Published and Approved USTS Projects
This page contains information about projects for which use of the 2015 U.S. Transgender Survey dataset has been approved. Please check back here for the most current information about approved projects prior to submitting a data request.
As a note, researcher names and affiliations for approved projects in progress are not listed for privacy reasons. If you are interested in connecting with a researcher about a project listed below, please submit your inquiry to firstname.lastname@example.org, and we will connect you with the researcher if possible.
Approved Projects in Progress
Intersection of Gender, Ethnoracial, and Class Stigma and HIV Testing Patterns among Transgender Women of Color
The disparate rates of individual and structural discrimination faced by transgender women of color is embedded in misogyny, transphobia, racism, and classism. There is scant research examining the interconnected processes of gender, race/ethnicity, and class discrimination towards transgender women of color. This study will explore the social processes—forms of oppression producing health disparities—of discrimination based on gender, race/ethnicity and class targeting transgender women of color aware and unaware of their HIV status. Moreover, it will examine the relationship between intersecting processes of discrimination and HIV testing patterns. Addressing the link between discrimination and reasons to not get tested for HIV is necessary to improve awareness of HIV status and subsequent engagement in care and/or engagement in prevention efforts.
The Effect of Gender Transition-Related Health Care Utilization on Suicidal Thoughts and Behaviors: Findings from the 2015 U.S. Transgender Survey
Prior research suggests a higher prevalence of suicidal thoughts and behaviors among transgender people compared to the U.S. general population. There is an urgent need to identify effective interventions to improve mental health outcomes for trans people. Meta analyses and clinical research suggests that hormone therapy and surgical care are effective in alleviating gender dysphoria. Prior research has also found that hormone therapy, along with surgical care for transition, has resulted in significant improvements in suicidal thoughts and behaviors. This study will examine the effects of medical gender affirmation (hormones and/or surgery) for gender transition on risk of suicidal thoughts and behaviors using a large, non-clinical sample of trans people. The study uses USTS data on lifetime and past-year suicidal thoughts and behaviors, including age at onset and recurrence of suicidal behaviors, as well as age at onset of hormone therapy, and age at first receipt of surgical care for transition. Findings have implications for public health and health policy, including delivery of transition-related health care and future intervention research to mitigate trans mental health disparities.
The Role of Identity, Discrimination, and Safety in the Political Attitudes and Behavior of the Transgender Population
In recent years, the debate over the rights of transgender people has become a dominant issue in political discourse with an impact in the legislative, executive, and judicial branches of government at the state and federal levels. This undoubtedly has an effect on the political behavior of transgender people. Given the salience of issues impacting transgender people, it is important to gain an understanding of factors that influence the political attitudes and behavior of transgender people. This research seeks to fill gaps in the literature and provide vital information about the political attitudes and behavior of transgender people by examining several forms of political participation among transgender people as assessed in the USTS. Measures of political attitudes and behavior include political efficacy, voting, and other forms of political participation. The study examines factors that may impact political attitudes and behavior, including identity and discrimination. The study explores various aspects of transgender identity to determine how identity impacts political attitudes and behavior. Additionally, through the development of a discrimination scale and the analysis of several variables related to an individual's sense of safety, this research examines how discrimination affects the political attitudes and behavior of transgender people. This study will provide an in-depth analysis of factors that impact the political attitudes and behavior of transgender people and much-needed information about political participation in the transgender population.
Patterns of Suicide Risk in Transgender Adults: a Latent Class Analysis
Previous studies of transgender and other gender minority individuals have linked suicidal behavior to a wide range of personal characteristics, behaviors, and stressful life experiences, notably gender identity-related rejection, discrimination, and victimization. Although suicide risk is a complex multidimensional phenomenon, research in this area has largely focused on identifying the association of single risk factors to suicide-related outcomes, rather than examining patterns of simultaneously-occurring factors that can likely explain these outcomes in a more comprehensive and holistic manner. This study uses USTS data to identify and describe distinct groups of respondents who evidence common patterns of suicide risk. Specifically, the study aims to identify “latent classes” of survey respondents, describe these classes using distributions of demographic/personal characteristics, and examine how class membership is associated with past-year suicidality.
