A report on the largest survey ever of trans Americans’ health was released on Wednesday, June 11, and its findings reaffirmed what many academics, health care providers and trans people already know: gender-affirming care saves and improves lives, but transphobia often dissuades people from pursuing or continuing it when they need it most.

Over 84,000 trans, nonbinary, and gender nonconforming people aged 18 and up responded to the 2022 U.S. Transgender Survey, spearheaded by Advocates for Trans Equality (A4TE). Of respondents who had transitioned, 9 percent had gone back to living as their sex assigned at birth at some point in their lives, at least for a short while — but in almost every single case, the reason was anti-trans discrimination from one’s family, friends, or community.

“Social and structural explanations dominated the reasons why respondents reported going back to living in their sex assigned at birth at some point,” the report found. “Only 4% of people who went back to living in their sex assigned at birth for a while cited that their reason was because they realized that gender transition was not for them. When considering all respondents who had transitioned, this number equates to only 0.36%.”

Meanwhile, respondents who received gender-affirming hormone therapy (GAHT) or gender-affirming surgery overwhelmingly reported feeling “more satisfied” with their lives, 98 percent and 97 percent, respectively.

This watershed report contradicts the popular narrative being circulated by mainstream media, far-right politicians, and anti-trans groups that transgender people are “detransitioning” en masse due to life-shattering “transition regret.” In reality, it shows gender diverse people are living rich and vibrant lives, so long as they are provided the space, support, and care they need from their health care providers and communities.

The survey found a trans person’s overall health and wellbeing also heavily depend upon rates of familial support, a factor that has a profound influence over a trans person’s lifetime experience of suicidality.

The survey has been released in increments as researchers at A4TE wade through the unprecedented amounts of data from trans people who lent their voice to the project. It is a much-needed, comprehensive overview of the challenges — and victories — seen in trans health care since the prior iteration of the study. The report is especially vital considering the Trump Administration moved to remove transgender people from the U.S. Census and other government websites, rendering trans communities potentially invisible, and robbing researchers of crucial data informing public policy decisions.

“Having real concrete and rigorous data about the realities of trans people’s day-to-day lives is also a vital part of dispelling all of those assumptions and stereotypes that plague the public discourse about our community,” said Olivia Hunt, A4TE’s Director of Federal Policy, during a press briefing this week.

The report also touched upon trans people’s access to health care, which increased between 2015 and 2022; the quality of care, as trust between doctors and trans patients has improved; disparities between trans people across racial groups, which showed trans people of color are generally more prone to experience discrimination compared to white trans people; and the mental health challenges facing the trans community, as 44 percent of respondents met the criteria for serious psychological distress, compared to less than 4 percent of the general U.S. population.

Many of these issues have likely been exacerbated since the data was collected. The lead-up to President Donald Trump’s return to the Oval Office incited a new wave of anti-trans animus, impeding access to care and stirring up transphobic vitriol and harassment.

“From 2015 to 2022, state-level policy environments became more protective in some ways for trans people; however, in 2022 alone, when the USTS was administered, 315 anti-LGBTQ bills were introduced across the country, many of which harm trans and nonbinary people’s access to healthcare, participation in sports, access to public facilities, or other facets of public life,” the report says.

“This political landscape has only worsened since the administration of the 2022 USTS, with the introduction of 571 anti-LGBTQ nationwide in 2023 and 489 in 2024,” it continues. “At the time of writing, data on trans and nonbinary people has been erased from federal health surveys. As funding for LGBTQ research is stripped away, the USTS has become an ever more critical resource on the lived experiences of trans and nonbinary people.”

Nonetheless, trans life and trans joy have persisted, as testimonies featured in the U.S. Trans Survey demonstrate.

“I have thrived in the past 12 months in transition, I have a genuine smile on my face most days & laugh with genuine joy,” wrote Charlotte, a trans woman, in her survey response. “I have grown into the woman I was meant to be.”

And as Roo, a nonbinary person, wrote: “Once I learned what it meant to be trans, I never looked back. I traded in my Regina George-esque life for a future with a balding head and a predisposition for a beer gut. I’ve never been more happy to be alive—every single day. ”