Transforming trauma

Transforming trauma: a journey toward wellness and healing

Our vision for health justice is a world free of violence, where Transmasculine people, our families, and communities have what we need to take care of ourselves and each other. This will require prevention work that reaches to the root causes of violence experienced by Transmasculine people. It also requires transformative responses to harm and trauma that can address needs and experiences of Transmasculine survivors.

The data on this page is here to validate and bring attention to violence experienced by Transmasculine people, particularly those who are Black, Indigenous, People of Color. We also include data on the high rates of mental health symptoms, the medicalization of trauma, and experiences with mental health supports and services. We lift up a few of the many ways Transmasculine people engage in healing.

This section includes information about violence and harms experienced by participants including sexual violence, self-harm, homelessness, incarceration, institutionalization. Reporting this information was important to the organizers of this report in efforts to bring visibility to violence experienced by Transmasculine people and mobilize resources to address these serious problems. We write this with love, please take care of yourself.

There is space for everyone to speak up. There is space for everyone to be here in this world and everyone is valid.

TM HEALTH JUSTICE RESEARCH INITIATIVE - ADVISOR

How would you rate your own health?

WE used a validated measure to ask participants about their self-rated health. “In general, would you say your health is poor, fair, good, very good, or excellent?”

0 %

self-reported having very good to excellent health

excellent
12%
very good
33%
good
38%
fair
14%
poor
4%

EXPERIENCEs of violence & abuse across the lifespan

Violence in childhood & adolescence

We asked participants if they had experienced violence or abuse before age 18 by a parent or other primary caregiver. We also asked if participants had ever lived in or be placed in the foster care system or a youth group home.

 

violence or abuse by a primary caregiver
53%
foster care placement
5%
youth group home
3%

Young people who do not conform to gender roles may be more likely to experience violence than those who are not. The majority of survey participants had experienced violence or abuse by a parent or primary caregiver.

5%  of participants had been in a foster care placement. While not a direct comparison, current estimates suggest that less than 1% of all children in Los Angeles County are in foster care (link to source – kidsdata).

I may not disclose abuse, particularly if it's related to sexual health, and I'm not comfortable, even if that means I avoid health care.

TMSHRJ:LA survey participant​

SExual VIOLENCE

We asked participants if they had experienced sexual violence in the past year, in their lifetime, and during childhood and adolescence.

 

0 %

experienced sexual violence in their lifetime

 The question specifically asked if participants had experienced “unwanted sexual contact (such as oral, genital, or anal contact or penetration, sexualized touching/fondling, rape).”

before age 12
37%
before age 18
55%
in the past year
12%

More than 1 in 2 participants they experienced sexual violence before they were age 18. This compares to national estimates of about 1 in 4 girls and 1 in 13 boys.

Participants who were Black, Indigenous, People of Color (BIPOC) were particularly likely to say they had experienced sexual violence as children and/or teens as seen in the figures below. 

The reasons are complex and include the shaming, targeting, and social isolation of gender nonconforming young people, enforced racialized gender roles, the criminalization and displacement of trans and gender nonconforming BIPOC youth from families and places of origin, and lack of access to services and other public resources, among others.

 
BIPOC

BIPOC participants were especially impacted by sexual violence as children and adolescents. Nearly 44% of BIPOC participants had experienced sexual violence before age 12 and nearly 60% had before by age 18.

BEFORE AGE 12

BIPOC
44%
WHITE
27%

BEFORE AGE 18

BIPOC
60%
WHITE
47%
One of the things that came out in this study was the high numbers of people who experienced sexual violence before the age of 18, which disrupts the national count of one and four. There's already research that shows that gender non-conformity as a child increases the risk of sexual violence, so I think that's a really important thing.

TMHJ:LA advisor

INTIMATE PARTNER VIOLENCE

We used a standard measure for indications of INTIMATE PARTNER VIOLENCE. We also tailored questions specifically for this study.

 

0 %

indicated experiencing intimate partner violence in the most recent relationship (using a previously validated screening measure)

We used the the Hurt, Insult, Threaten, Scream (HITS) screening tool at an indicator of intimate partner violence (IPV). We also asked the additional questions (to the right) about patterns of control that were not included in the standardized measure. We developed these questions with support from the National Institute on LGBTQ IPV.

