Discrimination is linked with worse health among transgender Americans, study shows

In a new study, Indiana University researchers find that transgender people who are more frequently "read" as transgender are more likely to face major and everyday discrimination, as well as verbal harassment. The authors also find that transgender people who face more discrimination are more likely to attempt suicide, to abuse drugs and alcohol and to smoke cigarettes.

The linkages between gender nonconformity, discrimination and health among the transgender population are addressed in the research of Lisa R. Miller, Ph.D. candidate in the Department of Sociology, and Eric Anthony Grollman, assistant professor at the University Richmond and an IU alumnus. Their article, "The Social Costs of Gender Nonconformity for Transgender Adults: Implications for Discrimination and Health," is published in the journal Sociological Forum.

Discrimination against the transgender community has been the subject of past research as well. Data from the National Transgender Discrimination Survey confirms that 70 percent of all transgender people have experienced discrimination on the basis of their gender identity.

The research by Miller and Grollman finds that gender nonconformity -- that is, how easily individuals are "read" as transgender by others -- is a factor that both increases transgender adults' exposure to discrimination and also their engagement in risky health behaviors. The researchers interpreted their findings to mean that as a consequence of facing more discrimination, more gender nonconforming transgender individuals are at a greater risk for poor health.

"As transgender celebrities and activists have pointed out in recent months, there is diversity in the experiences of transgender people," said Miller. "Rather than assuming that all members of the transgender community are equally at risk, we need to investigate the extent to which some members may face disproportionate exposure to discrimination and poor health."

The study also finds that there are sociodemographic differences in the amount of discrimination that members of the transgender community face. Trans women reported more events of major discrimination than trans men, including discrimination in arenas beyond the workplace such as health care and public transportation. And some transgender people who belong to multiple disadvantaged groups, such as multiracial and lower income individuals, faced more transphobic discrimination than more advantaged groups.

Miller and Grollman also discovered a paradoxical relationship between medical and social transition statuses and discrimination among transgender adults. Greater steps to medically transition, through hormonal therapy or surgical treatment, and socially transition through living full time in one's desired gender led to greater amounts of transphobic discrimination.

These findings can be understood as less counterintuitive than they initially appear, argue Miller and Grollman, because it is possible that trans adults who received surgery experienced more discrimination prior to transitioning. Alternatively, those who have lived longer in their desired gender have had more time and opportunities to face discrimination.

"This research suggests that the consequences of being read as transgender and gender nonconforming are often far-reaching," Grollman said. "We interpret the results to mean that that society must become more accepting of diversity in gender identity and expression. Doing so would help put an end to systemic prejudice and discrimination against transgender people."