6% “Serious psychological distress” measure is based on the Kessler 6 scale, which is a widely used tool for assessing mental health outcomes. It involves a battery of questions about feelings of distress and how those feelings impact one’s life.

25% had trans-related health insurance problem Health Insurance and Health Care In the past year: 25% had trans-related health insurance problem 23% didn’t seek health care for fear of being mistreated 33% didn’t seek health care because they could not afford it

33% had at least one trans-related negative experience Health Care Of those who saw a health care provider in the past year: 33% had at least one trans-related negative experience

1.4% of all respondents were living with HIV— 5X higher than the U.S. population (0.3%) Among Black trans women, the rate was 19% Among American Indian trans women, the rate was 4.6% Among trans Latinas, the rate was 4.4%

Substance Use 3X illicit drug, marijuana, and/or nonmedical prescription drug use in the past month than U.S. population 29% versus 10%

USTransSurvey.org