Contrary to one of the most often cited premises in so-called “bathroom bills” such as North Carolina’s House Bill 2, transgender people do not pose a threat to others in public or private spaces, according to a new study from RTI International.

Rather, the report concludes that transgender men and women as well as other members of the LGBTQ+ communities are at “high risk” of being victims of physical and sexual assault as well as other crimes.

“There is no evidence indicating that LGBTQ+ persons pose a threat to non-LGBTQ+ persons in public (or private) spaces,” says the study, which RTI, an international nonprofit research organization based in RTP, launched and funded last July as the HB2 debate intensified in North Carolina.

One of RTI’s stated objectives was to find out if the victimization threat against women and children over bathroom use and other issues based on an individual’s gender identification was factual. Such threats have been cited as a key reason for passage of HB2 and other similar legislation across several other states. RTI also cited the massacre at a gay bar in Orlando last year in launching the study to “better understand the ​LGBTQ+ community and violence in the United States.”

Tasseli McKay, Shilpi Misra, and Christine Lindquist of RTI authored the report, titled “Violence and LGBTQ+ Communities What Do We Know, and What Do We Need to Know?” The 56-page report is based on a review of studies about LGBTQ+ issues over the past two decades. McKay, who earned a Masters in public health at UNC-Chapel Hill, is a Social Science Researcher, Center for Justice, Safety & Resilience at RTI.

RTI used the acronym LGBTQ+, which stands for “Lesbian, Gay, Bisexual, Trans, Queer/Questioning, and Others.”

Citing HB2 and the recent massacre in Orlando, RTI said it is seeking to “better understand the LGBTQ+ community and violence in the United States.”

Public perceptions not changing

The study also concludes that public attitudes toward LGBTQ+ communities remains negative.

“Despite the perception that society is becoming more open and welcoming of LGBTQ+ persons, victimization disparities have not improved since the 1990s (when they were first measured),” the authors wrote, citing a variety of surveys and other reports.

“Some forms of victimization, particularly those affecting youth, appear to be worsening. This has serious, lifelong impacts on the physical and behavioral health of LGBTQ+ youth and adults.”

In drawing their conclusions, McKay said the team “spent several hundred hours reviewing the research literature, as well as looking at unpublished analyses and data sources, including over 102 peer-reviewed articles from 20 years of research,” McKay, the lead author, explained in an interview.

“With regard to the idea that including LGBTQ+ individuals in certain public spaces would put others at risk, what’s most striking here is the sheer lack of evidence — especially considering the breadth and depth of our search and of the field in general.”

Evidence about threats against transgender people and others, however, is abundant, McKay pointed out.

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“With regard to whether LGBTQ+ individuals themselves are at risk for victimization, whether in public or private spaces, what’s most striking is how strongly the evidence from dozens and dozens of studies in different settings, in different samples, and using different survey tools converges — and it all suggests a pattern of heightened victimization risk for LGBTQ+ people,” she said.

Especially in schools, McKay added.

“School-based victimization is an area where we actually have a great deal of statistical data, thanks in part to representative, school-based surveys like CDC’s Youth Risk Behavior Survey and other similar efforts. Although prevalence estimates for school-based bullying based on sexual orientation or gender identity vary from study to study, they are consistently high. For example, researchers at the University of Washington found that, among a representative sample of students in Washington State, 14 percent of 8th grade boys and 11 percent of 8th grade girls reported being bullied because of perceived sexual orientation in the past month alone (Patrick et al., 2013).”

HB2, transgender debate continues

The study is being published Thursday as the transgender debate continues. Legislators in North Carolina are still debating a repeal of HB2, and the Trump Administration recently turned the transgender issue back to states, overturning a stand taken by the previous Obama Administration.

The Supreme Court also decided recently to not hear a transgender/bathroom case brought in Virginia by a high school senior,Gavin Grimm, who seeks the right to use the boys’ bathroom at his school.

Such “bathroom laws” being considered elsewhere could mean trouble for transgender people and others, McKay noted.

“We can’t say for certain whether these laws put LGBTQ+ people at higher risk, but the available evidence is certainly cause for concern,” she said when asked if these bills posed a threat.

