Limited information exists about the number of transgender people experiencing homelessness. There are very few data sets relative to this population, but all the data tells a similar story: transgender people are more likely to be unsheltered than their cisgender peers, and those who are unsheltered have considerably more health and safety challenges than those who are sheltered.
Growing Numbers and a Lack of Shelter
According to the Point-in-Time Count (PIT), homelessness and unsheltered rates among transgender people are increasing at an astounding pace. The number of adult transgender individuals experiencing homelessness increased 88 percent since 2016 and the number experiencing unsheltered homelessness increased 113 percent during the same period.
Transgender individuals are disproportionately unsheltered. Sixty-three percent are living in such situations. For comparison, 49 percent of cisgender people experiencing homelessness are unsheltered.
Highly Vulnerable
While the PIT offers information about where and how many people are transgender and homeless, data from the VI–SPDAT1 provides information about their characteristics and the challenges and vulnerabilities they face. This data points to an unsheltered transgender population in need of shelter, housing, and other services.
Being Unsheltered Tied to Greater Levels of Vulnerability
Unsheltered transgender people are more vulnerable than their sheltered counterparts across nearly all measures. Table 1 highlights the differences between the two groups. Although it is not possible to determine whether the higher rates of vulnerability among unsheltered people are the cause or the result of their being unsheltered, it is clear that they face greater challenges in most domains, are extremely vulnerable, and are in need of greater assistance.
Table 1
|
Transgender Vulnerability by Shelter Status |
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|
|
Sheltered |
Unsheltered |
|
|
Trimorbid (co-occurring physical, mental and substance use disorders) |
3% |
60% |
|
|
Chronic Health Issue |
3% |
38% |
|
|
Mental Health Issue |
16% |
50% |
|
|
Drug/Alcohol Issue |
4% |
69% |
|
|
Physical Disability |
4% |
30% |
|
|
Learning Disability |
23% |
39% |
|
|
HIV Housing Interest |
0% |
21% |
|
|
Avoids Medical Treatment |
2% |
42% |
|
|
Harm Self/Others |
11% |
43% |
|
|
Trauma/Abuse |
38% |
31% |
|
|
Attacked while Homeless |
42% |
39% |
|
|
Risky Behavior |
18% |
98% |
|
|
Forced to Do Things They Do Not Want to Do |
11% |
40% |
|
|
Legal Issues |
8% |
48% |
|
Table 1 indicates that across a spectrum of health and behavioral health domains, unsheltered transgender people are considerably more ill than those in shelter. It also indicates that in terms of survival behaviors, risk and safety, unsheltered people are more challenged than sheltered people.
The VI-SPDAT data provides further insight into vulnerability by indicating the number of interactions transgender people experiencing homelessness have with medical and criminal justice systems. Table 2 details that transgender people who are unsheltered average significantly more ambulance rides, emergency room visits, police contacts, and stays in jail or prison.
Table 2
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Average Number of System Interactions Per Person in the Last 6 Months by Shelter Status |
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|
|
Sheltered |
Unsheltered |
|
Ambulance Rides |
1.2 |
2.6 |
|
Emergency Room Visits |
4.9 |
7.6 |
|
Police Contacts |
2.7 |
21.3 |
|
Jail/Prison Stay |
0.8 |
8 |
Unsheltered Transgender Homelessness and Vulnerabilities by Race
Limited data exists for racial and ethnic groups outside of Black and White transgender people experiencing unsheltered homelessness. Therefore, the details following will only compare these two racial groups (see Table 3).
Table 3
|
Unsheltered Transgender Vulnerability Indicators by Race |
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|
|
Black |
White |
|
Trimorbid |
58% |
59% |
|
Chronic Health Issue |
32% |
43% |
|
Mental Health Issue |
48% |
51% |
|
Drug/Alcohol Issue |
62% |
74% |
|
Physical Disability |
38% |
23% |
|
Learning Disability |
56% |
26% |
|
HIV Housing Interest |
18% |
23% |
|
Avoid Medical Treatment |
44% |
36% |
|
Harm Self/Others |
58% |
30% |
|
Trauma/Abuse |
24% |
38% |
|
Attacked while Homeless |
56% |
26% |
|
Risky Behavior |
100% |
97% |
|
Forced to Do Things They Do Not Want to Do |
56% |
26% |
|
Legal Issues |
60% |
38% |
This Table shows that both Black and White unsheltered transgender people have extraordinary health and safety issues. Notably, a staggering percentage of both Black and White unsheltered transgender people engage in risky behavior: 100 percent of Black and 97% of white people.
Finally, unsheltered Black transgender people experiencing homelessness also average somewhat more system interactions than their unsheltered White peers (see Table 4).
Table 4
|
Unsheltered Transgender Average Number of System Interactions Per Person in the Last 6 Months by Race |
||
|
|
Black |
White |
|
Ambulance Rides |
3.2 |
2.2 |
|
Emergency Room Visits |
9.0 |
6.7 |
|
Police Contacts |
22.5 |
19.5 |
|
Jail/Prison Stay |
8.9 |
6.5 |
Additional Information
Transgender homelessness is increasing, and the majority of those who become homeless are unsheltered. The health and safety challenges of this unsheltered group are much greater than those of their sheltered counterparts. Studies show that transgender people have difficulty accessing shelter, at least in part because of their gender identities. Being unsheltered is associated with much higher rates of illness and poor health among all homeless populations, and this is exacerbated among transgender people by the heightened risk they face living on the streets.
Transgender people in general are highly vulnerable to hate crime victimization. In 2019, at least 26 known transgender people were murdered and 91 percent were Black. So far in 2020, there have been 18 murders of transgender people. Living on the streets and being forced to engage in risky survival behaviors elevates the risk of violence and victimization among this extraordinarily vulnerable group.
While unsheltered transgender people are more likely to be victims of crime, they are also more likely to have interactions with the criminal justice system. They average a higher number of police contacts and jail or prison stays than their cisgender peers. It is unclear to what degree this is due to criminalization of homelessness, or to risky behaviors transgender people may be forced to engage in when unsheltered. They need safe, appropriate shelter, a rapid pathway to housing, and connection to any needed services, including health care.
Conclusion
Many transgender people already face challenges such as discrimination, rejection, and legal battles; and physical and behavioral health battles, as well. Such problems are exacerbated when they are homeless and can become life threatening when they are unsheltered. While further research is needed to fully understand the nature and dynamics of homelessness among transgender people, one thing is certain: the homelessness system should support, not reject them. Homeless shelters should provide services and beds to all people in alignment with their gender identities. Their health and safety issues should be addressed, and they should be put on a pathway to housing and connected with needed services.
1. The Vulnerability Index and Service Prioritization Decision Assistance Tool (VI-SPDAT) is a widely used assessment instrument that helps communities triage people experiencing homelessness for the most appropriate housing resources based on several criteria. OrgCode Consulting developed the tool and has also released anonymized data for the period of 2/1/15-4/13/18. The data is self-reported information for individual adults age 25 and older.