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Report
Dismantling a Culture of Violence
Understanding Violence Against Transgender and Non-Binary People and Ending the Crisis
Human Rights Foundation | Updated October 2021
Dismantling a Culture of Violence
Table of Contents
Introduction
Since 2013, more than 250 transgender and non-binary individuals have been killed in the United States.
Even in the face of this physical danger, hatred and discrimination, transgender and non-binary Americans live courageously and overcome unjust barriers in all corners of our country. But until we as a country collectively address and dismantle these barriers, transgender and non-binary people will continue to face higher rates of discrimination, poverty, homelessness and violence.
While it’s tempting and common to pursue largely reactive and temporary solutions, we must address the root causes of this violence to make our communities safer for everyone. It is unacceptable that transgender and non-binary people are killed simply because of who they are.
It’s not enough to grieve the loss of victims of violence against transgender and non-binary people. We must honor their memories with action.
In this resource, we hope to demonstrate how stigma against transgender and non-binary people, denial of opportunity and increased risk factors compound to create a culture of violence. But most importantly, we provide clear ways that each of us, no matter who we are, can directly make an impact to make our society a safer place for transgender people.
WHAT LEADS TO VIOLENCE AGAINST TRANSGENDER AND NON-BINARY PEOPLE?
Since 2013, HRC and other advocates have tracked at least 256 cases of known fatal violence against transgender and gender non-conforming people in 37 states, territories and the District of Columbia, across 150 cities and towns nationwide. Although each case is unique in its tragic circumstances, we know this epidemic disproportionately impacts trans women of color, who comprise approximately 4 in 5 of all known violent killings of transgender, non-binary and gender non-conforming people.
Ending this epidemic requires addressing and eliminating stigma against transgender and non-binary people and discrimination across all facets of society — and embracing people of all genders for who they are.
Read the following sections to learn how you can take action to help end the violence.
Stigma Against Transgender and Non-Binary People
For many transgender and non-binary people, living openly can be its own act of defiance in a society that continues to set rigid cultural norms for gender identity and expression.
Transgender and non-binary people face stigma surrounding who they are from an early age. Often rooted in inaccurate beliefs and politically-motivated attacks on transgender and non-binary identities, this stigma erects barriers in virtually every facet of life, denying transgender and non-binary people the equal opportunity to succeed and be accepted for who they are. Moreover, stigma against transgender and non-binary people can have long-term impacts on mental health and economic and housing stability, especially if individuals experience familial rejection and isolation from social support systems.
Lack of Family Acceptance
Transgender and gender expansive youth face heartbreaking levels of familial rejection, often from an early age. This rejection can take a devastating toll on individuals and isolate them from physical and emotional resources that are essential to their well-being.
In contrast, research shows that familial acceptance is a protective factor for transgender young people and can contribute to lower rates of depression, anxiety, substance use, HIV acquisition and suicide attempts.
As adults, many transgender people continue to face familial rejection and isolation, including being kicked out of their homes or physically harmed by family members. In one of its most heartbreaking forms, grieving family members will misgender or erase the identities of victims of violence against transgender and non-binary people after their deaths.
When family members reject, deny or disown transgender individuals, it can have a devastating effect on their well-being and self-worth. It can also impact educational, economic and housing stability and have long-term effects on mental health.
We must take action to ensure transgender and non-binary people of all ages are accepted by their families and safe in their own homes.
For many parents, their transgender or non-binary child may be the first transgender or non-binary person they have ever met. Sadly, fear of the unknown and stigma against transgender and non-binary people lead many to initially reject or deny their children for who they are. You can help reshape the narrative by elevating the wonderful stories of transgender and non-binary people and leaders. By being a visible friend and ally of transgender and non-binary people, you also show others that you support transgender and non-binary people and their right to live openly and safely – with the full support of family and loved ones.
Familial rejection of transgender and non-binary people can be even more challenging for those who hold racial, ethnic, linguistic, religious, immigrant and other cultural identities that appear to conflict with LGBTQ+ identities. Resolving a family member’s bias against transgender and non-binary people requires addressing the sources of their biases and why it causes them to reject or deny transgender and non-binary people. We must provide relevant information, counseling and support for all transgender and non-binary people and their families, especially within faith communities and communities of color where such resources may be less readily available.
Sadly, LGBTQ+ youth comprise a disproportionate percentage of homeless youth, often as a result of familial rejection regarding their identities. These young people desperately need our support, whether in the form of housing, clothes, financial assistance, educational resources or LGBTQ+ affirming mental health providers. Support the work of local organizations performing this important work and advocate for additional government funding for these crucial resources. If you know someone who may be facing familial rejection, affirm your support for them and offer assistance in whatever way you can.
ENDING THE DANGEROUS PRACTICE OF “CONVERSION THERAPY”
Parents who are struggling to accept their child’s gender identity may be urged to subject them to so-called “conversion therapy,” a dangerous and ineffective practice that has been discredited by virtually every mainstream medical and mental health organization.
