Lessons From the 2022 U.S. Trans Survey Preliminary Report

By Pau Crego–

Earlier this month, the National Center for Transgender Equality published a preliminary report on the 2022 U.S. Trans Survey (USTS), the largest and most comprehensive study of trans people in the country. Given that most studies fail to include or capture trans people as a unique demographic, this survey is an invaluable resource to describe structural inequities. The previous USTS, from 2015, was instrumental to inform policy, advocacy, and resource allocation, so trans advocates have been eagerly awaiting the results of this fresh round of data.

The first striking difference between the 2015 and the 2022 reports is the number of respondents. While the already-impressive 2015 USTS reflected the experiences of 27,715 trans people nationally, that number grew exponentially in this latest survey: the 2022 USTS leverages data from 92,329 respondents. This dramatic increase is probably a result of the comprehensive outreach and community engagement plan that took place leading up to the 2022 survey, in partnership with organizations like the Black Trans Advocacy Coalition, the National Queer Asian Pacific Islander Alliance, and the TransLatin@ Coalition.

The preliminary report published this month does not yet provide the detailed analysis that the full report will offer. It also does not include population-specific analyses to shed light on how inequities are distributed among various trans communities. (For example, the 2015 data served to develop breakout reports for Black respondents, Latino/a respondents, and other subpopulations, as well as reports for each state.) Nevertheless, the initial data from the 2022 USTS can help us begin to understand how trans people’s experiences of health, economic mobility, and violence have changed or remained the same in this country over the past seven years.

Some notable highlights are:

• Trans people’s current experiences in, and barriers to, healthcare are similar or worse compared to seven years ago. In 2022, 28% of trans people did not see a doctor in the previous year due to cost (compared with 33% in 2015), and 24% did not see a doctor in the previous year due to fear of mistreatment (similar to the 23% in 2015). However, of those who saw a healthcare provider in the past year, 48% had at least one negative experience because they were trans, such as being refused treatment, being misgendered, or being physically or verbally abused by their provider. This is a significant increase from the 2015 rate (33%) of people who had negative experiences in healthcare over the previous year due to transphobia.
• The rates of unemployment and poverty for trans people in 2022 have increased compared to 2015. While in 2015 the unemployment rate among trans people was three times that of the general population (15% vs 5%), by 2022 that gap had widened to trans people being unemployed five times more than the general population (18% vs 3.6%). The proportion of trans people experiencing poverty went up from 29% in 2015 to 34% in 2022. When compared to the general poverty rate in each of those years, we see that, in 2015, trans people were experiencing poverty at more than twice the rate of the general population (29% vs 14%), and in 2022, that inequity became greater with trans people experiencing poverty at almost three times the rate of the U.S. population (34% vs 11.5%).
• Harassment rates have subsided. In 2022, 9% of trans people reported being denied service in the previous year due to their gender identity or expression, compared to 14% in 2015. Moreover, 30% reported being verbally harassed and 3% were physically attacked in the previous year because of their gender identity or expression; these rates are notably lower than the 2015 data on verbal harassment (39%) and physical attacks (9%) due to transphobia.

The 2022 USTS also included new questions that could prove useful in resisting the wave of anti-trans legislation across the country. For instance, 94% of people who lived at least some of the time in their current gender identity reported feeling more satisfied with their life now compared to before transitioning. 98% of people currently receiving hormone treatment, and 97% of those who have undergone gender-affirming surgeries in their lifetime, reported a higher life satisfaction as a result of that medical care. This data proves that gender-affirming healthcare—which many states are currently repealing—increases life satisfaction and mental health for an overwhelming majority of trans people.

Finally, the 2022 survey asked about trans people’s decisions to relocate due to anti-trans sentiment. For instance, 40% of people thought about moving somewhere else due to experiencing discrimination, and 10% actually moved for that reason. Furthermore, 47% thought about moving to another state because their home state had either considered or passed an anti-trans law, while 5% actually moved out of state for the same reason. This describes what we have seen and heard anecdotally in recent years: trans people are being forced to uproot their lives due to anti-trans laws and attitudes, hoping for better life opportunities in their new home states.

As we await a more in-depth analysis of the 2022 U.S. Trans Survey, advocates should leverage the data we have right now to remind decision-makers that, despite significant gains in trans visibility over the past decade, trans people’s access to basic life resources remains sorely inadequate, and far behind that of the general population.

Pau Crego (he/him) is a queer and trans immigrant who has worked towards equity for trans and LGBTQI+ communities for almost two decades, both in the San Francisco Bay Area, and in Spain where he is originally from. His advocacy has included direct services, technical assistance, training and education, program design, and policy change. Crego worked at the Office of Transgender Initiatives (OTI) from 2017–2023, most recently serving as the Office’s Executive Director. He is also faculty in the Health Education Department at City College of San Francisco, and a published author and translator in the field of public health.

Musings on Trans Liberation
Published on February 22, 2024