A recent or current partner HAS..

disclosed info about your gender when you didn’t want them to?
9%
forced you present gender differently than you want (e.g., to pass or be stealth, prevents you from transitioning, etc)?
8%
been controlling (e.g., doesn’t want you to see friends, keeps tabs on you, excessive calls/texts)?
14%
restricted access to money or other shared resources?
6%

Housing insecurity & incarceration

Lifetime homelessness

We asked participants if they have ever lived in on the streets or camped due to homelessness, stayed at an emergency or domestic violence shelter, or lived in an transitional housing program.

 

0 %

of participants had experienced homelessness in their lifetime

lived on the streets due to homelessness
15%
stayed in a homeless shelter
7%
STayed at a domestic violence shelter
2%
BIPOC

BIPOC participants were especially impacted by housing insecurity. More than 1 in 4 participants of color had experienced homelessness in their lifetime and nearly 1 in 10 had spent at least one night in a homeless shelter.

 

LIFETIME HOMELESSNESS

BIPOC
26%
WHITE
13%

HAS STAYED IN A HOMELESS SHELTER

BIPOC
9%
WHITE
2%
I am in a different place every couple of weeks, housesitting, petsitting, or staying with friends (post divorce after transitioning).​

TMSHRJ:LA survey participant​

INCARCERATION

We asked participants if they had ever stayed a night in a jail or prison, juvenile detention, or immigration detention. If yes, we asked about their longest period of incarceration.

 

0 %

Participants were incarcerated in their lifetime

jail or prison
7%
incarcerated in juvenile detention
2%
immigration detention
1%
incarcerated for 2 weeks or more
2%
BIPOC

All participants who had been in juvenile detention were Black, Latinx, Asian and/or Pacific Islander. All participants who had been in an immigration detention were Latinx. Most participants who were incarcerated for 2 weeks or more were Latinx.

mental health & access to care

Lifetime mental health treatment

We asked participants if they have ever been prescribed medications for mental health symptoms. We also asked if participants had ever stayed a night in a psychiatric hospital.

 

0 %

had been prescribed medications to treatment mental health symPTOMS

 

has been prescribed medications for:

 

depression
60%
anxiety
52%
mood stabilization
26%
attention
18%
psychosis
8%

 

LIFETIME PSYCHIATRIC HOSPITALIZATION

 

hospitalized at least once
23%
two or more times
12%
BIPOC

Fewer BIPOC participants had been prescribed medications to treat depression and/or anxiety. More research is needed to better understand the very high rates of medicated mental health symptoms among transmasculine people overall, as well as racial differences in access and utilization of psychotropic medications.

 

PRESCRIBED ANTI-DEPRESSANTS

BIPOC
54%
WHITE
70%

PRESCRIBED ANTI-ANXIETY MEDICATIONS

BIPOC
44%
WHITE
63%
It's very important to not forget about mental health [...] we've seen in nationwide research that suicide rates for trans folks are way higher than for other populations.​

TM HEALTH JUSTICE RESEARCH INITIATIVE - ADVISOR

Symptoms of depression

We used the PATIENT HEALTH questionnaire (PHQ-9) to ask participants about symptoms they HAD experienced WITHIN THE past two weeks.

0 %

indicated symptoms of moderate to severe depression​

We used the Patient Health Questionnaire-9 to ask about current symptoms of depression.

severe
9%
moderately severe
10%
moderate
20%
mild to no symptoms
62%

Nearly 1 in 3 participants indicated that during at least a few days in the last two weeks they had thoughts that they would be better off dead or of hurting themselves in some way.

 

SOME FACTORS ASSOCIATED WITH LOwer rates of DEPRESSION

Experiences with Mental health care

We asked participants if they had accessed mental health services and, if so, whether they had any negative experiences and if they had ever delayed seeking mental health care for fear of misunderstandings or mistreatment based on their gender. We also asked if participants had ever received excellent mental health care.

