North Carolina among top ten states whose restrictive laws lead people to leave

Published February 8, 2024

By Joe Killian

North Carolina is among the top ten states transgender people report leaving because of state laws targeting them for unequal treatment, according to data released this week from the U.S. Transgender Survey.

The other states are Alabama, Arizona, Florida, Georgia, Missouri, Ohio, Tennessee, Texas, and Virginia.

“Across the country, our community has been facing unprecedented and relentless attacks,” said Rodrigo Heng-Lehtinen, executive director of the National Center for Transgender Equality, which conducted the new survey. “In 2023, last year, we fought over 500 bills targeting the LGBTQI+ community — of which, over 450 specifically targeted transgender people.”

A head shot of Rodrigo Heng-Lehtinen
Rodrigo Heng-Lehtinen, executive director of the National Center for Transgender Equality. (Photo: NCTE)


“This year, we’re already tracking over 300 pieces of anti-trans legislation,” Heng-Lehtinen said in a Tuesday press conference. “And it’s only early February.”

The survey found nearly half of respondents (47%) have thought about moving because of bills or laws targeting transgender people. The top ten list of states reflects places respondents actually reported leaving. Just over 40 percent of respondents were from the South, the region with the most states that have passed such laws.

The spike in anti-transgender legislation has been accompanied by a national rise in violence against transgender people. In that environment, Heng-Lehtinen said, tools for understanding the actual lives and experiences of transgender people are invaluable.

The new survey, conducted at the end of 2022 by the National Center for Transgender Equality, is the largest survey of American transgender people. Its data reflect the views of roughly 92,000 transgender respondents aged 16 and older across all fifty states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the U.S. Virgin Islands, and U.S. military bases overseas.

The group’s last national survey, in 2015, had 27,715 respondents.

“It will come to define the world of transgender rights advocacy for years to come,” Heng-Lehtinen said of the new data.

Transgender people may be more visible than ever before, Heng-Lehtinen said. But there’s still “a drought of information” regarding their actual experiences and needs.

Who’s who among the U.S. transgender population

With more than three times as many respondents as the 2015 survey, the 2022 survey data gives an updated picture of how respondents describe their own gender identities.

The largest number of respondents (38%) described themselves as nonbinary, identifying as neither male nor female. Thirty percent of those nonbinary people said they were assigned female at birth, while 8% said they were assigned male at birth.

The next largest group was transgender women at 35%, followed by transgender men at 25%. Crossdressers, most of whom identify with the gender they were assigned at birth, made up just 2 percent.

Five percent reported they are intersex, or “born with a variation in physical sex characteristics or had an intersex variation or Difference of Sex Development.”

A breakdown of respondents by gender identity.
(Image: NCTE)


Information — and misinformation — on gender transition

Last year, North Carolina joined a wave of states whose Republican legislative majorities passed laws targeting transgender people and particularly transgender youth. Those laws, which restrict everything from health care for transgender people, to the school sports teams on which they can play, to how they can be discussed or refer to themselves in public schools, were passed in spite of the strong opposition of many transgender people, their families, doctors and every major medical and psychological association.

“At best we’re working in a vacuum of information,” Heng-Lehtinen said. “At worst, we’re combating dangerous misinformation being spread by anti-trans extremists.”

House Bill 808 became law when the General Assembly’s GOP majority overturned Gov. Roy Cooper’s veto last August. It bans all gender-affirming medical care – from puberty blockers and hormone treatment to various surgeries – for anyone under 18, irrespective of their doctor’s advice and parents’ consent. 

The law also prohibits state funds and Medicaid dollars from being used for such care, directly or indirectly. Doctors providing such care could face civil penalties and lose their medical licenses under the new law.

During debate on the bill, Republican lawmakers highlighted the experiences of “detransitioners” — people who say they identified as transgender and underwent gender transition but no longer identify that way. These people, who have been traveling to legislative hearings across the country to testify for restrictive laws, say they regret transitioning and believe others — especially young people — will too. Though proponents of restricting gender transition presented these experiences as common, data from the new survey tells a very different story.

Seventy-nine percent of respondents in the survey reported they were “a lot more satisfied” with their lives since gender transition and 15% reported being “a little more satisfied.” Three percent said they were neither more or less satisfied, 1% “a little less satisfied” and 2% “a lot less satisfied.”

A graphic illustrating the life satisfaction of respondents after gender transition.
(Image: NCTE)


Those for whom medical procedures were part of their transition reported even higher levels of satisfaction, with 88% saying they were “a lot more satisfied” with their lives after gender-affirming surgery. Another 9% said they were “a little more satisfied” after such surgeries.

Among those for whom hormone therapy was a part of their transition, 84% reported being “a lot more satisfied” with their lives, while 14% said they were “a little more satisfied.”

A graph illustrating satisfaction with hormone therapy among respondents.
(Image: NCTE)


Harassment, unequal treatment

The 2022 survey data also provides a look at the experiences of transgender people being denied equal treatment and service as well as their experiences with harassment, threats and violence.

Among the findings:

  • Four percent (4%) of respondents reported being denied access to a restroom in a public place, at work, or at school in the last 12 months.
  • Six percent (6%) of respondents reported being verbally harassed, physically attacked, or experienced unwanted sexual contact when accessing or using a restroom. 
  • Nearly one in ten (9%) respondents reported being denied equal treatment or service in the last 12 months because of their gender identity or expression.
  • Nearly one-third (30%) of respondents reported that they were verbally harassed in the last 12 months because of their gender identity or expression.
  • More than one-third (39%) of respondents reported that they were harassed online in the last 12 months because of their gender identity or expression. 
  • Three percent (3%) of respondents reported that they were physically attacked in the last 12 months because of their gender identity or expression.

The new data should serve as a crucial tool for education, research and policy, Heng-Lehtinen said. That’s crucial as LGBTQ people (and particularly transgender people) face a political landscape that is much changed since 2015, he said, and much more hostile.

“This data is giving us a rich and detailed texture of transgender Americans’ day to day experiences,” Heng-Lehtinen said. “We’ve never had that kind of data before. This is the first survey that we have conducted since the change in the political climate and it’s the only survey of its kind.”