Executive Summary
The U.S. Census Bureau’s Household Pulse Survey provides an opportunity to compare the experiences of transgender and cisgender people in the U.S. during the COVID-19 pandemic. In this report, we compare transgender and cisgender people in the U.S. on measures of demographics, economic well-being, employment experiences, health and health care access, COVID-19 illness, and vaccine uptake. Additionally, we seek to understand if transgender people’s experiences during the COVID-19 pandemic differ from cisgender people’s experiences over time. For instance, we assess whether the percentage of those in poverty has changed over time for transgender people in the same way it has changed over time for cisgender people.
Key Findings
Demographics
- Transgender people are younger than cisgender people. Over 80% of transgender people in the Household Pulse Survey were under the age of 40, compared to just over a third of cisgender people.
- Transgender and cisgender people were similar in proportions reporting their race as White (63.7% vs. 62.6%). However, a higher percentage of transgender people were Latinx or Hispanic (21.8% vs. 17.0%) and multiracial (6.6% vs. 3.7%). A higher percentage of cisgender people than transgender people were Black (11.3% vs. 5.6%) and Asian (5.5% vs. 2.3%).
Economic well-being
- Transgender people were living in poverty more so than cisgender people (30.6% vs. 17.7%).
- Transgender people were more likely than cisgender people to be unable to pay their energy bills in full each month (7.4% vs. 4.7%) and had more difficulty with household expenses (50.0% vs. 31.7%).
Employment experiences
- Among those in the workforce, a higher percentage of transgender people had not worked in the seven days prior to the survey compared to cisgender people (8.1% vs. 5.4%).
- Among those in the workforce, transgender people teleworked or worked from home in the past seven days more so than cisgender people (41.8% vs. 31.6%).
Health and health care access
- A higher percentage of transgender people were not covered by insurance, with 12.9% reporting no health insurance compared to 7.5% of cisgender people.
- Three times as many transgender respondents had symptoms of severe psychological distress in the past two weeks compared to cisgender respondents (41.2% vs. 11.9%), and more than double the prevalence of anxiety (65.2% vs. 26.9%) and depression (57.6% vs. 21.5%).
COVID illness and vaccine uptake
- Transgender people were more often unsure if they ever had COVID (4.7% vs. 0.8%).
- Transgender people were more likely than cisgender people to have had one or more doses of a COVID vaccine (88.2% vs. 83.9%).
- Transgender people were less concerned about vaccine side effects (40.9% vs. 54.8%) and more concerned about the cost of the vaccine (8.3% vs. 2.3%) compared to cisgender people.
- Transgender people more often stated that it was hard for them to get the vaccine compared to cisgender people (11.7% vs. 2.0%).
Change in economic status and health over time
- We considered five different indicators of economic well-being and health (not working in the past week, poverty, severe psychological distress, anxiety, and depression) over five time periods covered in the Household Pulse Survey to assess whether significant differences between transgender and cisgender people persist over time and to consider if there are significant differences in how transgender and cisgender people trend over time on these indicators. For instance, did poverty improve for cisgender people but not for transgender people?
- We found that significant differences between transgender and cisgender people persist over time across these measures. Cisgender and transgender people did not experience different trends over time on these five measures.
Consistent with prior research, we found disparities for transgender people compared to cisgender people in nearly all areas under study. We found that these disparities have persisted during the pandemic and have not shown signs of improvement over time. We found that cisgender and transgender people do not have significantly different trends over time on key measures of health and economic well-being. Additional research is needed to bring to light the impact of the COVID-19 pandemic on transgender people in all areas of life. In addition to studies that are tailored to understanding transgender people’s unique experiences during the pandemic, their needs, and how these needs can be met, we must also add questions to identify transgender individuals to all ongoing, large, population-based surveys that monitor the health and economic well-being of the U.S. population.