Insidious: Extreme Pressures Faced by Trans People

“So, what was Stonewall?”
January 25, 2013
WWLT-TV, I Find Your Lack Of AP Stylebook Trans Understanding Disturbing
January 27, 2013

Insidious: Extreme Pressures Faced by Trans People

Studies show that the trans population lives under extreme psychological pressures unseen in even active military personnel. Fifty-five percent of trans people  [1,2] were found to live with social anxiety. Within the general American population, similar types of anxiety are experienced by only 6.8% [3] of the population while these levels of anxiety were found to exist at a rate of 8.2% among military personal. [4]

chart

Levels of social anxiety experienced by population.

This graph compares the social anxiety transgender people feel against levels of social anxiety within the general American population and that experienced by military personnel.

Transgender and gender variant persons are frequently harassed and discriminated against when seeking housing or applying to jobs or schools, are often victims of violent hate crimes, and face challenges in marriage, adoption and parenting rights.

Discrimination and lack of equal civil rights is damaging to the mental health of transgender and gender variant individuals. For example, gender-based discrimination and victimization were found to be independently associated with attempted suicide in a population of transgender individuals, 32% of whom had histories of trying to kill themselves, and in the largest survey to date of gender variant and transgender people 41% reported attempting suicide.

The APA joins other organizations, including the American Medical Association and the American Psychological Association, in endorsing strong policy statements deploring the discrimination experienced by gender variant and transgender individuals and calling for laws to protect their civil rights.

The American Psychological Association, 2012

The National Institute of Health defines Social Anxiety Disorder as being characterized by a, “… persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships.”

“… ethnic minority MtF transgender persons who experience negative interactions with health providers and face discrimination in the health care system feel strong barriers to utilizing health care services, and consequently exacerbate health disparities. Transphobia experience, depression, and economic pressure would also contribute to the barriers to utilizing services experienced by MtF transgender persons of color. This vicious cycle must be eliminated by developing health intervention programs specific to MtF transgender persons.” – Nemoto, Operario and Keatley, 2005 [5]

The studies reviewed found that over half of respondents claim significant anxiety over the way in which the cisgender population may react to them as transgender women. This is not a baseless concern; the trans population suffers significant rates of housing and employment discrimination, rape and assault. Housing discrimination contributes to homelessness; employment discrimination contributes to chronic unemployment and forced participation in underground economies such as sex work which then drives high rates of HIV within the trans population. Violence and discrimination narrows the experience of life for a significant portion of the trans population to the simple need to physically and psychologically survive. Thus begins a cycle which reinforces depression and shame while simultaneously validating disempowerment and fatalism.


Connecting the Dots

I have spent so many hours avoiding public multi-stall bathrooms  that I have damaged my bladder and put pressure on my kidneys. The problem was a daily one. I’d think about where I was going what bathrooms I’d have access to, how much I drank during the day, whether I’d be with people who could help stand guard…

–  Response to a 2002 survey conducted by the San Francisco Human Rights Commission which found that nearly 50% of transgender respondents reported harassment or assault when simply attenpting to use a public bathroom

We live under the constant threat of horrifying violence. We have  to worry about what bathroom to use when our bladders are aching.  We are forced to consider whether we’ll be dragged out of a bathroom and arrested or face a fist fight while our bladders are still aching .  It’s an everyday reality for us. Human beings must use toilets… If I go into the women’s bathroom, am I prepared for the shouting and shaming? Will someone call security or the cops? If I use the men’s room, am I willing to fight my way out? Am I really ready for the violence that could ensue?

– Leslie Feinberg, Trans Liberation: Beyond Pink or Blue, p 68 – 69

Police officers often harass or abuse transgender and gender nonconforming people regardless of which sex-segregated bathroom they use. This harassment intensifies when coupled with the stereotyping of trans people as sexual predators. As such, the use of the  ‘wrong’ bathroom . . . often results in arrests for crimes such as public lewdness, public obscenity, or public indecency. Refusing to  comply with or simply questioning a police officer’s direction as to  which bathroom the individual must use can often lead to charges  such as resisting arrest or disorderly conduct.

– Pooja Gehi, Struggles from the Margins: Anti-Immigrant Legislation and the Impact on  Low-Income Transgender People of Color, 30 WOMEN’S RTS. L. REP. 315, 326 (2009)

[Non-discrimination protections based upon gender identity] would allow all males – including registered sex offenders or males subject to a domestic violence order of protection – to assert “gender identity” as a means to invade female-only space. Indeed, these laws provide a legal basis for males to be in sex-segrigated space. It is well-documented that males as a class have a demonstrated history of harming females as a class by exploiting bemale biology (ie, rape, sexual violance, unwanted pregnancy).