Performative Partisanship: Investigating the Partisan Gender Gap in the Transgender Community
One of the more fundamental findings in the gender and politics literature is the existence of a "gender gap" in terms of partisan affiliation: that is, women have been consistently found to be more likely to identify as Democrats than are men. Our project intends to investigate whether or not this pattern exists within the transgender community. Although this sort of research, due to limited individual-level data, has been difficult to conduct in the past, we have been able to recover a sample of 1041 transgender individuals from the 2016 Cooperative Congressional Election Study. Preliminary results suggest that the partisan gender gap is indeed represented in the transgender population. We theorize that this is the case due to the political content of gender and thus the potential for a performative aspect to one's politics.
State-Level Discrimination Laws, Violence Victimization, and Self-Harm among Transgender and Gender-Nonconforming People
Little research to date has investigated violence victimization and self-harm in transgender and gender-nonconforming (GNC) populations. Evidence indicates that legal climates, such as the presence or absence of state-level gender identity nondiscrimination laws, may have a significant effect on the health and safety of transgender and GNC individuals. This analysis will use data from the U.S. Transgender Survey (USTS) to assess the relationship between state-level discrimination laws and violence victimization and self-harm reported by USTS participants. We hypothesize that a lack of state-level nondiscrimination laws inclusive of transgender and GNC populations creates environments that sanction discrimination and ultimately foster violence against transgender and GNC people. The analysis will be a multi-level logistic regression using a mixed effect regression model, which allows for the use of both fixed and random effects to model observations with intracluster correlations. A two-level model will be used to specify random effects for the site clusters and adjust for any unobserved individual- or state-level confounding. We will specify person at level one and state at level two (i.e. the state in which the participant current resides) and will focus on experiences of violence within the last 12 month. Outcomes of interest will include suicidal ideation, suicide attempt(s), physical violence victimization, verbal harassment, and unwanted sexual contact. Individual-level covariates (level 1) will include variables frequently associated with violence in transgender or GNC populations, such as race and socioeconomic status. At the state level (level 2), the main relationship of interest will be between experiences of violence and whether the state has any state-level statutes or regulations prohibiting discrimination on the basis of gender identity. Other descriptive analyses will be conducted to complement the findings, including frequency of violence, perpetrators, and access to care and services following violence victimization or self-harm.
Exploring the Role of Spirituality/Religion in the Lives of Trans-Spectrum People
Over the past two decades, scholars have placed increasing focus on the spirituality and religious identity and its influence on various health & wellness outcomes. The research highlights the value that individuals place on this aspect of their life, along with a wide range of positive personal outcomes. Even so, there is sparse research exploring the spirituality and religion of queer spectrum people. More notably, current studies all but exclude the specific voices of non-cisgender individuals, due, in part, to small sample sizes. This study explores the role of spirituality/religion in the lives of trans spectrum people. Specifically, it focuses on trans spectrum spirituality/religion (section 5) and outcomes including suicidal ideation (section 16), resiliency, and the Kessler 6 (questions 12.2 and 12.3). To more fully illuminate across-group differences and allow for investigation of age-specific experiences, it will also examine demographic (sections 1 and 2) and college experience (section 26) data.
Transgender Military Inclusion: Transgender Service Members’ Health and Well-being at the Brink of Open Service
In 2015 the U.S. Armed Forces effectively halted discharges for transgender service members as the Department of Defense initiated a study on open transgender service. At the time of USTS data collection, service members’ experiences were highly dependent upon the support of their military leadership and medical providers. Using a minority stress theoretical framework, the proposed study will investigate the impact of command support and access to transition-related care on the health and wellbeing of transgender Service Members. Researchers have demonstrated that experiences of minority stressors (such as gender-based trauma, expectation of rejection, experiences of discrimination, social rejection, etc.) predict poor health and mental health outcomes for transgender persons. However, critics of open transgender service continue to cite mental health disparities experienced by the transgender community in order to challenge the psychological and medical fitness of transgender service members. This study seeks to provide a more nuanced understanding of how systemic supports and barriers impact the health and wellbeing of transgender military personnel.
Suicide Thoughts and Attempts among Transgender Adults
This study seeks to increase understanding of suicidal thoughts and behaviors among transgender people through an analysis that aims to identify key characteristics and experiences that are correlated with suicide thoughts and attempts in the USTS sample as a whole, and to examine how suicide thoughts and attempts vary among different groups of transgender people, based on both demographics and experiences. This includes examination of factors that are known risks for suicide thoughts and attempts among the general population, such as certain demographic profiles, substance use, experiences of interpersonal trauma, and psychological distress, to understand how these known risk factors correlate with suicide thoughts and attempts among USTS respondents. The study also assesses risk factors that uniquely impact transgender populations, including experiences related to minority stress, such as discrimination, victimization, and lack of access to transition-related health care.