Efforts that falsely claim to change a person’s sexual orientation, gender identity or gender expression can lead to lasting trauma and other adverse mental health conditions. We must combat misinformation about these practices as we look to support LGBTQ+ people and their families.
To learn more, visit HRC’s resource on The Lies and Dangers of Efforts to Change Sexual Orientation or Gender Identity.
Hostile Political Climate
There are currently very few explicit legal protections for transgender or non-binary people. Despite historic court victories and some marginal gains in state and local policies that support and affirm transgender people, recent years have been marked by anti-LGBTQ+ political attacks.
Hateful efforts have included discriminatory legislation aimed at banning transgender youth from participating in sports alongside their peers, so-called “bathroom bills” designed to restrict transgender people from accessing public spaces,
efforts to stop transgender and gender-expansive youth from accessing transition related medical care including counseling, and attempts to remove gender identity from non-discrimination policies or create overly broad religious exemptions that undermine non-discimination protections.
These discriminatory efforts send a harmful message to our overall society and culture that transgender people are not worthy of equal protection under the law or recognition as full members of our society.
We must demand better from our elected officials and reject harmful legislation against transgender and non-binary people appearing at the local, state and federal levels.
We must ensure that transgender and non-binary voices have a seat at the table at all levels of government and civic engagement. Raise the profile of transgender and non-binary leaders and elevate their concerns about policies that affect your community. Support transgender, non-binary and other pro-equality elected officials who are committed to addressing the needs of all of their constituents – including combating the epidemic of violence against transgender and non-binary people.
LGBTQ+ people still lack discrimination protections in employment, housing, health care, education and public accommodations in many parts of the country. The protections that do currently exist are increasingly under attack by anti-equality forces, and discrimination against transgender and non-binary people is often at the epicenter of such dangerous efforts. We must fight to preserve existing protections and continue to pursue policies like the Equality Act that make our country more inclusive and fair for all.
When discriminatory, legislation against transgender and non-binary people is being considered in your state and at the federal level, amplify your voice to educate others about multifaceted forms of discrimination and violence that transgender and non-binary people face in America. Dispute harmful rhetoric that seeks to dehumanize transgender and non-binary people, and educate those who are not informed of the many barriers transgender and non-binary people experience. Advocate for the recognition of transgender and non-binary people as equal members of our society deserving of the same level of dignity, respect, representation and opportunity as every other member of our society.
Cultural Marginalization and Invisibility
Transgender and non-binary people continue to be ignored, ostracized and excluded from full participation in communities across the country, including faith communities, cultural communities, educational spaces or geographically bound communities and neighborhoods.
This marginalization is often rooted in a lack of awareness of transgender identities and in long-held beliefs dictating gender norms and behavior. It can further be perpetuated by a history of stereotypes and invisibility of transgender and non-binary individuals in media and politics.
Meanwhile, rigid cultural or religious beliefs, a lack of exposure to transgender and non-binary people and discriminatory political attacks from our highest elected officials contribute to a culture of stigma against transgender and non-binary people, discrimination and violence.
Without full acceptance in their communities, transgender and non-binary people will continue to lack support systems, social networks and an overall safety net that many other people take for granted, especially in the role these systems play in their future success and well-being.
We must increase the cultural visibility of transgender and non-binary people and ensure their full inclusion within all communities.
Take the personal initiative to speak to family members, friends and other individuals in all communities you are a part of to ensure these spaces are fully welcoming to transgender and non-binary people. Make time to have personal, heart-to-heart conversations about transgender-centered allyship with people in your workplace, place of worship, neighborhood and other spaces. We all have a personal responsibility to make sure transgender and non-binary people are safe and supported in every community – and to work to transform the spaces where they have yet to be fully included.
Support artists, athletes, activists, political leaders and other transgender and non-binary public figures who are sharing their stories and lived experiences. Uplift these individuals by elevating their projects and sharing their work among your personal network and communities. Support the accurate portrayal and authentic casting of transgender and non-binary actors in prominent media works to reduce harmful, inaccurate images of transgender people that contribute to anti-trans stigma.
Educate people in your community about the different forms of discrimination that transgender and non-binary people face on a daily basis, including stigma against transgender and non-binary people, systemic denial of opportunities and increased societal risk factors. Help your community members understand the sources of these forms of mistreatment, and how together they create an overall culture where transgender and non-binary people are at a higher risk of violence simply for being who they are.
Denial of Opportunity
Across virtually every facet of society, unjust and discriminatory barriers deprive transgender and non-binary people of the right to full and equal participation in society. Whether formalized through law or policy or upheld due to cultural misconceptions about gender, these systemic barriers must be abolished in order to end the marginalization and consequent risk of violence transgender and non-binary people face in their daily lives.
Setbacks in Education
Across the country, educational environments are often hostile or unwelcoming to transgender and gender-expansive youth. Many transgender and gender-expansive students still lack adequate policies to protect their rights and experience rampant mistreatment and discrimination from peers and staff. As a result, they may miss large amounts of class due to feeling unsafe at school.
