6 key takeaways from the Post-KFF survey of transgender Americans

A mosaic illustration of people of diverse genders and races.
(Loveis Wise for The Washington Post)
4 min

Since January, state legislators have introduced more than 200 bills that seek to limit transgender rights, whether it is access to gender-affirming care, what children can learn about transgender identity in schools or whether trans girls can play sports.

In this atmosphere of intense polarization around transgender rights, The Washington Post and KFF set out to hear what transgender Americans had to say, on topics ranging from their experiences as children in school to navigating the workplace, the doctor’s office and family relationships as adults. The resulting Post-KFF Trans Survey, which also includes responses from cisgender Americans on trans-related restrictions, is the largest nongovernmental survey of U.S. trans adults to rely on random sampling methods.

Here are six key takeaways from the survey.


Whether a trans person is out to family and friends depends on their age.

The Post-KFF survey finds about 9 in 10 transgender adults under age 35 are out to their family or friends, while about 2 in 10 trans adults 35 and older have not told friends or family about their gender identity.


Most trans people consider themselves gender non-conforming or nonbinary.

A 62 percent majority of trans adults identify as “trans, gender non-conforming” or “trans, nonbinary,” while 33 percent identify as a “trans man” or “trans woman.” Nearly half ask people to refer to them with they/them pronouns, although most say they use she/her or he/him pronouns.


Most have not had transition-related medical treatments.

Trans Americans reported a breadth of experiences in how they present physically and what transitioning has meant for them.

About three-quarters of trans Americans say they have changed their type of clothing (77 percent) or hairstyle or grooming habits (76 percent) to better fit their gender identity. Most also have used a different name than the one on their birth certificate (57 percent). Just 31 percent have used hormone treatments, HRT or puberty-blocking hormones, and 16 percent have undergone gender-affirming surgery or another surgical treatment to change their physical appearance.


Many transgender people knew they were trans from a young age.

Two-thirds of trans adults (66 percent) say they were younger than 18 when they began to understand that their gender was different from their sex assigned at birth, including 32 percent who became aware of it when they were 10 or younger.


Most transgender adults say they have faced discrimination or verbal harassment.

More than 6 in 10 trans adults (63 percent) say they “sometimes” or “frequently” feel discriminated against because of their gender identity or gender expression, while 36 percent say this “seldom” or “never” happens.

A 64 percent majority of trans adults say they have been verbally attacked because of their gender identity, gender expression or sexual identity, and 25 percent say they have been physically attacked.


Most transgender adults say living as a gender different from the one assigned to them at birth improved their lives.

Despite those hardships, the vast majority of trans adults say they were happier than before they transitioned.

Among those who present themselves differently from their gender assigned at birth, 78 percent of trans adults say that living as a gender different from the one assigned to them at birth has made them more satisfied with their lives. More than 4 in 10 (45 percent) say they are “a lot” more satisfied.

The Washington Post-KFF Survey Project is a partnership combining survey research and reporting to better inform the public. The Trans Survey is the 36th in the series. It was conducted in English and Spanish from Nov. 10-Dec. 1, 2022, among 515 U.S. adults who identify as trans and 823 cisgender U.S. adults. Sampling, data collection, weighting and tabulation were managed by SSRS. Trans adults were reached via three survey panels recruited using random sampling methods: The Gallup Panel, NORC’s AmeriSpeak Panel and the SSRS Opinion Panel. Additional trans respondents were recontacted from previous randomized telephone interviews. Cisgender adults were recruited through the SSRS Opinion Panel. Random sampling methods help ensure results are representative of the trans population overall. The samples of trans adults were combined and weighted to match the demographics of the national U.S. adult trans population. Results among the sample of trans adults have a margin of sampling error of plus or minus seven percentage points and the margin of sampling error is plus or minus four percentage points among the sample of cisgender adults. In collaboration with The Post, KFF researchers worked to design the survey sample and questionnaire, analyze and report findings. The project team from KFF included Mollyann Brodie, Ashley Kirzinger, Audrey Kearney, Alex Montero and Grace Sparks.