Transition-Related Health Outcomes
Self-reported health and wellbeing status
USTS respondents reported poor outcomes across many domains of health and wellbeing—but crucial factors, like social and medical transition, were associated with better outcomes.
- 66% of 2022 USTS respondents reported they were in “excellent,” “very good,” or “good” health, which was substantially lower than the 81% in the general adult population and the 78% in the 2015 USTS.
- Those who had socially or medically transitioned had a higher prevalence of reporting good health compared to those who had not (67% vs. 61% for social transition; 70% vs. 58% for medical transition).
Mental Health
The impact of social acceptance and discrimination
Adverse mental health indicators, such as depressive symptoms, psychological distress, and suicidality, were elevated among respondents compared to the general U.S. population. However, several factors were associated with better mental health, including support from family members. Discrimination and harassment were associated with worse outcomes.
- The lifetime prevalence of suicidality among 2022 USTS respondents was striking—78% reported lifetime suicidal thoughts and 40% reported lifetime attempts.
- Those with supportive families reported less suicidality compared to those with unsupportive families—78% of respondents with supportive families reported suicidal thoughts compared to 88% of those with unsupportive families.
- 31% of those who experienced no discrimination or harassment reported past-year suicidal thoughts compared to 50% of those who were verbally harassed, 53% of those who were denied equal treatment, and 63% of those who were physically assaulted.
Trans Health and Happiness
Gender transition as a source of happiness
Respondents who reported social or medical transition consistently reported higher happiness, thriving, and satisfaction.
- Those who reported social transition more often reported they were “very to pretty happy” (71% vs.52%), “thriving” (36% vs. 18%), and satisfied with their lives (43% vs. 24%) compared to those who have not socially transitioned.
- We found similar results for medical transition and happiness (72% vs. 55%), reports of thriving (37% vs. 19%), and life satisfaction (43% vs. 27%).
General Health and Experiences with Health Care Providers
Health status and access to care
Stigma and discrimination have a significant impact on the health and wellbeing of many transgender people, and they encounter numerous barriers to the medical and mental health care they need to be healthy.
- Approximately two-thirds of respondents reported that their health status was “good” (36%), “very good” (24%), or “excellent” (6%). One-quarter (25%) rated their health status as “fair,” and 9% said it was “poor.”
- More than one-quarter of respondents (28%) did not see a doctor when they needed to in the last 12 months due to cost.
- Nearly one-quarter of respondents (24%) did not see a doctor when they needed to in the last 12 months due to fear of mistreatment.
- Forty-four percent (44%) of respondents experienced serious psychological distress in the last 30 days (based on the Kessler 6 Psychological Distress Scale).
- Seventy-nine percent (79%) of respondents saw a doctor or health care provider within the last 12 months, and 9% saw a provider between 1 and 2 years ago.
- Of those who saw a health care provider within the last 12 months, nearly one-half (48%) reported having at least one negative experience because they were transgender, such as being refused health care, being misgendered, having a provider use harsh or abusive language when treating them, or having a provider be physically rough or abusive when treating them.
Health Insurance
Coverage and issues with insurance companies
- Eighty-seven (87%) percent of respondents had health insurance coverage.
- Approximately 1 in 4 respondents (26%) had at least one issue with their insurance company in the last 12 months, such as being denied coverage for hormone therapy, surgery, or another type of health care related to their gender identity/transition; gender-specific health care because they were transgender; or routine health care because they were transgender.