Experiences of Health Care Discrimination Among Transgender People of Color in the USTS
Although prior studies have noted the negative experiences within health care settings transgender and gender non-conforming (TGNC) individuals may encounter, there is still a paucity of research on the unique experiences of TGNC people of color (POC) in the health care system. Specifically, within-group differences in experiences of health care discrimination among TGNC POC are rarely examined. This study seeks to use latent class analysis to identify mutually exclusive subgroups of individuals based on their responses to observed binary variables, including: having to teach one's doctor or other health care provider about trans people to receive appropriate care, being refused trans-related care, being refused other health care, having a doctor use harsh or abusive language when being treated, having a doctor be physically rough or abusive when treated, being verbally harassed in a health care setting, being physically attacked in a health care setting, or experiencing unwanted sexual contact in a health care setting. We also plan to examine the association of demographic and health indicators including being "out" in health care settings, health insurance status, and undergoing transition-related procedures with latent class membership.
The Influence of Psychological Distress and Substance Use on Suicide Ideation Among Transgender People Over Four Age Cohorts
Guided by theories of minority stress and transgender-related stigma and using an intersecting identities lens, this study investigates the constructs of psychological distress and substance use as risk factors for suicide ideation among four age cohorts of transgender people. The study examines which demographic characteristics are associated with suicidal ideation and how psychological distress and substance use are associated with suicide ideation. The study methodology employs SEM analysis to determine the unique effect of various demographic characteristics on projected outcomes mediated by the construct of psychological distress and substance use.
Together We Rise: The Role of Community Socialization in Transgender Citizens’ Levels of Civic Engagement
In the academic debate on civic engagement, many variables have been considered as predictors, among them socio-economic status, race and ethnicity, and age. One understudied variable is community socialization and connectedness. Particularly for disadvantaged communities, however, community connectedness may be an important source of political socialization. This study will investigate the role of community in levels of civic engagement, considering political self-efficacy as a key moderator of that relationship. Specifically, the study predicts that community connectedness increases political self-efficacy, which in turn drives civic engagement. Moreover, as both the practice and study of the American transgender rights movement advances, it is important to understand the factors that drive transgender Americans’ political participation. This study would helpfully contribute to our understanding of one potentially meaningful factor—connection to other trans people, as measured in the USTS.
Predictors of Non-Medical Prescription Drug Use Among Transgender and Gender Nonconforming Adults: Findings from the 2015 U.S. Transgender Survey
In light of the current opioid use epidemic, we propose to examine non-medical prescription drug use among the USTS sample. Based on current knowledge about the predictors of non-medical prescription drug use among the general population, we will test whether such drug use is related to physical health, lack of housing stability, race/ethnicity, and socioeconomic status. In addition, we will test a number of predictors particularly relevant to the TGNC population, such as stigma, gender affirmation (both social and medical), and participation in sex work.
Transgender Identity Development Across the Lifespan: Findings from the 2015 U.S. Transgender Survey
Recent studies of transgender and gender nonconforming (TGNC) people indicate that, in addition to minority stress, stress associated with the process of identity development affects health, psychosocial adjustment, and wellbeing. Many TGNC individuals adapt successfully to the related challenges and develop resilience over time. This study will examine associations between stage of identity development, operationalized through such proxy variables as age, status and time passed since relevant developmental milestones (e.g. disclosure, social transition, medical transition), perceived stigma and outcomes of mental health and wellbeing.