When transgender and gender-expansive students are left unprotected from the discrimination they face at all levels of education, it can negatively impact their overall well-being, future economic stability and employment opportunities.
We all must take steps to ensure transgender and gender-expansive students have access to inclusive learning environments where they are able to thrive.
Less than 5 percent of LGBTQ+ youth believe that all of their teachers are accepting of LGBTQ+ people. We need to work in our communities to establish transgender and non-binary inclusive training, data collection, accommodations, registration protocols and curricula. Transgender youth must be supported and affirmed in educational settings to fully thrive as students and as future leaders.
In the absence of federal legislation, establishing school district policies, state department of education requirements and state laws is imperative to protect transgender students. Work with your local school board or state officials to enact change that will make educational spaces more welcoming for all.
Over the past few years, there has been a surge in legislation seeking to ban transgender people from public spaces – including school facilities such as restrooms and locker rooms. These bills are predicated on misinformation about transgender people. When passed, they not only put transgender youth in harm’s way, but create a toxic environment where they may be unable to fully achieve their highest potential in the classroom.
Supporting transgender and non-binary students, in their own words:
Too many transgender and non-binary students face harassment or are denied full participation in learning environments:
“I wait until I get home to use the bathroom, even when I’m at school for 10+ hours… I wear my gym clothes over my normal clothes to avoid changing in locker rooms.”
“I transitioned in 7th grade and was bullied profusely by my peers. I asked my health teacher to educate the class. She said that it was too complicated for the students.”
However, when transgender and gender-expansive students are fully supported in schools, they thrive:
“My counselor has always been very supportive of me and has cared a lot about my mental health issues, and always made me feel like a priority. I felt comfortable talking to her because she was very open and understanding and never, ever judged me.”
“I wish school staff were more open about their opinions on LGBTQ+ issues. I visited a school last week and some teachers had signs on their door that welcomed LGBTQ+ students.”
“My school counselor is the sole reason I am here today. She is the most wonderful, most accepting being I could ever think of.”
Take action in your community to support transgender youth. Support LGBTQ+ inclusive policies and work to make your local schools places where all students are able to reach their fullest potential.
Quotes from the 2018 LGBTQ+ Youth Report, a study of more than 12,000 young people nationwide conducted by the HRC Foundation and the University of Connecticut. To learn more about transgender youth, read the full breakout report.
Employment Discrimination
Transgender and non-binary people face devastating levels of discrimination and harassment in the workplace. These barriers are even higher for Black transgender people, who have double the unemployment rate of all transgender people, and four times that of the U.S. general population.
With limited access to workplaces that are affirming and inclusive, transgender and non-binary people are put at greater risk for poverty, homelessness and involvement with criminalized work. Together, these factors put transgender and non-binary people at an increased risk of violence and danger.
We must act to ensure transgender and non-binary working people have fair and equal access to well-paying jobs.
In June 2020, the Supreme Court ruled that sexual orientation and gender identity discrimination are forms of sex discrimination under federal employment law.
Currently, 22 states and the District of Columbia explicitly prohibit employment discrimination based on gender identity and sexual orientation. Voice your support for legislation at all levels, including the Equality Act, and encourage elected officials in your community to enact these protections.
Encourage your employer to establish internal non-discrimination policies that fully include transgender and non-binary colleagues, including providing transgender and non-binary inclusive health benefits, cultural competency training and expanded recruiting and hiring practices. For more information on how some of America’s largest companies are building LGBTQ-inclusive workplaces, refer to HRC’s Corporate Equality Index.
Beyond policies and dismantling stigma against transgender and non-binary people, we must provide avenues for transgender and non-binary people to obtain the education, training and skills that far too many have been denied due to racist and anti-LGBTQ+ systemic barriers. We must provide inclusive career fairs, mentorship, networking opportunities and career coaching for transgender and non-binary workers and raise awareness about their rights as employees.
Barriers for Immigrants, Refugees & Asylum Seekers
LGBTQ+ people face extremely high levels of discrimination and violence in several parts of the world. Many come to the U.S. to claim asylum and escape persecution based on their sexual orientation and/or gender identity. Once in the U.S., LGBTQ+ immigrants and asylum seekers face a higher risk of violence as a result of the U.S. immigration system.
Undocumented immigrants may actively avoid going to police to report being a victim of a crime out of fear of arrest or deportation. Transgender and non-binary detainees held by U.S. Immigration and Customs Enforcement (ICE) may be placed in facilities that do not match their gender identity and are often unable to access gender affirming and life saving medical care and treatment.
We must demand the humane treatment of all immigrants, refugees and asylum seekers.
The dangerous levels of reported sexual abuse and violence that transgender and non-binary people face in immigration detention indicate that ICE is failing to ensure their safety and well-being. We must hold ICE accountable for failing to address these deficiencies immediately and demand that all detainees be treated with respect and dignity. ICE should utilize alternatives to detention for those in custody who are not flight risks, pose no threat to community safety and are not subject to mandatory detention.
LGBTQ+ people face extremely high levels of discrimination and violence in many parts of the world. We must stand united in sending a powerful message that refugees are welcome in the United States by setting higher refugee admissions numbers.
