Executive Summary
Despite the positive public policy landscape in California, challenges remain for trans and nonbinary residents, including those residing in Los Angeles (LA) County. The LA County Trans & Nonbinary Survey is part of a study that aims to bring light to these challenges, with the goal of providing new information that policymakers, educators, advocates, and service providers can use to better meet the needs of this community and design solutions to problems outlined in this report. The LA County Trans & Nonbinary Survey was conducted by the TransLatin@ Coalition and the Williams Institute in collaboration with the Royal Collection Corporation and the Connie Norman Transgender Empowerment Center (CoNoTEC). In addition to listening sessions with 32 community members and organizational staff, we received survey responses from 322 trans and nonbinary adult residents of LA County. Their voices and experiences are reflected in this report and will serve to inform the ongoing work to make real, positive changes in people’s lives in LA County.
Key Findings
Demographics and identity documents
- Our survey respondents came from many different parts of LA County. They were more likely to be Latino/a/x/e, immigrants, and younger than the population of LA County as a whole. They represented a spectrum of gender identities. Ten percent (10%) identified as intersex.
- Respondents’ identities were not always accurately listed on their IDs, based on the name and gender that appear. Twenty-two percent (22%) had no IDs that listed their correct name or gender.
Happiness, community, and priority issues
- Respondents report happiness levels similar to those of the U.S. population and are politically engaged.
- The majority (72%) were connected or somewhat connected to their communities in LA County. A majority (69%) also believed that LA County is a good place for trans or nonbinary people.
- The cost of living was the top issue for respondents, with 59% reporting it’s a serious problem.
- Issues regarding housing, financial stability, violence, access to jobs, and mental health care also topped the list of serious problems for our respondents.
Accessing services in LA County
- We asked respondents what makes a public space welcoming for trans and nonbinary people. The most popular response (75%) was having trans and nonbinary staff members present.
- The majority of respondents said they accessed services at LGBT-focused community-based organizations (52%) and trans-focused community-based organizations (45%).
- Forty-six percent (46%) said they had unmet needs, including mental health services designed for LGBTQ+ people of color, disability services, services for nonbinary people, and others.
- Half (50%) of respondents who visited community-based organizations (CBOs) feel less comfortable getting services from government offices than CBOs.
- Many respondents who did access government benefits or services or visited government offices reported negative experiences related to their trans or nonbinary status.
Economic well-being
- Eleven percent (11%) of respondents had at least one child under the age of 18 living in their household, with the same number reporting that they had child dependents.
- Survey participants were more likely to be living at or near the federal poverty line compared to residents of LA County as a whole (52% vs. 14%). Women and transfeminine respondents (66%) and immigrants (73%) were more likely than others to be living at or near poverty.
- One-third (33%) of respondents reported that they sometimes or often did not have enough food of any type to eat. Respondents also cited challenges in obtaining basic household necessities.
Sources of income and employment experiences
- Twenty-eight percent (28%) were unemployed, compared to 5% of LA County overall.
- Seventy percent (70%) reported that they had taken actions at work to avoid discrimination, like staying in a job they’d rather leave (33%). Nearly one-third (29%) reported at least one negative experience at work in the last 12 months, including 5% who were forced to resign.
- While 23% of the sample reported engaging in sex work or working in the sex industry in the last 12 months, 70% of those respondents said they would not continue to do so if they could make the same amount of money doing something else.
- The percentage of those who reported engaging in sex work in the last 12 months was elevated among women and transfeminine respondents (33%) and immigrants (35%).
Housing
- Of those who rent or own, 74% were housing cost-burdened (spending more than 30% of household income on housing). Respondents seeking housing expressed frustration with the high cost of living and extensive hurdles for potential tenants set by landlords.
- Of respondents who have sought housing in the last five years, 21% believed they have been denied housing specifically because of being trans or nonbinary or their gender expression.
- Among respondents who have rented a home in LA County, 11% have ever been evicted for any reason. Six percent (6%) have ever been evicted due to being trans or nonbinary.
- Twenty-five percent (25%) of respondents are currently experiencing homelessness, and an additional 24% previously experienced homelessness in LA County. Of those who have tried to access shelters, 28% believe they have been denied access because they are trans or nonbinary.
- The most common reason respondents didn’t seek a shelter when needed was concern for their personal safety (58%).
Transportation
- Forty-eight percent (48%) of respondents said they have regular access to a car they drive, whereas roughly 91% of households in LA County have access to at least one vehicle.
- Respondents who lacked access to a car were likely to be in economically unstable positions, such as living at or near poverty or currently unemployed.
- One-third (33%) of respondents said it is not safe to walk or bike in their area, and 32% said it is not safe to use public transportation in their community.
- Transportation barriers meant respondents sometimes could not get to the places they needed to go. In the last three months, respondents were unable to go to social outings (33%), medical appointments (25%), or even missed work (19%), among other places.
Health and health care access
- We found significant disparities in health and health care access at the intersections of immigrant status, housing instability, and economic hardship.
