The Fenway Institute and the Center for American Progress have joined forces to produce the policy brief state anti-transgender bathroom bills threaten transgender people’s health and participation in public life.

Over the last several years, our country has experienced unprecedented progress for transgender Americans. With such progress, however, has come a targeted backlash from some legislators and activists. More and more state and local legislatures across the country are considering controversial bills that would restrict access of gendered public facilities, such as restrooms and locker rooms, based on sex assigned at birth rather than on gender identity. These bills are primarily meant to prevent transgender people from accessing facilities consistent with their gender identity. This new wave of anti-transgender legislation follows a historical precedent of using legislation to preempt or invalidate laws or ordinances that provide equal rights and protection from discrimination to gay, lesbian, bisexual, and transgender people. Most recently, this was seen when conservative voters used a referendum to repeal Houston’s Equal Rights Ordinance, which would have provided protection against discrimination on the basis of gender identity in public accommodations. Though the Houston ordinance provided protections for 15 classes of people across multiple areas of life, opponents branded it as a “bathroom bill” and played on the general population’s lack of knowledge about transgender people to evoke fear and anxiety.

The move by anti-LGBT activists and legislators to pass laws preventing transgender people from using bathrooms in accordance with their gender identity is at least the third wave of legislation aimed at overturning municipal nondiscrimination ordinances or preemptively preventing people from accessing a right then being debated in the courts. The first wave involved ballot campaigns to repeal or prevent the passage of sexual orientation nondiscrimination laws. These ballot campaigns occurred from 1974 until the early 2000s. The second wave involved the anti-same-sex marriage laws passed starting in the mid-1990s, and ballot campaigns to ban state recognition of same-sex marriage put forth by antigay activists from the early 2000s through 2012. The third wave is this current set of legislation aimed at undermining or gutting local nondiscrimination ordinances, ranging from overly broad state Religious Freedom Restoration Acts—which could allow businesses to refuse service to LGBT customers on religious grounds—to this new anti-transgender legislation. Opponents of equality cite public safety as their main focus, claiming that ensuring access to shared facilities based on gender identity, rather than biological sex at birth, increases the risk of voyeurism and sexual assault. LGBT advocates and supportive legislators, on the other hand, argue that such measures are unnecessarily stigmatizing and exclusionary, and that they make it very difficult for transgender people to leave their homes to work, go to school, socialize, and otherwise live their lives without significant anxiety about how they will access bathrooms when the need arises. As reviewed below, there is no evidence to suggest that expanding nondiscrimination ordinances to cover gender identity will lead to increased incidents of violence. The denial of equality has significant negative consequences for transgender people.

In addition to concerns regarding enforceability or marginalization of people beyond the transgender community, anti-transgender bathroom bills also pose a significant public health problem for transgender people. While there is no statistical evidence to support the claim that such legislation enhances public safety, there is statistical evidence that shows the wide array of harmful physical and mental health outcomes that affect transgender people as a result of discrimination in public accommodations. While public accommodations include retail and grocery stores, hospitals, hotels, and restaurants, access to bathrooms and sex-segregated facilities within those spaces remain a core component of full and equal access to public accommodations. A 2013 survey of 452 Massachusetts transgender and gender nonconforming adults carried out by the Fenway Institute and the Massachusetts Transgender Political Coalition found that 65% of respondents had experienced discrimination in public accommodations during the previous 12 months. This discrimination in public accommodations was significantly associated with a wide array of deleterious physical and mental health outcomes for the respondents. For example, 55% of respondents who felt discriminated against in public accommodations based on their gender identity or gender expression reported physical symptoms of stress, such as headache, upset stomach, tensing of muscles, or pounding heart within the past 30 days. In contrast, only 37% of respondents who did not report any discrimination in public accommodations reported the same physical symptoms within the past 30 days. Public accommodations discrimination was also significantly associated with an asthma diagnosis and a gastrointestinal diagnosis.

Of course, if the whole point of the exercise is to bar transgender people from participating in public affairs, then, "Job well done."