Associations of Prejudice and Health Among Gender Minority Youth with Binary and Non-Binary Gender Identities
Compared to binary individuals, non-binary individuals may be at increased risk for substance use and adverse mental health due to stigma related to being non-binary. The proposed research integrates Minority Stress Theory and Intersectionality Theory to propose that non-binary gender minority (GM) individuals, particularly those with other minority identities, may experience prejudice across different settings, which may adversely affect their health. Examining associations between prejudice and health among binary and non-binary GM youth is critical to identifying protective factors that moderate the adverse effects of prejudice on substance use and mental health. These associations will be examined via secondary analysis of quantitative data from binary and non-binary GM young adults, age 18-25 years, from the 2015 U.S. Transgender Survey (N=27,715). The aims of this proposal are to: 1) Compare the prevalence of prejudice experienced in three settings between binary and non-binary GM young adults, and examine differences in exposure to prejudice at the intersections of gender identity and sex assigned at birth, race/ethnicity, and sexual orientation. We hypothesize that non-binary GM young adults will experience more prejudice in each setting than binary GM young adults (H1), and that GM youth who hold other minority statuses will experience more prejudice than GM youth who do not hold other minority statuses (H2). 2) Investigate the impact of minority stressors on substance use and mental health outcomes, and examine protective factors as moderators among binary and non-binary GM young adults. We hypothesize that minority stressors will be associated with increased substance use and adverse mental health (H3), and that protective factors will moderate the adverse effects of minority stressors on substance use and mental health (H4). Findings from this study will inform interventions to reduce adverse effects of prejudice on health among binary and non-binary GM youth to better ensure development into healthy adulthood.
Impact of Pro-LGBT Legislation on the Social and Health Disparities Experienced by Transgender People
Studies and reports have shown transgender populations to report high levels of discrimination and distress. To address this, advocates and others seek to establish legislative protections against discrimination and violence. Currently, there are 16 states and 400 cities and counties with nondiscrimination legislation targeting discrimination against people's sexual orientation and gender identity, and 17 with anti-LGBT hate crime legislation. Using data from the 2015 U.S. Transgender Survey, this study will examine the difference between states and cities/counties with legislative protection and those without to examine the protective effects of such legislation. Do these legislative remedies benefit transgender people by reducing their experiences with discrimination, or reduce their distress and provide benefits to their health and well-being.
Gender Identity Profiles and Trans-Related Health Care Seeking
Gender identity can be conceptualized as a latent, multi-dimensional construct with contributions from an individual's personal identification, interactions with others, and timelines of gender development. The USTS survey gives individuals the opportunity to identify in multiple, complex ways. Latent profile analyses can be used to be begin to cluster identity trajectories together and correlate them with treatment seeking behaviors and intentions. Such a nuanced analysis allows for a better understanding of how stated gender identity characteristics fit with treatment needs and creates an opportunity to examine norms in treatment and insurance coverage for treatment and how those things are or are not attuned to individual identity profiles.
The Lives of Trans Millennials
This study will use qualitative data from the USTS to examine differences between the participants who were 35 years old or younger at the time they completed the survey. Specifically, it will consider responses to the last question, “Please tell us anything else that you would like to tell us about your experiences of acceptance or discrimination so we can better understand your experiences.” The study will focus on the different experiences the respondents discussed in response to that questions and the language they used in discussing these experiences.
Educational Attainment of Transgender Adults: Does the Timing of Transgender Identity Milestones Matter?
Adolescence is a difficult life stage in which to navigate a transgender identity, yet adolescence plays a key role in shaping educational trajectories. While transgender-related stigma and victimization within secondary school persists, the social climate in which transgender adolescents navigate their identity has changed over time. Analyzing data from the U.S. Transgender Survey, a national, non-probability sample of U.S. transgender adults, we propose to address the following research questions: 1) Is experiencing transgender identity milestones in adolescence associated with educational attainment?; 2) Does this association vary by birth cohort?
Report on Transgender Adults in Mississippi, Alabama and Arkansas
This report will focus on the experiences of USTS participants living in Mississippi, Alabama and Arkansas, comparing the experiences of participants in these three states to the national sample. Where there are substantial differences between the three states, data will be presented separately for each. In addition, where there are notable differences by participants’ race, age and gender identity, these findings will be presented separately. The report will cover outcomes in the areas of violence; police contact and incarceration; sex work; employment; and healthcare access. The report will be written for a non-scholarly audience and is intended to support programmatic and policy efforts in the states.
Report on Transgender Adults in the Workplace
This report will describe the workplace experiences of USTS participants nationwide. The report will describe participants’ career trajectories (educational attainment, rates of paid employment and self-employment, union membership, income, and source of health insurance coverage). It will then address rates of discrimination in the workplace, including access to gender-appropriate facilities, discrimination in hiring, promotion and job separation, and gender-based harassment. When appropriate, rates of these experiences will be presented separately by gender, race and age group. The report will be written for a non-scholarly audience and is intended to support efforts to improve transgender inclusion in the workplace.