– Cathy Brennan and Elizabeth Hungerford United Nations letter

… their arrogance and oppressiveness is amazing. It is funny though that they are so used to Feminists immediately bowing before them that they don’t know how to deal with that we don’t care what happens to them. They expect we’ll be shocked to see statistics about them being killed, and don’t realize, some of us wish they would ALL be dead.

– BevJo, Radical Feminist leader

I believe if I was standing at a dressing room and my wife or one of my daughters was in the dressing room and a man tried to go in there — I don’t care if he thinks he’s a woman and tries on clothes with them in there — I’d just try to stomp a mudhole in him and then stomp him dry.

– State Rep. Richard Floyd (R)


NOTES:

  1. Kenagy, G., & Bostwick, W. (2005). The health and social service needs of transgender people in Chicago. International Journal of Transgenderism, 8(2/3), 57-66. doi: 10.1300/J485v08n02_06
  2. Padgett, P., & Risser, J. (2010).Transgender HIV behavioral survey (thbs): Pilot study in Houston, TX. Unpublished manuscript, School of Public Health , The University of Texas, Houston, Texas.
  3. NIH Social Anxiety: http://www.nimh.nih.gov/statistics/1SOC_ADULT.shtml
  4. Social anxiety disorder and social fears in the Canadian military: Prevalence, comorbidity, impairment, and treatment-seeking, Journal of Psychiatric Research, Volume 44, Issue 14, October 2010, Pages 887–893
  5. Nemoto, T., Operario, D., Keatley, J., Han, L., Soma, T. (2006) HIV risk behaviors among male-to-female transgender persons of color in San Francisco. American Journal of Public Health,  94(7):1193-1199

ptsd

Editor’s Note: Read more about the rate of social anxiety/PTSD in military personnel here. Rates cited here were between 8% and 43%, depending upon the type of combat the soldier survived. Even the high-bound level of 43% seems to be dwarfed by levels found in trans studies.
Cristan Williams
Cristan Williams
Cristan Williams is a trans historian and pioneer in addressing the practical needs of the transgender community. She started the first trans homeless shelter in the South and co-founded the first federally funded trans-only homeless program, pioneered affordable healthcare for trans people in the Houston area, won the right for trans people to change their gender on Texas ID prior to surgery, started numerous trans social service programs and founded the Transgender Center as well as the Transgender Archives. Cristan is the editor at the social justice sites TransAdvocate.com and TheTERFs.com, is a long-term member and previous chair of the City of Houston HIV Prevention Planning Group.

30 Comments

  1. @tgmentalhealth Insidious: Extreme Pressures Faced by #Trans People http://t.co/CIWzNFIs #girlslikeus

  2. @metalmujer says:

    RT @ParisLees: 55% of trans people live under extreme psychological pressures unseen in even active military personnel. Not surprised! http://t.co/0N4cqaKw

  3. RT @ergeekgoddess: RT @metalmujer: @ergeekgoddess 55% of trans people face daily stress levels exceeding those of soldiers in combat. http://t.co/n0xT4rRw

  4. RT @ParisLees: 55% of trans people live under extreme psychological pressures unseen in even active military personnel. Not surprised! http://t.co/0N4cqaKw

  5. @quarridors says:

    55% of trans people found to have social anxiety http://t.co/0CUFxnM4

  6. @Stefonknee says:

    RT @transadvocate: Insidious: Extreme Pressures Faced by #Trans People http://t.co/2BFtChgU #girlslikeus

  7. @TransPoP says:

    RT @TransEnough: Incedious: Extreme Pressures Faced by Trans People http://t.co/nHHydt29

  8. RT @transadvocate: Insidious: Extreme Pressures Faced by #Trans People http://t.co/2BFtChgU #girlslikeus

  9. @Sarah_LNX says:

    RT @ParisLees: 55% of trans people live under extreme psychological pressures unseen in even active military personnel. Not surprised! http://t.co/0N4cqaKw

  10. @ian_rivers says:

    RT @christineburns: US Studies show trans population lives under extreme psychological pressures unseen in even active military personnel. http://t.co/MvZDvejA

  11. @scattermoon says:

    RT @ParisLees: 55% of trans people live under extreme psychological pressures unseen in even active military personnel. Not surprised! http://t.co/0N4cqaKw

  12. @funkjunk says:

    RT @ParisLees: 55% of trans people live under extreme psychological pressures unseen in even active military personnel. Not surprised! http://t.co/0N4cqaKw

  13. @Sarah_LNX says:

    @stellduffy Glad of that but many were though. This useful to explain I think http://t.co/3zrhtU4U @TransMediaAct @jonanamary @leftytgirl

  14. RT @12thKnight: Trans* people suffer from a fuckton of social anxiety? No shit. http://t.co/mQYauaYH

  15. @thomvernon says:

    “@BuckAngel: Insidious: Extreme Pressures Faced by Trans People http://t.co/p2yh9k5l via @zite” @TheDriftsLive

  16. Likelihood of experiencing social anxiety: transgender population: 55%; cisgender population: 6.8% http://t.co/5oAPah8u

  17. @laurustina says:

    RT @missparkermarie: Likelihood of experiencing social anxiety: transgender population: 55%; cisgender population: 6.8% http://t.co/rb2xk44y

  18. @Artemissian says:

    RT @laurustina: RT @missparkermarie: Likelihood of experiencing social anxiety: transgender population: 55%; cisgender population: 6.8% http://t.co/rb2xk44y

  19. @Mind_Out says:

    RT @christineburns: US Studies show trans population lives under extreme psychological pressures unseen in even active military personnel. http://t.co/MvZDvejA

  20. @DaveT63 says:

    RT @christineburns: US Studies show trans population lives under extreme psychological pressures unseen in even active military personnel. http://t.co/MvZDvejA

  21. @jackmolay says:

    RT @cristanwilliams: @jackmolay Insidious: Extreme Pressures Faced by #Trans People http://t.co/CIWzNFIs #girlslikeus

  22. Insidious: Extreme Pressures Faced by Trans People: http://t.co/rCffeiVF

  23. RT @cristanwilliams: Insidious: Extreme Pressures Faced by #Trans People http://t.co/CIWzNFIs #girlslikeus

  24. […] while these levels of anxiety were found to exist at a rate of 8.2% among military personal.” http://www.transadvocate.com/extreme-pressures-faced-by-trans-people.htm This statistic is sad, but unsurprising. We know from numerous studies that rates of violence and […]

  25. […] Studies show that the trans population lives under extreme psychological pressures unseen in even active military personnel. Fifty-five percent of trans people were found to live with social anxiety. Within the general American population, similar types of anxiety are experienced by only 6.8% of the population while these levels of anxiety were found to exist at a rate of 8.2% among military personal. […]

  26. […] Studies show that the trans population lives under extreme psychological pressures unseen in even active military personnel. Fifty-five percent of trans people were found to live with social anxiety. Within the general American population, similar types of anxiety are experienced by only 6.8% of the population while these levels of anxiety were found to exist at a rate of 8.2% among military personal. […]

  27. […] Cristan Williams, Extreme Pressures Faced by Trans People […]


  28. What does “transgender” mean?
    Transgender is an umbrella term that signals movement between or across genders.  A transgender person is someone who identifies as a gender other than the one they were assigned at birth based on the appearance of their sex organs.  Many transgender people experience anxiety and distress that their gender — their personal sense of being male, female, or non-binary — is not reflected by the way they interpret their body or the way others interpret their body..
    Some transgender people find significant mental, emotional, and physical relief when they begin using a name and pronouns which align more with their gender identity, rather than with their assigned sex. Trans people may also choose to dress in a way that more accurately reflects their gender identity, and sometimes to pursue hormonal treatment and/or surgery which brings their body more into alignment with the gendered expectations associated with their gender.
    This means that transgender bodies can be very different than cis expectations.  Some trans women, for example, do not have breasts. Some trans men, for example, have vaginas and menstruate each month.
     
    “cisgender” or “cis-gender”A cisgender person is someone whose gender identity matches the one they were assigned at birth. The prefix “cis-” signals a sense of being all on the same side, in contrast to “trans-” which signals a movement between or across.
     
    “transgender man” or “trans man”A transgender man is an individual who was assigned or designated female at birth (usually based on sexual characteristics), but who identifies as male.
     
    “transgender woman” or “trans woman”A transgender woman is an individual who was assigned or designated male at birth (usually based on sexual characteristics), but who identifies as female.
     
    “nonbinary”Non-binary gender describes any gender identity which does not fit within the binary of male and female.
     