0 %

has accessed mental health services

 

ACCESSED mental health services (past year)
67%
had a negative experience with mental health services
73%
has delayed care due to concerns of gender-related mistreatment
66%
has received excellent mental health care
71%
BIPOC

Fewer BIPOC participants had accessed services in their lifetime and in the past year compared to white participants. However, more white participants said they have had a negative experience in mental health care compared to BIPOC participants. 

ACCESSED MENTAL HEALTH SERVICES (IN THE PAST YEAR)

BIPOC
61%
WHITE
76%

HAS HAD A NEGATIVE EXPERIENCE WITH A MENTAL HEALTH CARE PROVIDER

BIPOC
66%
WHITE
80%
My experience with the 'gatekeepers' for access to surgery has sucked. My private/individual therapist is awesome and not covered by insurance. These differences might be important to sort out.​

TMSHRJ:LA survey participant​

SUBSTANCE ABUSE & RECOVERY

Substance use

drank alcohol in the past month
53%
indicated binge drinking
11%
indicated heavy alcohol use
1%
smoke tobacco daily
10%
use marijuana daily
23%

Recovery

had participated in a substance abuse recovery or sobriety program
17%
had stayed in a rehab or treatment facility
10%

We did not find an elevated use of alcohol or tobacco among survey participants, as has been found in some other studies. About 10%  of participant said they smoked tobacco compared to 12% of the general adult population in Los Angeles.

About 53% of survey participant said they drank alcohol month, which compares to about 57% of Californian adults who said they drank alcohol in the past month in a survey conducted the same year (link to CDC data). About 11% of participants indicated binge drinking and only 1% indicated heavy alcohol use, compared to about 16% and 7% of adults nationally, respectively. (link to CDC data and definitions).

 

BIPOC

Of participants that drank alcohol at least once a month, a greater portion of BIPOC participants indicated binge drinking compared to white participants. 

BINGE DRINKING IN THE PAST MONTH

BIPOC
18%
WHITE
12%

OTHER HEALING & WELLNESS STRATEGIES

Holistic and self care

We asked participants about some of their strategies for self-care and well-being.

uses alternative medicines or herbs to treat health symptoMS
35%
uses marijuana
34%
body work (e.g., massage, rolfing, Reiki, etc)
26%
traditional or spiritual healer
9%
traditional chinese medicine
5%

There are many ways that transmasculine people take care of themselves and each other. Our survey only asked about a few. 1 in 3 participants used alternative medicines or herbs to treat health symptoms and 1 in 3 also said they used marijuana (at least once a week).  Some had access to body work and other forms of cultural or traditional health care. We include this as a wellness strategy while recognizing that addiction can become a health concern for some people. We look forward to engaging in more research in this area.

faith and spirituality

We asked participants about their connections to communities of faith or spiritual practice.

0 %

Connected to a faith community or spiritual practice

Druid, Muslim, Taoist, Science of the Mind, Alcoholic Anonymous, self-realization, yoga, The Dao, and “my spiritual community is only about 5 people.”


Religious and spiritual communities can be a source of strength, belonging, and cultural connection. For many trans people, religion or faith communities may have been or still be a source of stigma, exclusion, and harm. We asked an intentionally broad question about connections to faith or spiritual practices, and less than one-fifth said yes.

I don't have a temple I go to. But I pray at my altar quite often in my home.

TMSHRJ:LA survey participant​

relationships with families of origin

We asked participants if they maintained relationships with their families of origin and whether those relationships were generally positive or negative. 

0 %

had a positive relationship with their families of origin

mostly positive
39%
somewhat positive
35%
somewhat negative
10%
mostly negative
11%
no relationship
6%

Many studies show that family support reduces stress and mental health symptoms among trans people. Family ties can also be an important economic support unit. However, family relationships are also often complicated by stigma and abuse, forced migration, and inter-generational trauma.

Most survey participants had a somewhat or mostly positive relationship with their family of origin. However, more than 1 in 4 said the relationship was negative or that they had no relationship.


[We should be asking] more questions about family. I believe family has a major impact on mental health.​

TMSHRJ:LA survey participant​

KEY TAKEAWAYS

0 %
experienced violence or abuse by a primary caregiver before age 18
1 %
experienced sexual violence in their lifetime
1 %
had taken medication for depression or anxiety
1 %
experienced psychiatric hospitalization
OUr partners