We must sound the alarm about atrocities against LGBTQ+ people worldwide and hold our governments accountable to their commitments to protecting and advancing human rights abroad.
Violence Against Transgender and Non-Binary People Around the World
Despite tremendous challenges, progress towards greater inclusion for transgender and non-binary people is occurring around the world. Recently, governments in New Zealand, Pakistan and Uruguay passed critical legal protections for transgender and non-binary people. Courts in Botswana, Ecuador, Europe and Nepal issued rulings recognizing the rights of transgender and non-binary people.
Even as we look to address the epidemic of violence within our own country, we must continue to support LGBTQ+ rights and freedom of expression around the world.
Exclusion From Healthcare and Social Services
Transgender people are especially vulnerable when it comes to accessing social services and health care, including finding doctors who respect and affirm their identities. Many experience discrimination from medical providers, while others may simply struggle to access medical and mental health professionals who are knowledgeable in transgender and non-binary specific care. Others may be denied health insurance coverage to pursue transition related care or lack insurance altogether, especially those living in or near poverty and living in states where they do not have access to health care through Medicaid.
Concurrently, denial from social services prevents transgender and non-binary people from receiving the resources they need, especially during times of vulnerability. In nationwide studies of transgender and non-binary people who have pursued such services, many report being expelled or denied access to homeless or domestic violence shelters, while others said they avoided shelters altogether because they feared mistreatment or harassment.
Exclusion from these vital safety nets doesn’t just worsen physical and mental health outcomes, it directly contributes to higher risk of homelessness, sexual assault and violence.
There are many actionable steps we must take to ensure transgender and non-binary people have equitable access to health care and social services.
Support the prohibition of discrimination against transgender and non-binary patients in private insurance and Medicaid and the elimination of health plans that include exclusions on necessary transition-related care. Fifty-five percent of transgender and non-binary people report that their insurance denies them from medically necessary transition-related surgery, while 1 in 4 report that they were denied coverage for hormone therapy. At least 179 cities now offer transgender and non-binary inclusive health care benefits for municipal employees, but this trend needs to be followed throughout the United States for all working people.
Health care and social work professionals must increase their skills to offer welcoming, inclusive and up-to-date services, which includes abiding by the National Association of Social Workers Code of Ethics and LGBTQ+ inclusive policy recommendations already published by the American Medical Association. Work within your community to ensure your local providers are providing competent care and make sure to know your rights should you or a loved one face discrimination from a provider.
Across the nation, state and local governments are increasingly recognizing the need to provide transgender and non-binary specific services to a community that is disproportionately at risk. An alarming 70 percent of transgender people who have stayed in a homeless shelter report experiencing some form of mistreatment because of their transgender identity. Start by connecting with local shelters and services to ensure they are able to fully support the needs of transgender clients. Check whether your local or state government has LGBTQ+ and transgender and non-binary specific initiatives for its public welfare programs.
Unequal Policing and the Criminal Justice System
Inequities in the existing justice system continue to lead transgender and non-binary people to mistrust and avoid the very systems supposedly designed to protect them. Many transgender and non-binary people, and especially transgender and non-binary people of color, avoid interaction with law enforcement because they fear harassment, intimidation, incarceration or violence — leaving transgender and non-binary victims of crime without the legal recourse and protections they vitally need. Only 21 states and the District of Columbia currently have laws that address hate or bias crimes based on gender identity. As a result, bias-motivated crimes against transgender and non-binary people often go uninvestigated, unreported and thereby unaddressed.
Meanwhile, transgender and non-binary inmates face disproportionate levels of mistreatment during confinement that leave them vulnerable to violence. They are often housed in facilities that do not match their gender identity and inappropriately placed in solitary confinement. While incarcerated, they also face extremely high rates of sexual assault. In the absence of a criminal justice system that serves and protects them equally, transgender and non-binary people face a heightened risk of discrimination and violence.
We must address inequities in the criminal justice system, including holding law enforcement to a higher standard in serving transgender and non-binary people and communities of color.
Encourage local law enforcement agencies to designate an LGBTQ+ police liaison and enact policies that ensure respectful, culturally competent and non-discriminatory interactions with transgender and gender non-conforming people. In addition, law enforcement agencies should hold regular mandatory trainings on these policies as well as on ways officers can better serve LGBTQ+ populations and understand the unique challenges that transgender people may face in their communities.
These actions are imperative to the larger law enforcement community’s ability to accurately gauge the scope of bias-motivated crimes and effectively address them. Because reporting hate crimes is currently not mandatory under federal law, municipal police departments must take every step possible to ensure that their hate crimes data is transmitted to the FBI accurately and on time. Moreover, local legislators should ensure that city ordinances include provisions that require local police departments to identify and report hate crimes to state law enforcement agencies as well as the FBI.