- Respondents were twice as likely to be in fair or poor health (27%), twice as likely to be uninsured (14%), and twice as likely to go without health care (46%) than all of LA County.
- Of those who delayed getting needed medical care, 49% said that they thought they would be disrespected or mistreated as a trans or nonbinary person.
- Nearly one-third (29%) of respondents reported mistreatment or being misgendered during recent routine health care visits.
- Forty-one percent (41%) of respondents rated their mental health as fair or poor, nearly twice the percentage of adults in the U.S. that rate their mental health as fair or poor (21%).
- Forty-two percent (42%) of respondents reported that they wanted counseling or therapy during the last 12 months but were not able to receive it.
Access to gender-affirming health care
- Half of our sample (50%) said they get most of their information about gender-affirming care from LGBTQ or trans-community-based organizations.
- Eighty-six percent (86%) of respondents wanted to access some type of gender-affirming care in the 12 months prior to the survey. Of those, 44% reported they delayed or did not get the gender-affirming health care services they needed.
- Of those who received gender-affirming care, 69% said that the health center where they receive that care has the services they need, but one-third (32%) did not agree that the distance to the health center and the time it takes to get there were appropriate.
- Thirteen percent (13%) disagreed that health care providers are respectful to them as a trans or nonbinary person, and 20% disagreed that health care providers use their correct name and pronouns.
Law enforcement and incarceration experiences
- Fifty-two percent (52%) reported being uncomfortable asking the police for help, including because they are trans or nonbinary.
- A substantial number of respondents had interactions with police and law enforcement in the last year (38%) and reported negative experiences with officers, including harassment and assault.
- Eleven percent (11%) of all respondents had been held in a jail, prison, or juvenile detention in LA County in the last five years. Of these respondents:
- 40% said their housing placement was not what they wanted in regard to the gender they were housed with.
- 34% were physically assaulted or attacked by another inmate, and 14% were physically assaulted or attacked by facility staff.
- 11% reported that they had been sexually assaulted by another inmate, and 14% had been sexually assaulted by facility staff.
Immigrants and immigration experiences
- Immigrants in our sample had lower educational attainment and lower income. Seventy-three percent (73%) of immigrant respondents reported that they lived at or near the federal poverty level compared to 44% of non-immigrants.
- Immigrants were also twice as likely to have engaged in sex work in the last 12 months compared to non-immigrants (35% vs. 17%). Immigrants were less likely to see any viable alternatives to sex work.
- Nearly one-third of respondents who have been held in immigration detention experienced assault there.
Key Recommendations
Findings from this survey reaffirm many of the recommendations presented in recent local studies, including from focus groups of trans, nonbinary, and intersex (TGI) residents of the City of Los Angeles and a TGI Community Town Hall, hosted by LA County’s Anti-Racism, Diversity, and Inclusion (ARDI) Initiative. We add to these recommendations based on new findings from this study.
Improving service delivery for trans and nonbinary people
- Government officials should bolster services through established community organizations that the community trusts, such as through increased funding for service delivery from trans-led organizations. Within government, hire community liaisons or specialists who can facilitate community partnerships and funding.
- Service providers can make their offices more welcoming by having trans and nonbinary staff members present and all-gender restrooms. Service providers should consider ways to recruit, hire, train, and empower trans and nonbinary employees throughout all areas of their organization. Support for languages other than English is also needed.
- Government officials and benefit and service providers should enact policies that seek to eliminate negative experiences that are impacting benefits and delivery of services to the community. Staff should receive ongoing education and training to work respectfully and positively with the trans and nonbinary community, with accountability for mistreatment and misgendering.
- Government offices and community-based organizations should consider the location of their services in relation to public transportation or the availability of parking for clients with cars and improve accessibility.
- Service providers could also reduce the burden of traveling on participants through “pop-up” or mobile clinics and expanding office locations.
- Opportunities to offset costs related to transportation, such as complimentary transit passes or parking for appointments, would be helpful for community members.
Addressing the high cost of living
- The high cost of living in LA County was a top issue for our respondents. The high cost of living must be addressed in a variety of ways, including through economic well-being and access to safe and affordable housing.
- Government officials should review and improve benefits levels to meet the community’s needs, given the high cost of living.
- Government, in collaboration with community-based organizations, should work to create pathways for trans and nonbinary people to find employment and earn higher wages in more positive and affirming environments.
- Government should work with community-based organizations to provide both personal and small business finance education and training for community members.
- Educational, workforce, and assistance programs could especially benefit trans and nonbinary people who are immigrants if tailored to their needs. Food supports and other economic supports would also be beneficial.
- Government should work with community-based organizations, particularly trans and nonbinary-led organizations, to increase trans- and nonbinary-affirming shelter capacity and transition housing with wrap-around services.
Improving interactions with health care providers, employers, landlords, and law enforcement
- Work to eliminate mistreatment and misgendering that occur during health care services delivery by reviewing and establishing needed policies, training, and systems of accountability.
