February 8, 2024 - 1:20pm

Yesterday, the National Center for Trans Equality published preliminary findings from the latest United States Transgender Survey, providing a snapshot — or perhaps a snapshot of a snapshot — of the demographics, attitudes, beliefs, and experiences of 92,329 individuals who identify as transgender. 

The headline findings include a demographic overview (trans-identified individuals are whiter than the US population as a whole), breakdown of how people self-identify (35% of the sample identified as trans women, 25% as trans men and 38% as non-binary, with crossdressers rounding out the last 2%) as well as self-reported satisfaction with life after transition. 

There were also interesting nuggets buried in the results. For example, among trans-identified adults who have children, 17.6% report having a child who is also transgender-identified. Reporter Evan Urquhart notes that, “[i]n some ways that figure is very high” and may support “the hypothesis that some aspects of gender identity may be genetically heritable”. Other interpretations — that parents who model trans identification will predictably exert influence over their children’s self-understandings — are available. 

 The researchers acknowledge a few of the survey’s many limitations, namely that the sample was not randomised and may not be representative of trans-identified individuals in the United States. Respondents were recruited through transgender advocacy organisations, LGBTQ support groups, health centres and online communities, and were incentivised to participate by the possibility of winning cash prizes. (The last time this survey was conducted, back in 2015, there were no mechanisms in place to prevent respondents from participating multiple times — thus increasing their chances to win prizes and skewing the results — and there is no evidence to suggest that researchers took any steps to verify participants’ identities and prevent repeat responses.) 

Activists wasted no time in mobilising these latest results in service of the cause. But the USTS survey data doesn’t settle any of the arguments in which it will be enlisted. The survey evades critical questions about desistance and detransition, even as activists deploy the results as a “gotcha” to outlets reporting on negative outcomes of transition or pointing to the rapid rise of trans identification among adolescent females. 

Sure, 94% of adult respondents describe themselves as a lot or a little more satisfied with their life after transitioning. But if you only survey people who currently identify as transgender (as the USTS does), you shut out negative outcomes. Ask active Moonies how they feel about the Unification Church and you may get similarly stellar results. Include former members and the picture will look quite different. And so 94% of currently trans-identified adult respondents do not, in fact, tell us anything about how many adolescents and young adults may regret transition in the future. That’s not to mention the highly persuasive effects of sunk costs. The sacrifices patients make on the altar of transition — removing healthy body parts, consigning future fertility and sexual pleasure — make it painful to reconsider whether transition is working. 

Among respondents who reported having undergone “gender-affirming” surgery, 88% said they were “a lot more satisfied” post-surgery. But patient satisfaction is a notoriously unreliable measure of whether a procedure that is advertised as a treatment for a medical condition worked as intended. The use of patient satisfaction — rather than more reliable indicators such as ability to function in society and symptom management — strikes at the uncertain status of transgender surgeries. Activists argue these interventions are “life-saving”, but patient satisfaction is how we measure the results of cosmetic surgery, not actually life-saving interventions like insulin therapy or chemotherapy. 

The survey also highlights struggles that just about everybody could find it in their hearts to care about: 30% of respondents reported having experienced homelessness; 11% reported losing employment due to their gender identity or expression; 48% reported negative experiences with healthcare providers, including physical abuse; and 24% reported that fear of such mistreatment interfered with seeking medical care. Of the 16- and 17-year-olds surveyed, 60% reported experiencing difficulties at school, including bullying and harassment. 

Public support for activist priorities like putting boys in girls’ sports and green-lighting hormonal and surgical interventions for adolescents is quickly crumbling. Yet a platform built around addressing issues like homelessness, discrimination in employment and healthcare settings, and bullying in schools would likely attract wide sympathy and support. These issues speak directly to the safety and dignity of individuals who identify as trans, and don’t require anyone else to adopt metaphysical beliefs about gender or pretend sex doesn’t matter. If trans activists decide to start searching for common ground, this is it.

Eliza Mondegreen is a graduate student in psychiatry and the author of Writing Behavior on Substack.