While incarcerated, nearly one quarter of transgender people report being physically assaulted by staff or other inmates. Ensure that your local and state detention facilities have non-discrimination policies that expressly cover gender identity and ensure that transgender and non-binary detainees are addressed, transported and housed consistent with their gender identity. Advocate for the right for inmates to have access to medically-necessary, transgender and non-binary competent care while being detained.
Barriers to Legal Identification
Transgender and non-binary Americans face significant barriers to obtaining identity documents that accurately reflect their gender. Some reside in states that forbid gender marker changes on IDs. Others may live in places with onerous requirements for such changes, including unnecessary medical procedures, medical documentation, court orders and processing fees. Transitioning is a personal choice and the degree to which transgender and non-binary people decide to undergo transition related care varies considerably, depending on personal preference, safety, financial circumstances and access to specialized care. However, several states still require proof of “surgical procedure” or other treatments before allowing ID changes.
The hurdles are greater still for non-binary people, as only a handful of states currently allow the use of a third gender (e.g., “X” or “NB”) on IDs.
ID discrepancies are not just an inconvenience. They impact access to virtually every aspect of life, including daily transportation, travel, housing, health care, education, employment, public accommodations, and even exercising the right to vote. Identification that does not match a person’s gender identity can also threaten their physical safety and overall well-being. It may lead to discriminatory and potentially dangerous interactions with medical professionals, law enforcement and community members.
We must act to ensure all transgender and non-binary people have the right to accurate legal identification that allows them to fully participate as members of society.
Only 22 states and the District of Columbia currently facilitate gender marker change on both birth certificates and driver’s licenses. Raise awareness about the importance of legal identification as an LGBTQ+ issue, and voice your support for policies that will allow all Americans to obtain accurate identity documents.
All individuals should have the right to obtain identification that reflects who they truly are, without the need to furnish documentation on medical procedures they do not want or may not be able to afford. Simultaneously, we must address the cost of legal name changes, which typically range from $150 to $500, and prevents access to many who cannot afford it. Speak out about these exclusionary hurdles, and consider donating to or creating a name change fund in your community that provides financial assistance to low-income people seeking name changes.
Regardless of legal status, transgender and non-binary people can still face stigma and adverse treatment from those who act as gatekeepers to public accommodations, including travel security agents, employees at restaurants and bars, school officials, law enforcement and others. To ensure that competent care is given to all individuals, establishments and public agencies should take steps to train staff on LGBTQ+ issues and how to approach what one might perceive as a potential discrepancy on identification.
Increased Risk Factors
Although every case is unique, we know from research and transgender and non-binary advocacy that the targets of fatal violence share common experiences that put them at a higher risk. Moreover, women of color, who must also contend with racism and sexism prevalent in our society, are even further impacted by these issues.
Anti-equality forces often use these statistics and research surrounding these fraught topics to erroneously (or maliciously) blame victims for their plight. Instead, we know that stigma and denial of opportunity from an early age leads many transgender people to face these challenges.
Although there are many ways we can support those who are impacted by these risk factors, there are no easy solutions to addressing these issues. Instead, we must ensure that everybody in our society has the equal opportunity to succeed – no matter who they are.
Intimate Partner Violence & Sexual Assault
Intimate partner violence (IPV) and sexual assault can have a devastating impact on any person, but transgender and non-binary people face elevated risks and challenges to receiving care and justice. In the face of discriminatory treatment from law enforcement, medical providers, shelters and other services, many transgender and non-binary survivors of IPV and sexual assault may be hesitant to seek help or fear losing their privacy within care settings. Higher rates of IPV are also correlated with other risk factors that are disproportionately observed among transgender and non-binary people. For instance, 77 percent of transgender people who have engaged in sex work and 72 percent of transgender people who have been homeless report having experienced intimate partner violence.
Many of the cases that HRC has tracked since 2013 have been linked to sexual violence and/or were committed at the hands of intimate partners. We must address these issues simultaneously in order curb violence against transgender and non-binary people — and it starts with dismantling stigma and the dehumanization of transgender and non-binary lives that put individuals at a higher risk of violence.
We must ensure all transgender and non-binary people have the support they need when they experience intimate partner violence and sexual assault.
LGBTQ+ people are often left out of coversations surrounding intimate partner violence and sexual assault, and this is especially true for transgender and non-binary people. Learn the signs of the common types of abuse transgender and non-binary people experience. Advocate for the inclusion of gender identity and sexual orientation markers in research studies to ensure we have the data available to better understand and combat these issues in LGBTQ+ relationships and populations.
Support specialized service providers who offer transgender and non-binary specific care, services and support to survivors of sexual assault and IPV. We must also urge all care providers and organizations to offer professional development opportunities for their staff so they can provide culturally competent services to transgender and non-binary survivors who seek care in hospitals, primary care settings and mental health settings.
To avoid further victimization, law enforcement officials must be prepared and expected to treat transgender and non-binary survivors with respect and dignity. We also need to ensure reported cases of intimate partner violence and sexual assault are appropriately documented and investigated. Encourage your local police department to hold a webinar or training on this specific issue, and hold them accountable to accurate and comprehensive data reporting of violence against transgender and non-binary people.
