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%  of the population while these levels of anxiety were found to exist at a rate of 8.2% among military personal. 
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 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 
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.
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)
- 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
- 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.
- NIH Social Anxiety: http://www.nimh.nih.gov/statistics/1SOC_ADULT.shtml
- 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
- 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