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Trans Americans are so afraid to use public restrooms that 8% have had kidney problems

Nearly 60 percent of transgender Americans have avoided using public bathrooms in the last year because they are worried about being confronted, harassed, or assaulted, according to a new survey.

The 2015 U.S. Transgender Survey, released Thursday, claims to be the largest survey to explore the realities of life for transgender Americans “and the complex systems they are forced to navigate in multiple areas of their lives in order to survive and thrive.”

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The survey, conducted by the nonprofit National Center for Transgender Equality, reflects the views of 27,715 transgender adults, approximately 2 percent of the estimated transgender population in the United States, and across all 50 states.

Public bathrooms have emerged as a key battleground area in transgender rights over the last year, after North Carolina’s controversial “Bathroom Bill,” HB2, signed by now former Gov. Pat McCrory in March, made it mandatory for transgender individuals to use a bathroom according to the sex they were assigned at birth rather than of their preferred gender identity. The bill sparked a backlash from civil rights groups and a legal battle between North Carolina lawmakers against the U.S. Department of Justice.

Conservative lawmakers in favor of the bill argued that, for example, a transgender woman using women’s bathrooms could put other women at risk, but the study indicates it may be the other way around. Here are more key data points from the survey:

  • 12 percent of respondents reported being verbally abused in a public bathroom in the past year.
  • 1 percent said they had been physically assaulted in a bathroom in 2015.
  • 32 percent said they limited how much they ate or drank so that they wouldn’t have to use a public restroom.
  • 8 percent reported having contracted a urinary tract infection or kidney infection as a result of avoiding bathroom use.

Bathrooms weren’t the only arena where respondents reported harassment, experiencing fear, or discrimination.

  • 58 percent of respondents reported being harassed by police.
  • Transgender women reported that police frequently assumed that they were sex workers.
  • This was more extreme for black transgender women, 33 percent of whom said they’d had an experience in the past year when an officer assumed they were a sex worker.
  • 23 states have no laws protecting transgender Americans from discrimination.
  • 40 percent have attempted suicide at some point in their lives, compared to 4.6 percent of the general U.S. population.

More than half of respondents who sought insurance coverage for transition-related surgery were rejected. A quarter of those who sought coverage for hormone therapy were also rejected. Earlier this year, after the survey was conducted, the Department of Health and Human Services clarified Section 1557 of the Affordable Care Act — the nondiscrimination provision — to explicitly say it applied to gender identity.