If you or someone you know has been affected by intimate partner violence or sexual assault, you can seek help by calling a helpline or seeking counseling and information from one of the LGBTQ-friendly resources listed below.
FORGE: serves transgender and non-binary survivors of domestic and sexual violence; provides referrals to local counselors, 1-414-559-2123
Let’s Talk About It: A Transgender Survivor’s Guide to Accessing Therapy
The Anti-Violence Project: serves people who are LGBTQ; Hotline 1-212-714-1141, Bilingual 24/7
The Network La Red: serves people who are LGBTQ, poly and kink/BDSM; Bilingual. Hotline - Voice: 1-617-742-4911; Toll-Free: 1-800-832-1901; TTY: 1-617-227-4911
National Sexual Assault Hotline: 1-800-656-HOPE (4673) 24/7 or Online Counseling
Love is Respect Hotline (for youth): online chat; 1-866-331-9474 (24/7); TTY: 1-866-331-8453; or Text “loveis” to 22522
LGBT National Help Center: Youth Hotline 1-800-246-PRIDE (7743); LGBT National Hotline 1-888-843-4564; Sage LGBT Elder Hotline 1-888-234-7243; or Online Chat here
Northwest Network: serves LGBT survivors of abuse; can provide local referrals: 1-206-568-7777
Engagement in Survival Sex Work
In the face of discrimination and economic barriers, many transgender and non-binary people engage in sex work (i.e., the exchange of sex for money or goods) out of survival. According to media reports, several victims engaged in such work out of financial necessity in the face of employment discrimination and poverty. Others told loved ones that they were doing so to save money for expensive but medically-necessary transition-related care.
Engagement in sex work and the current criminal status of sex work are intricately tied to the epidemic of violence that impacts transgender and non-binary people.
Transgender people who engage in sex work face higher rates of intimate partner violence and sexual assault. Unfortunately, the criminal status of sex work leads many to avoid interactions with law enforcement or to decline to seek assistance, even when they themselves are victims of a crime or traumatic event. It can also prevent those with criminal charges from securing housing or other employment opportunities. Advocates and researchers around the world are increasingly elevating this issue and how it directly impacts public health, especially among transgender and non-binary communities.
We must consider the stigma and legal status surrounding sex work and address its impact on violence against transgender and non-binary people.
The criminalization of sex work directly impacts the already strained relationships that transgender and non-binary people may have with law enforcement. Eighty-six percent of transgender people who had engaged in sex work report being mistreated by police officers. Meanwhile, one-third of Black transgender women who had interacted with law enforcement report that officers assumed they were sex workers. The reality is that many transgender and non-binary people – and especially transgender and non-binary people of color – distrust and avoid law enforcement altogether, leaving many victims of violent crime unprotected and unsupported. We must educate policy makers on how criminalization of sex work contributes to a higher risk of violence and hold law enforcement agencies accountable to equally serving transgender and non-binary individuals regardless of their engagement in sex work.
Denial of opportunities across the board leads many transgender and non-binary people to resort to the underground economy for survival. In order to decrease the percentage of individuals who engage in sex work out of financial necessity, we must provide greater employment opportunities and affordable access to gender-affirming care for transgender and non-binary people. We must also create spaces where sex workers can receive judgment-free care, support and resources, especially as we look to resolve the higher rates of health disparities and violence they face.
Harmful stereotypes regarding the transgender and non-binary community and sex work dehumanize and delegitimize the violence that impacts transgender and non-binary people. Despite popular portrayal, the decision to engage in sex work is complex and influenced by the various barriers individuals face to obtain other gainful employment and sufficient sources of income. Just like with poverty, homelessness and health disparities, we must educate others on the root causes of this issue in order to provide greater support to those who engage in this work.
Poverty and Homelessness
Transgender and non-binary people face disproportionate rates of poverty and homelessness in the United States. These issues are more severe for transgender women of color, who face even higher rates of homelessness, including:*
- American Indian women (59 percent),
- Black women (51 percent),
- Multiracial women (51 percent),
- Middle Eastern women (49 percent), and
- Latina women (35 percent).
Many of those living in poverty rely on the underground economy to survive, which includes sex work, drug sales and other currently criminalized work.
Involvement in these systems increases the risk of violence, including intimate partner violence, sexual assault, health disparities, police harassment and fatal violence.
The poverty and homelessness experienced by transgender and non-binary people does not exist in a vacuum. We must eliminate societal barriers in education, employment and other areas to ensure transgender and non-binary people have access to well-paying jobs and are able to fully participate as working people within our communities. We must also continue to support those currently living in poverty and homelessness with transgender-inclusive services.
*Percentage who reported experiencing homelessness during one’s lifetime to the 2015 USTS.
We must ensure transgender and non-binary people have access to inclusive resources and support when they are experiencing homelessness and poverty.
Increase community awareness of the disproportionate rates of homelessness within this community. Support policies that address this issue in ways that include targeted resources for transgender and non-binary people of color.
