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Survey of over 90,000 trans people shows vast improvement in life satisfaction after transition

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A survey of more than 92,000 transgender people in the United States found that the vast majority reported more life satisfaction after transitioning, despite facing discrimination in healthcare and the workplace settings. 

Early insights from the survey - which aims to broadly examine the experiences of transgender people in the United States - were released on Thursday. The findings show that people who transitioned were largely happier with their life after the process, though many people who identify as transgender or non-binary said they dealt with discrimination in the workplace or in healthcare settings. 

Some respondents said that they were even considering moving across state lines to avoid discriminatory legislation. 

"Those of us who provide gender affirming care find that nearly all of our patients are very satisfied with their medical care but are anxious because of hostility in some parts of society," said Dr. Joshua Safer, the executive director of the Center for Transgender Medicine and Surgery in New York's Mount Sinai Health System. 

Survey finds increased satisfaction after transitioning 

When asked how they felt about life after transitioning to their preferred gender identity, more than three-quarters of respondents said they were "a lot more satisfied" with their life, while 15% were "a little more satisfied." 

Three percent of respondents said their satisfaction with life did not change with transitioning. A similar percentage were less satisfied – 1% of people were "a little less satisfied," and 2% of people were "a lot less satisfied" with life. 

Safer said the results of the survey "mirror what we practitioners believe we are seeing in practice," calling the statistics around gender-affirming hormone treatment "especially striking." 

People who were taking hormone treatment overwhelmingly reported being more satisfied with their lives. 84% of people said that taking hormones to match their gender identity made them "a lot more satisfied," and another 14% of people were "a little more satisfied" while on hormones. 

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People who had surgery to match their gender identity were even more likely to be satisfied with their lives, the survey found, with 88% of people who had at least one form of surgery to match their gender identity reporting that they were "a lot more satisfied" with their lives. Another 9% of respondents were "a little more satisfied." One percent of people said that surgery had no impact, while less than 2% of people said they were a little or a lot less satisfied after undergoing gender-affirming surgery.  

"If we want to see improvements in the well-being of transgender people who seek medical care, the biggest opportunities for improvement are earlier engagement with care and more support by society in general," Safer said. 

Despite strides, respondents still struggle with healthcare and workplace mistreatment

When it comes to healthcare, almost a quarter of respondents said they did not see a doctor when they needed to in the past year because they were afraid of mistreatment. Of those who did see a healthcare provider in the past year, about half said they had "at least one negative experience because they were transgender."  Health providers used hard or abusive language and were physically rough or abusive. In some cases patients were misgendered or refused care.

In the workplace, more than one in ten people who took the survey said they had been fired, forced to resign, or otherwise lost their job because of their gender identity or expression. The unemployment rate among survey respondents was 18%. Meanwhile, about a third of respondents said they were experiencing poverty, and 30% said they had experienced homelessness at some point in their life. 

People who responded to the survey said that generally, they experienced harassment and violence because of their gender identity, with nearly one in ten respondents saying that they were denied equal treatment or service in the past year because of their identity or expression. Nearly a third of respondents said they were verbally harassed, while 39% of people said they experienced online harassment

Three percent of people said they were physically attacked in the last year. Four percent of people said they were denied access to a restroom in a public place, at work or in school because of their gender identity in the past year, while 6% of respondents said they had been verbally harassed, physically attacked or experienced unwanted sexual contact when accessing or using a restroom. 

Candles and portraits
Candles and portraits of people from the transgender community are pictured during a ceremony to support the transgender community and raise awareness on the issues that transgender people face in the country. HILDEGARD TITUS/AFP via Getty Images

Respondents say they experience harassment, discrimination - and move across state lines to avoid it 

Many respondents said they dealt with some form of discrimination and nearly half said that they had considered moving out of their home state because of proposed or passed legislation targeting transgender people.

"The data makes it clear that gender-affirming care helps trans people feel more satisfied with their lives," said Rodrigo Heng-Lehtinen, executive director of the National Center for Transgender Equality, in an email to CBS News. "And still, we see discriminatory policies in states all around the country that cause real harm by creating barriers to such care."  

Nearly half of respondents said they had thought about moving to another state because the government in their home state had "considered or passed laws that target transgender people for unequal treatment," including banning access to bathrooms, health care or sports. Five percent of respondents, or one in 20 people, said they had actually moved because of such legislation. 

The survey found that the top 10 states that respondents had moved from because of laws targeting transgender people are Alabama, Arizona, Florida, Georgia, Missouri, North Carolina, Ohio, Tennessee, Texas and Virginia. Those states were listed in the survey in alphabetical order, not by how many people had moved from them.

Forty percent of respondents said they had thought about moving to another area because of discrimination or unequal treatment where they lived, while 10% of respondents had actually moved because of this.

Over 92,000 transgender and non-binary people 16 and older in the U.S., U.S. territories and on U.S. military bases overseas were surveyed, and the insights were based on data collected by the National Center for Transgender Equality over six weeks in 2022. 

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