Trans people report greater health and mental health outcomes when they have social support and access to gender-affirming medical care, according to long-awaited data from the U.S. Transgender Survey, the only comprehensive study of transgender life in America. 

The nonprofit Advocates for Transgender Equality (A4TE) recently released data from the 2022 survey of more than 92,300 trans and nonbinary people. The last data release took place in 2015, when 27,700 people took the survey. Respondents answered 605 questions about their health care, families, education, identification and sense of safety, among other things. 

The U.S. Transgender Survey, conducted and released when possible, is often cited by Congress, the Supreme Court, media outlets, law enforcement, universities, medical institutions and local governments. But the full release of 2022 data has been delayed by organizational turmoil and the pandemic. 

In 2019, the National Center for Transgender Equality, which had published the survey, faced allegations of racism and union busting from staff that nearly ended the organization. The survey, planned for 2020, took a back seat as the center regrouped, rebranded and eventually merged with the Transgender Legal Defense and Education Fund.

This latest data rollout contains only health and wellness data. Additional findings, including state-by-state breakouts, are expected to be published on an ongoing basis over at least the next year. 

The survey found that people who transitioned medically were more likely to report being happy with their lives. Ninety eight percent of those who had taken hormone therapy as part of their transition said they were more satisfied with their lives afterward, and 97 percent who underwent transition-related surgery also reported increased satisfaction. Just 0.36 percent of those who medically transitioned made the decision to detransition, with the predominant reason being societal pressure. 

Social transition and social support went a long way. The report found that 72 percent of people who medically transitioned and 71 percent who had socially transitioned reported being happy. 

“Further, research focused on trans and nonbinary people have found that social support may be one of the most important factors in reducing suicidal thoughts and suicide attempts,” the report notes.

Ankit Rastogi, A4TE’s director of research, said the report makes clear that discrimination plays a huge role in mental health outcomes for trans people.

“I think it was really stark where people who were physically attacked at some point in their lives had more than five times the prevalence of attempting suicide in the year before the survey,” Rastogi said. “And so it’s really critical to highlight the features that might be making people healthier and happier.” 

When it came to substance use, 46 percent of those polled reported drinking alcohol in the past month compared to 53 percent of the U.S. adult population overall, and 12 percent reported they were smokers, compared to 16 percent of U.S. adults. Marijuana use was more than double among trans people — 35 percent reported using it in the past month compared to 17 percent in the general population. General substance abuse data came from the 2021 National Survey on Drug Use and Health conducted by the federal Substance Abuse and Mental Health Services Administration.

Not all trans people were thriving as of 2022. Forty-four percent of those polled reported serious psychological distress, a number that had climbed substantially from 35 percent in 2015. General health also appeared to decline— just 66 percent rated their health as “good” compared to 78 percent in 2015. 

A4TE will continue to release findings from the 2022 report, Rastogi said, including raw data to researchers and academics.