More than one-quarter of transgender people who have experienced homelessness say they avoided shelters out of fear of mistreatment. This can include harassment or assault from others staying at the shelter, but also being denied access or having to stay in a sex-segregated facility that does not match their gender identity – an issue even more challenging for non-binary individuals. There are many resources available to shelter workers to ensure their space is affirming of transgender and non-binary people who are experiencing homelessness. Connect with your community homeless resources to ensure they are providing competent care and protection for all.
Nearly one in five transgender and non-binary people report receiving negative treatment when they went to a public assistance or government benefits office. These resources, designed to assist individuals in escaping poverty, need to be accommodating and knowledgeable of the unique challenges transgender people face while experiencing poverty and homelessness.
Physical & Mental Health Disparities
Confronted with barriers in virtually every facet of life, transgender and non-binary people can be more susceptible to elevated mental health risks including depression, anxiety and suicide. Although higher rates of these issues have been erroneously (and maliciously) used to portray transgender and non-binary people as “broken” or inherently flawed, it is actually the stigma and rejection of transgender and non-binary people prevalent in our society that leads to higher rates of mental health challenges among transgender youth and adults.
Transgender and non-binary people are also more likely to face physical health conditions, often related to the risk factors discussed in this report.
For instance, the rate of HIV among transgender people working solely in the underground economy, including survival sex work, was more than ten times higher than other transgender and non-binary people living with HIV. Transgender and non-binary people who have experienced homelessness are twice as likely to be living with HIV.
Unfortunately, limited access to transgender and non-binary inclusive care too often prevents health conditions from being fully addressed. In lieu of affordable and affirming care, countless transgender and non-binary people will continue to lack the resources they need to improve their well-being and overall safety.
We must address the factors that lead to disparities in transgender and non-binary physical and mental health and ensure transgender people have access to the care they need.
All transgender and non-binary people face difficulties in finding competent care, but the barriers are even greater for transgender and gender-expansive youth during an age where well-being can have long-term impacts on success. We must ensure all young people have access to gender affirming medical care, which has been shown to improve the mental health of transgender people. We must also provide greater training for youth-serving professionals in schools and our communities who can help monitor and mitigate mental health conditions. By providing support at an early age, we give transgender and non-binary people a greater opportunity to develop, grow and thrive in our communities.
Although transgender and non-binary affirming care is slowly becoming more available in many communities, transgender and non-binary people who are low-income or homeless may be completely locked out from these services – especially if they lack health insurance coverage, the ability to pay for care, and/ or the time off to pursue care. We must directly support social services and low-income care providers and ensure that they are prepared to support transgender and non-binary community members, including LGBTQ+ health centers. When doing so, we must acknowledge that many transgender and non-binary people have had negative and discriminatory experiences pursuing medical and mental health care – and create environments where they feel comfortable pursuing care.
For too long, the mental health disparities that transgender and non-binary people experience have been used to dehumanize them and delegitimize the struggles they experience. Transgender and non-binary identities and experiences are still heavily pathologized, and viewed as a mental health struggle in and of itself by many in the medical community, which prevents transgender people from receiving life-saving care. Transgender and non-binary people do not inherently struggle with mental health; instead, any disparities are created due to the systematic violence and discrimination transgender and non-binary people experience throughout their lives. Dispute this myth by educating others on the various forms of discrimination that transgender and non-binary people face, and how stigma and cultural marginalization can negatively impact mental health.
Addressing and Ending Suicide in the Transgender and Non-Binary Community
The most devastating toll of stigma and discrimination against transgender and non-binary people can be seen in the high rate of attempted suicide by transgender people, and especially transgender and gender-expansive youth, where current statistics constitute a national crisis at nearly nine times the national average.
Those who actively oppose the transgender and non-binary community occasionally use these deeply saddening statistics to portray transgender people as “broken” or “mentally unstable.” But in reality, it’s our transphobic culture and society that constructs barriers against transgender and non-binary people in ways that threaten the mental well-being of transgender and non-binary people. We must all take responsibility in reshaping our culture and our communities in ways that allow transgender and non-binary people to fully thrive.
Dismantling the barriers transgender and non-binary people face, starting with increased familial and community acceptance, political support and representation, cultural affirmation of transgender and non-binary identities, and increased access to gender affirming medical care will have an overwhelmingly positive impact on the mental health of transgender and non-binary people.
If you or someone you know may be at risk of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255. If you’re a young LGBTQ+ person and need to talk to someone, call The Trevor Project’s 24-hour crisis hotline for youth at 1-866-488-7386. If you are a transgender person of any age, call the Trans Lifeline at 877-565-8860.
Take Action
Violence against transgender and non-binary people is not a new phenomenon. We know that it disproportionately impacts young transgender women of color, and we can identify common risk factors shared among many of its victims. But in order for us to end this deeply complex crisis, we must constantly identify new approaches and engage wider audiences to address the root causes that lead transgender people to face a higher risk of violence.
Learn. Understand. Educate others. Support equality and show up for the transgender community.