    “AMAB” and “AFAB”AMAB is an acronym for “assigned male at birth,” and AFAB for “assigned female at birth.”  At birth (or prior to it, through observation in ultrasound), a baby’s genitals are observed by doctors and other medical professionals who declare that the child, based on sex organs, is “male” or “female.”  This is an assumption about gender based on anatomy and the gender binary.  
     What is cissexism, transphobia, and transmisogyny?
    The reality of living as a transgender person means experiencing prejudice, discrimination, material harm, and even violence. These negative outcomes result from a set of multiple overlapping social forces, which we will refer to as cissexism, transphobia, and transmisogyny.
     
    What is cissexism?
    Cissexism is the explicit or implicit assumption that cisgender narratives, experiences, and bodies are more natural, normal, or valid than trans ones.
    Examples of cissexism include:
    – Assuming that a woman has periods or can bear children (although this also affects a large number of cisgender women as well), or assuming that a non-woman doesn’t or can’t.
    – The assumption that everyone is either a man or a woman (including phrases like “brothers and sisters”, “the opposite gender”).
    –  Assuming that someone is cisgender because one cannot tell that they are trans.
    – Assuming that someone a man has always presented as male, been included in male spaces, and had experiences culturally expected as boys; and likewise for women.
    – The belief that trans womanhood or manhood is an imitation of cis womanhood or manhood, or that trans experiences of gender are not expressions of womanhood or manhood just as valid as cis experiences. Rather than challenging cisgender experiences of gender, transgender expressions and experiences can enhance the way all humans can experience gender and gender identity. Gender experiences are not restricted only to those who are cisgender. Trans women’s experiences are women’s experiences in the same sense that cis women’s experiences are. Being a woman in a boys’ locker room is a woman’s experience. An AMAB woman denying that she can possibly be a woman is a woman’s experience.
    – Terms like “biological sex,” even when used in medical contexts. Chromosomal configuration, genital configuration, secondary sex characteristics, or reproductive ability have been often treated in direct relationship to maleness or femaleness, and doing so inherently privileges cisgender narratives. In addition, chromosomal configuration, genital configuration, secondary sex characteristics, and reproductive ability do not always correspond with each other in a perfectly divided or “binary” way, and assuming that they do excludes and erases both trans people who have modified their bodies to alleviate dysphoria and intersex people.
     
    Cissexism is in many ways ingrained into many common expressions, including “men and women” as two contrasting and all-encompassing categories. One attempt to resolve this problem is the use of phrases such as “people with vaginas” and “people with penises”. This expression acknowledges the existence of trans men and and trans women, which is useful, but the expression then groups them with cis women and cis men, respectively. Except in a medical context, implying that cis women and trans men form a socially cohesive category (essentially, because they share sexual organs) is incorrect and very harmful, as is implying that trans women and cis men form a socially cohesive category. Even in a medical context, speakers should be careful to only say “people with vaginas” if vaginas are the relevant body part – assuming that all AMAB (assigned male at birth) or AFAB (assigned female at birth) people have the same anatomy is ignorant of the experiences of both trans and intersex people.
     
    What is transphobia?
    Transphobia is explicit anti-trans sentiment. The line between cissexism and transphobia is not always clear or meaningful or important.
     
    Examples of transphobia:
    – Believing that being transgender is a symptom of mental illness, a lie people tell, or a fad  [Insert link to Austen’s article on trans identity & mental illness.]
    – Belittling non-binary people for not fully identifying as male or female.
    – Requiring transgender people to use gendered facilities such as public bathrooms that are inconsistent with their identified gender.
    – Evaluating the validity of someone’s gender identity based on their ability “pass” as cis.
     
    What is “passing”?
    Passing is the ability of a trans person to appear to be a cis person of their gender. Passing is not absolute; many trans people only pass sometimes.
    Trans people who frequently pass are, for obvious reasons, less likely to experience direct anti-trans violence or discrimination. Additionally, even when others know they are trans, trans people who pass are often taken more seriously. However, all trans people, whether or not they pass, experience living in a world that is structurally not built to include them, and must cope with the practical consequences of that, as well as the internalized feelings that result.
    It is important to note that passing is not necessarily a primary goal for trans people. The validity of a trans person’s identity or experience is not related to how well they imitate cis-ness. Passing can result in protection from discrimination and violence, and can boost self-esteem due to internalized cissexism, but may not be important or worthwhile to every trans person. Depending on the person and their experiences, passing may take considerable effort. The pressure to “pass” can also increase internalized cissexism, potential for anxiety and depression or other mental illness, body dysphoria, and hyper-femininity or -masculinity (for example, a trans man attempting to eliminate all expressions of emotion because “boys don’t cry”).
     
