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.
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?”
self-reported having very good to excellent health
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.
Â
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%Â 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).
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.
Â
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).”
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 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
BEFORE AGE 18
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.
Â
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..
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.
Â
of participants had experienced homelessness in their lifetime
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.
Â
LIFETIME HOMELESSNESS
HAS STAYED IN A HOMELESS SHELTER
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.
Â
Participants were incarcerated in their lifetime
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.
Â
had been prescribed medications to treatment mental health symPTOMS
Â
has been prescribed medications for:
Â
Â
LIFETIME PSYCHIATRIC HOSPITALIZATION
Â
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.
Â
PRESCRIBED ANTI-DEPRESSANTS
PRESCRIBED ANTI-ANXIETY MEDICATIONS
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.
indicated symptoms of moderate to severe depression​
We used the Patient Health Questionnaire-9 to ask about current symptoms of depression.
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.
Â
potential protective FACTORS ASSOCIATED WITH LOwer rates of DEPRESSION
30% of participants who said they had received excellent mental health care (e.g., counseling, therapy) in the past were currently experiencing moderate to severe depression.
Compared to:
58% of participant who said they had not had access to excellent mental health care were currently experiencing moderate to severe depression.
34% of participants who had seen a transgender specific health care provider were currently experiencing moderate to severe depression.
Compared to:
47% of participants who had not seen a transgender specific health care provider that were currently experiencing moderate to severe depression.
Â
About 1 in 4 participants who earned more than $36,000/year indicated that they were currently experiencing moderate to severe depression (24%).Â
Compared to:
Nearly 1 in 2 participants who who earned less than $36,000 a year that were currently experiencing moderate to severe depression (46%).
30% of participants who said their relationships with their families of origin were positive were experiencing moderate to severe depression.
Compared to:
49% of participants who said they had a negative relationship or no relationship with their family of origin that were experiencing moderate to severe depression.
32% participants who were ages 25 and older were experiencing moderate to severe depression.
Compared to:
56% of younger participants, ages 18-24, who were experiencing moderate to severe 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.
had accessed mental health services in their lifetime
Â
Fewer BIPOC participants had accessed services in their lifetime and in the past year compared to white participants.
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)
HAS HAD A NEGATIVE EXPERIENCE WITH A MENTAL HEALTH CARE PROVIDER
TMSHRJ:LA survey participant​
SUBSTANCE ABUSE & RECOVERY
Substance use
Recovery
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 survey participants said they smoked tobacco compared to 12% of the general adult population in Los Angeles.
About 53% of survey participants 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 (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 (CDC data).
Of participants that drank alcohol at least once a month, a greater portion of BIPOC participants indicated binge drinking compared to white participants.Â
BINGE DRINKING IN THE PAST MONTH
OTHER HEALING & WELLNESS STRATEGIES
Holistic and self care
We asked participants about some of their strategies for self-care and well-being.
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.
Connected to a faith community or spiritual practice
- 4% - spiritual, but no affiliation
- 3% - Jewish
- 3% - Christian Protestant
- 1% - Catholic
- >1% - Native American traditional ceremonial
- >1% - Buddhist
- >1% - Hindu
- >1% - Wiccan
- 3% - other faiths or practices
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.
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.Â
had a positive relationship with their families of origin
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.
TMSHRJ:LA survey participant​
KEY TAKEAWAYS
OUr partners
