Transgender and Nonbinary (TGNB) people are individuals whose gender identity and expression are different from the cisgender norms most commonly-accepted in our society. TGNB is an umbrella phrase which references a diversity of nuanced human identities, including: Transgender, Nonbinary, Intersex, Genderqueer, Gender Non-Conforming (GNC), Two Spirit, Agender, Bigender, Gender Fluid, Gender Flux, Questioning, and many more. TGNB is often used interchangeably with the terms gender expansive, trans*, and non-cisgender.

For Transgender and Nonbinary people whose gender, name, and pronouns assigned at birth aren’t reflective of who they are, the single moment of gender assignment sparks a life-long battle for inclusion, respect, and belonging. TGNB people belong everywhere and deserve to feel that they belong. They deserve autonomy to live open, authentic lives without fear of discrimination, harassment, judgement, or violence.

Despite decades of tireless advocacy, TGNB people are still significantly more likely than their cisgender peers to experience violence (50% of transgender people have been sexually assaulted), harassment (53% of transgender people have experienced public harassment), and discrimination (90% of transgender people have experienced mistreatment or discrimination in their workplaces). These disparities are often further compounded by isolation, discriminatory laws, and a lack of access to appropriate primary and mental health care. Transgender and nonbinary people who are femme, disabled, queer, and/or of color—especially trans women of color—are most disproportionately impacted.

Many factors—both historical and contemporary—contribute to and perpetuate these harsh disparities. Prior to American colonization, more than 150 Indigenous tribal nations acknowledged other or “third” genders. By the mid-1800’s, however, it was illegal to be transgender or even to wear clothes that did not match one’s assigned gender in public. Historically, gender expansive people were subject to therapies to “cure” them, and Two Spirit people were systematically persecuted and erased. Today, some laws have changed, but some still remain. For example, TGNB are still required in many states to undergo invasive (often sterilizing) surgeries in order to legally change their gender on identification documents, and intersex people are still forced to endure non-consensual gender reassignment surgery as infants or children.

The lack of consistent legal protections regarding gender identity and expression creates barriers to improving TGNB health. Decisions and policies that impact the well-being of gender expansive people—like appropriate use of force by law enforcement, bathroom rights, businesses’ rights to refuse service, identity document laws, and transgender healthcare standards—vary by state and local jurisdiction. When layered with similar lack of protections against racial injustice, the risks are even more significant for TGNB people of color. White transgender people are twice as likely as cisgender people to be unemployed due to discrimination, but transgender people of color are four times more likely.

The TGNB community advocates for trans workers’ rights and access to public bathrooms, and against police violence and anti-trans healthcare legislation. At scale, we can advance TGNB health by advocating for policies and laws that protect transgender and nonbinary people at home, at work, and in public, regardless of their state or local jurisdiction. Local communities can support TGNB businesses, create safe spaces for TGNB youth, push for EDI (Equity, Diversity, and Inclusion) trainings, and advocate for policies that protect TGNB people from violence, harassment, and discrimination in all aspects of their lives. Because transgender and nonbinary peoples’ health is intrinsically tied to their ability to express their gender, we can also participate in improving TGNB health by using correct pronouns, chosen names, and gender-affirming language. Even small actions can foster belonging and be life-saving.