“First, participants in the focus groups that RTI and The Henne Group conducted shared over and over how they are living with the fear and prospect of victimization on a daily basis, and this appears to be especially true for transgender and gender non-conforming individuals when using public restrooms.

“Second, there’s some very early evidence that laws that expand LGBTQ+ rights have positive effects on their health and well-being—the study that just came out in JAMA Pediatrics last month by Julia Raifman and colleagues at Johns Hopkins is a great example of this, showing that same-sex marriage laws were associated with decreased LGBTQ+ youth suicide in states that adopted them.”

“Compelling” focus group reaction

In addition to a review of other studies, RTI worked with The Henne Group to conduct several focus groups in four different regions of the country, including three in the Triangle at RTI’s offices.

McKay said participants included “a group with two trans-masculine individuals, a group with four trans-feminine individuals, and another group with four lesbian, gay, bisexual, and queer individuals.”

She described two responses as “compelling” to her:

  • “We were raised, as female-bodied people, to be afraid of men, to be afraid of dark places, to be afraid of being alone. Then you transition, and you still hold that fear. I’m equally targeted now, but in a different way, and it’s equally terrifying.”
  • “HB 2 gives bigoted people permission to be bigoted toward us.”

McKay said reviews of “numerous studies” by the researchers “suggest that LGBTQ+ persons are more likely to be victims of various forms of violence and victimization, including physical and sexual assault, harassment, bullying, and hate crimes. LGBTQ+ persons experience violence and victimization in disproportionate numbers throughout childhood, adolescence, and adulthood.”

“It’s really hard to pick out a couple of studies, because we reviewed such an enormous body of research on different forms of victimization, in different settings, and at different points in the life course,” McKay added when asked about specific studies the researchers considered most reliable. “Many of those individual studies had great methods and compelling findings, but none of them conveys the whole picture—expressing that full picture was really the focus of our review.”

Studies cited

Among those cited were:

  • “The U.S. Transgender Survey (USTS), which surveyed a convenience sample of 27,715 transgender respondents from all 50 states, the District of Columbia, and U.S. territories, found that 10% of respondents who were out to their immediate families as transgender reported that a family member had used violence toward them because of their gender (James et al., 2017).
  • “Greytak and colleagues’ (2016) study using weighted web panel data from 1,367 middle and high school students found that 22% had experienced verbal harassment related to their gender expression and 19% had experienced verbal harassment related to their actual or perceived sexual orientation.
  • “For childhood physical and sexual abuse, two studies using nationally representative telephone survey data found that (1) sexual minority adults were more likely than heterosexuals to report serious physical maltreatment by a childhood caregiver (Corliss et al., 2002) and (2) adults who had ever lived with a same-sex intimate partner were more likely than those with (exclusively) different-sex cohabitants to have experienced sexual assault as children and to have been physically assaulted as children by an adult caretaker (Tjaden et al., 1999).
  • “Another study (Austin et al., 2008) found that 19% of lesbian and bisexual women had experienced childhood sexual abuse—a rate that was twice that of their heterosexual counterparts.
  • “Another study using a population-based sample found that 15% of gay men and 11% of bisexual men reported childhood sexual abuse, and that sexual minority men were up to five times as likely as heterosexual men to have experienced it (Hughes et al., 2010).
  • “A meta-analysis of data from 37 U.S. and Canadian studies found that sexual minority youth were 3.8 times more likely to experience childhood sexual abuse and 1.2 times more likely to be physically abused by a parent or guardian compared with non-sexual-minority youth (Friedman et al., 2011).”
  • “Analysis of data from 3,636 Canadian adolescents found that sexual minority youth (including “questioning” youth) were more likely than heterosexual youth to be victims of bullying, peer sexual harassment, and peer physical abuse (Williams et al., 2003).

To conduct the study, McKay said that RTI utilized a “professional reference librarian using PubMed; Web of Science, including Science Citation Index Expanded, Social Sciences Citation Index, and the Conference Proceedings Citation Indexes for Science and for Social Science & Humanities; PsycINFO; and the New York Academy of Medicine Grey Literature Database.”