U.S. Dept of Health and Human Services To Begin Counting Trans People

Today the Secretary of Health and Human Services Kathleen Sebelius announced a plan to develop and use survey questions to collect public health information on trans people.  This is the culmination of a lot of work from a lot of people.  Why is it so important?

• Public health data has never really been collected by the federal government.
• Federal public health data is the gold standard in public health data.
• Without such data, getting the federal government to focus on a public health problem is extremely difficult or impossible.
• Soon (or at least in a few years), we will have good public health data we can use to advocate with the federal government for programmatic focus on trans health disparities.

In other words, if there is no federal population-based study data identifying and quantifying a public health issue, there will be no governmental focus to solve it. Because of the HHS announcement today, there will soon be federal population-based public health data on a variety of trans public health issues.

NCTE and our allies have been working with the administration for several years to get to this point.  We especially thank the Coalition for LGBT Health, the Center for American Progress, the Williams Institute, the Network for LGBT Health Equity and a lot of individual researcher for this important work. This announcement today does several things:

• It reiterates the Obama Administration’s commitment to collect and use public health data about the disparities (inequalities) faced by trans and LGB people when seeking access to healthcare.
• It provides a commitment from the federal government to work with the right researchers and provide sufficient resources to all develop and test the kinds of questions necessary to accurate study LGBT people.
• For the first time, it lays out a plan for developing, testing and implementing gender identity research questions.
• The working group of researchers, of which we have been a part, will now be called upon as subject matter experts to help implement the research we would never be able to conduct on our own.

This is a very big deal. Many readers may be confused about now, wondering what I mean by developing and testing questions. I’ll explain.  Let me put on my researcher hat; many people don’t know that prior to my work at NCTE, my profession was opinion research, so, though I don’t have direct public health survey experience, I have some expertise that has been useful for me to understand this topic. I think generally trans people would assume we know how to ask questions about trans people on surveys.  Indeed we sort of do, but not in a solid, confirmed scientific way. Here are some of the considerations about which we are not sure. In any given study, do we want to be asking about people’s gender identity or expression? Who do we want to study? Transsexuals? Medically transitioned transsexuals? People who may face discrimination or bullying because of their gender identity or expression? Just people who are out of the closet? This isn’t settled and probably depends on the study being conducted. How do we ask a question so that it makes sense to both trans and non trans respondents?  For instance, a government researcher in one of our meetings once suggested we ask “Are you male female or transgender?” Non-trans people would probably answer that question easily, but it is a practical and political mess for many trans people. Something that has worked for trans people such as a two-part “What was your sex assigned at birth and what is current gender identity?” would be easier for trans people, but non-trans people would have little understanding of what was really being asked. Real theoretical and concrete discussions have been underway for several years, but we haven’t had the federal government research apparatus fully engaged.  That should change now. This is a really big deal. Read our full statement here. Read the full statement from HHS and their plan here.