- Cultural competency training and enforcing non-discriminatory hiring practices are needed, with follow-up to ensure implementation and accountability.
- It is essential to make the process of seeking and retaining housing inclusive and friendly to trans and nonbinary people. Education and training for landlords and realtors are needed, as well as added protections for trans people and nonbinary people in mortgage and lease applications.
- Law enforcement agencies in LA County should ensure that policies affecting trans and nonbinary people are up to date and responsive to community needs. Both the Los Angeles Police Department and the Los Angeles County Sheriff’s Department have policies on serving transgender community members. Continued consultation and collaboration with community leaders would help ensure that these policies are up to date, responsive to community needs, and meet their intended impact.
- The presence of LGBTQ+ or Transgender Liaisons would make some trans and nonbinary residents more comfortable seeking services from law enforcement. The LAPD, for example, has an LGBTQ+ liaison. LAPD and LA County should make further investments in LGBTQ+ Liaisons.
Providing better access to health care, including gender-affirming care
- Government officials and other policymakers should work to remove the most common barriers to health care, including improving access to insurance coverage, improving access to services for those who are not currently enrolled in insurance, and access to appointments with health care providers.
- Government officials and policymakers should examine whether any treatments or services commonly needed for transgender communities in LA County are not covered or fully covered under insurance plans. Develop strategies to make these treatments more affordable, through expanded coverage, cost offsets, help with co-pays, or other measures.
- Investigate the availability and capacity of existing gender-affirming care providers, including possible obstacles to provider participation, such as insurance coverage. Invest in strategies to ensure a sufficient network of gender-affirming care providers to fully meet the needs of community members.
- Ensure that existing providers of gender-affirming care, including public, private, and community-based providers, meet cultural competency standards for a respectful and inclusive environment, such as regular high-quality trainings for staff on issues like names and pronouns and inclusive systems and forms. Ensure accountability if providers don’t meet those standards.
Increasing public safety and community connectedness
- Physical safety in public spaces is a community concern that needs further research to identify best practices to improve public safety for trans and nonbinary people. Future research should consider both interpersonal violence, like physical violence and inability to rely on police, and structural causes of vulnerability to violence, like isolation from family and high rates of homelessness.
- In addition to online resources, physical spaces for community connection are needed, especially for those who have barriers to online participation. Because transportation is often a barrier to reaching all parts of the County, these physical spaces should be located throughout the County. Increase advertisement of existing physical spaces.
- Government should collaborate with community-based organizations to invest in social, recreational, and arts programs for trans and nonbinary people.
Providing support for the unique needs of trans and nonbinary people who are immigrants
- Those who engage in sex work need supports in place to meet the unique needs of immigrant trans and nonbinary sex workers, including other pathways to income sources, if that is a desired path for them. Further research is needed to better understand how to create these pathways.
- More support for asylum seekers is needed, as well as access to care in immigration detention. More research is needed into the conditions of confinement at immigration detention centers, with safety being a priority. Evaluations that have been done of county jails and prisons located in LA County and other parts of California could serve as a model.
Improving access to accurate identity documents (IDs)
- Those who set policy for various forms of ID, like government, student, and employee IDs, should review and revise processes and establish any needed programs to aid trans and nonbinary people in obtaining accurate IDs. Provide options for nonbinary people to obtain a gender marker that is accurate for them. Invest in collaboration with community-based organizations to assist community members with ID changes.
Looking toward the future, this study illustrates the need to build a pipeline for trans and nonbinary people to thrive in LA County. There must be a pathway for community members to become leaders in all aspects of life, including in government, business, education, health care, the arts, and community organizations. Trans and nonbinary people are best suited to envision this pipeline, with the support of trans-led organizations that have already begun this work. Work is underway on foundational tasks in this project, such as providing direct services for those most in need, improving health care access, offering educational opportunities, providing job training and placement, developing leadership skills, and generating opportunities for community members. LA County government should allocate resources and work collaboratively with the trans and nonbinary community to bring this pipeline to fruition.
More research is needed to better understand how and where to direct efforts and investments that will be most effective in positively impacting trans and nonbinary communities in LA County. Yet, it is already clear that those investments should include key pieces in building the pipeline, including the development of programs to provide training and experience for trans and nonbinary people on how to work with government entities to better leverage government resources and how to work in roles within the government. To position community members to pursue various career paths, LA County should invest in establishing and improving scholarships for trans and nonbinary people. Finally, LA County should design and implement a program to give credit for those who have been doing work in the community as certification for engaging in equivalent work on behalf of LA County.
Many trans and nonbinary people have faced barriers due to criminalization, incarceration, and the need for survival work. The well-being of all residents of LA County is the responsibility of our elected officials. It is imperative that resources be allocated in an equitable manner to uplift the lives of trans and nonbinary people in LA County, to improve quality of life, and to work toward a better future where trans and nonbinary people don’t just survive but thrive.