    What is transmisogyny?
    Transmisogyny is prejudice aimed specifically at trans women and AMAB (assigned male at birth) trans people. Some think of transmisogyny as a specific expression of misogyny, others as a kind of transphobia, and others as the intersection of misogyny and transphobia.
    Transmisogyny often manifests as a belief that trans women’s bodies are revolting, untouchable, or sexless. This message coincides with the misogynist belief that women’s bodies are inherently sexual, and therefore trans women’s bodies are constructed as having very little worth.
    Another common example of transmisogyny is the insistence that trans women are misogynists, or in some way threaten cis women. Transmisogyny gives all AFAB people, cis and trans, as well as cis men, structural power over trans women and other AMAB trans people. As a result, trans women are many times more likely to be abused, but are more likely to be seen as potential abusers.
    In many instances transmisogyny may be invisible to those who don’t experience it, in particular at times where transphobia is also operating. For example, consider the case of bathroom bills. These laws make it illegal for many or all trans people to use public bathrooms consistent with their identified gender. If these bills become law, trans people are required to use bathrooms consistent with the gender they are assigned at birth – rather than the gender they identify with and, in some cases, physically appear to be.
    The primary motivation behind these bills is to protect cis women and girls, who are seen as vulnerable, from “dangerous” and “fake” trans women and girls, who are seen as predatory men. In reality, trans women and girls are even more vulnerable to violence, not only from men, but from other women. While there have been no reported instances of trans women assaulting cis women in public restrooms, there have been many instances of cis women assaulting trans women.
    One popular response in opposition to these bills has been for gender-conforming, cis-passing trans people (particularly trans men) to take pictures of themselves in public bathrooms and post them online with captions such as “Do you really want me in the women’s bathroom?”, with the implication that because they do not appear to belong, they don’t. This response falls short because it obscures the fact that while general transphobia is certainly in play (in not believing trans people’s identified genders), a deeper motivation behind bathroom bills is transmisogyny. The implication that trans people don’t belong in the wrong bathroom because of how they look puts exactly the people who need the most protection from these laws, trans women who don’t pass as cis, at the most risk.
     
    What are the effects of anti-trans sentiment?
    While many examples of cissexism, transphobia, and transmisogyny listed above may seem relatively minor to those who do not experience them, they can have profound consequences. One in five trans people has been homeless, either due to housing discrimination or family rejection. Transgender people are far more likely to live in poverty than cis people due to family rejection, housing discrimination, and employment discrimination. Trans people face discrimination in health care as well – even when insured (which trans people, who frequently live in poverty and are uninsured, are less likely to be), trans people face discriminatory policies about health care coverage and discrimination from health care professionals.
    Fear of using public bathrooms is particularly prominent among trans people. Fifty-four percent of trans people have reported negative health outcomes, such as urinary tract infections, from avoiding bathroom use; 58% reported avoiding going out in public in order to avoid the problem altogether.
    Rates of mental illness among transgender people are very high. Approximately 6.8% of American cisgender people experience social anxiety, and 8.2% of military personnel. In contrast 55% of transgender people experience this type of anxiety. Forty percent of American trans people report that they have attempted suicide, as opposed to 1.6% of all Americans. 
    The distribution of anti-trans discrimination and violence is not even, however. Ninety-eight percent of physical violence against transgender people is perpetrated against AMAB trans people, and the bulk of that is against non-white AMAB trans people. For instance, of the 38 transgender people reported to have been murdered in 2003, 70% were trans women of color. Virtually all of the effects mentioned here are much more likely to affect AMAB trans people and trans people of color, and affect them more severely.
    Transgender people living in our society face face many significant obstacles of prejudice, borne both of ignorance and malice. The ways that our society conceives of gender are inherently exclusionary of trans people, and the consequences are profound. The negative ways that our society treats people affect trans women disproportionately, especially trans women of color. If any remedy is to be made for all of this, the voices of transgender people need to be given priority, and those not affected by these social structures must be willing to admit their own role in them, and be willing to change.
     
    Related Entries
    Is being transgender a mental disorder?
     
    Further Reading
    Movement Advancement Project, “Understanding Issues Facing Transgender Americans
    Jody L. Herman, “Gendered Restrooms and Minority Stress: The Public Regulation of Gender and its Impact on Transgender People’s Lives
    The TransAdvocate, “Extreme Pressures Faced by Trans People
    The Task Force, “Transgender Equality: A Handbook for Activists and Policymakers

Leave a Reply

Your email address will not be published. Required fields are marked *