Below, we summarize the major ways that we can address each issue within this larger crisis, as explained in detail earlier in this report. As you review them, think about what steps you may be most qualified or able to take on personally. Consider others you know — especially those either other areas of influence or expertise — whom you might be able to educate and raise awareness with about this crisis.
There are many steps all of us can take to address the stigma, discrimination and risk factors that lead to a higher rate of violence against transgender and non-binary people.
Eliminating Stigma Against Transgender and Non-Binary People
Lack of Family Acceptance
- Educate family members and other loved ones about transgender and non-binary inclusion
- Provide culturally-relevant resources for transgender and non-binary people and their families
- Offer additional support for youth who face rejection and homelessness
Hostile Political Climate
- Elevate transgender and non-binary voices and support pro-equality elected officials
- Fight for critical non-discrimination protections
- Actively voice your support for the transgender and non-binary community
Cultural Marginalization & Invisibility
- Make your communities more transgender and non-binary inclusive
- Support and elevate transgender and non-binary voices in media
- Raise awareness of the issues transgender and non-binary people face
Opening Opportunities Across Society
Setbacks in Education
- Create safe spaces for transgender and non-binary youth
- Advocate for transgender and non-binary inclusive policies and anti-bullying laws
- Combat misinformation about transgender and non-binary people in schools
Employment Discrimination
- Expand non-discrimination policies at the federal, state and local level
- Encourage all employers to engage in eliminating workplace discrimination
- Ensure transgender and non-binary working people have a pathway to success
Barriers for Immigrants, Refugees & Asylum Seekers
- Tell ICE they must ensure the safety and well-being of transgender and non-binary detainees
- Call for the U.S. Government to resettle at least 75,000 refugees in 2019
- Hold the U.S. government accountable to speaking up for international LGBTQ+ human rights
Exclusion from Health Care & Social Services
- Expand and protect health care coverage for transgender and non-binary people
- Increase provider expertise and cultural competency
- Provide transgender and non-binary specific social services
Unequal Policing & Criminal Justice System
- Enhance law enforcement response and training
- Ensure that law enforcement agencies accurately identify, investigate and report hate crimes based on sexual orientation and gender identity to both state and federal agencies
- Ensure that detention policies include protections for transgender and non-binary detainees
Barriers to Legal Identification
- Increase pressure on all states to facilitate gender marker changes
- Eliminate exclusionary barriers to ID changes
- Educate and train “gatekeepers” to public accommodation
Reducing Risk Factors to Violence Intimate Partner
Violence & Sexual Assault
- Explicitly include transgender and non-binary issues in conversations surrounding IPV and sexual assault
- Ensure medical and mental health services are available for transgender and non-binary survivors
- Train law enforcement to respond appropriately
Engagement in Survival Sex Work
- Explore and address the impact criminalization has on public safety
- Provide additional resources and support for survival sex workers
- Reframe the narrative surrounding sex work and its relation to the transgender and non-binary community
Poverty & Homelessness
- Educate others on disparities transgender and non-binary people face related to homelessness and poverty
- Ensure homeless shelters are welcoming spaces for transgender and non-binary people
- Demand transgender and non-binary inclusive resources for low-income individuals in your community
Physical & Mental Health Disparities
- Expand access to transgender and non-binary inclusive health services for youth
- Enhance services for low-income and homeless populations
- Change the narrative surrounding transgender and non-binary identities and mental health
We see you off with messages of solidarity and resilience from transgender and non-binary activists:
Walking in one’s truth does not mean you don’t recognize the truth of others, it means you have placed a value on your truth... it means you are resilient…"
Our transness embodies our resiliency, and in that resiliency we see our power. We see the individual agency we have demonstrated in living our truth despite all of the barriers in the world, and the bullies see that power and they are jealous of it. No matter the challenges we face, we must never forget the simple fact that resiliency is strength, authenticity and hope – and we carry that with us from the scariest of spaces to the safest of places.”
Resiliency comes in knowing that our blackness and trans identity are intertwined so beautifully they cannot be pulled apart. It is in the intersection of my identities that pride, like a phoenix, rises from the ashes of oppression. Resiliency is knowing the fire in my black trans heart burns brighter and with a purpose so strong, nothing can diminish it.”
Resiliency is that small ember, kept warm by love, encouraged by hope, lifted in faith that reminds us that we, too, have a right to be here. There are so many who look at us and say that because we are who we are, we are not enough. But I have the prayers of my parents, the courage of my child, the substance of my ancestors reminding me that yes, we are enough and we can and must keep going.”
About the Human Rights Campaign Foundation
The Human Rights Campaign Foundation improves the lives of lesbian, gay, bisexual, transgender and queer (LGBTQ+) people by working to increase understanding and encourage the adoption of LGBTQ+ inclusive policies and practices. We build support for LGBTQ+ people among families and friends, co-workers and employers, pastors and parishioners, doctors and teachers, neighbors, and the general public. Through our programs and projects, we are enhancing the lived experiences of LGBTQ+ people and their families, as we change hearts and minds across America and around the globe. The HRC Foundation is a nonprofit, tax-exempt 501(c)(3) organization.
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