COVID-19 shows 'marginalization has a price.' For transgender adults, it's food insecurity.

Corrections & Clarifications: Kathryn K. O’Neill is a co-author of a Williams Institute report on food insufficiency among transgender adults during the COVID-19 pandemic. Her name was listed incorrectly in an earlier version of this story.

Transgender adults are having a much more difficult time than the overall population in getting enough nourishment during the COVID-19 pandemic, according to a new study.

The Williams Institute at UCLA School of Law report, published this month, finds that transgender adults were three times as likely than other adults to face food insufficiency – defined as not having enough to eat in the past seven days – between July and October.

The gap was even more severe for transgender people of color, who were six times as likely to experience food insufficiency as cisgender white adults, according to the Williams Institute, which conducts independent research on sexual orientation and gender identity law and public policy.

The study, based on responses to the U.S. Census Bureau's Household Pulse Survey, found that 25.3% of transgender adults reported food insufficiency compared with just 8.3% of cisgender people. Transgender people of color experienced the highest rate (35.8%), with transgender white people at 17.1% and cisgender white people at 6%, the lowest rate among measured groups.

"The fact that 1 out of 4 transgender adults didn't have enough food to eat in the week prior to filling out the survey is a very sad fact," said lead author Kerith J. Conron, Blachford-Cooper Research Director at the Williams Institute.

A higher level of poverty among transgender people, often resulting from a lack of access to education and jobs because of discrimination, is a main reason for the disparity, according to the study. Other obstacles cited in the report, co-written by Kathryn K. O'Neill, include an inability to get out to buy food, for reasons such as a lack of transportation, immunocompromised health, disability and safety concerns.

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Dominique Morgan isn't surprised by the report's findings and says she sees real-life examples of hunger in her work as executive director of The Okra Project, a collective that provides home-cooked, healthy meals to Black trans people.

“You’re facing people who are choosing between feeding myself and feeding someone in my household,” said Morgan, whose group serves people in New York, New Jersey and Philadelphia. "A person could be living with HIV and AIDS and literally they can’t eat what’s being served at some of these soup kitchens or pantries. And so they’re drinking water to make it or bone broth. There are people who are doing drugs just to stave off the desire to want to eat. That is how dire it is.”

Morgan, a Black transgender woman who is executive director of Black & Pink, which works with current and formerly incarcerated LGBTQ people and those with HIV/AIDS, said discrimination and dangers vary by race, as it does in society overall.

"A white trans person absolutely is going to experience harm and oppression because of their gender identity depending on where they're at. But at the end of the day, they still have their whiteness to protect them," she said. "As a Black trans woman in this world … the oppression does not decrease, it just increases."

'Food is so central to all that we do'

Even when food is available, a lack of respect and even open discrimination can create barriers for transgender people, the report said, quoting the experience of Alex, a Black pansexual transgender man from Los Angeles.

"I would try to access the church food banks. It was difficult. Like, you go in there, and they just have this look on their face of like disgust – you really don’t wanna deal with them. You don’t wanna deal with that," he said. "You already emotionally defeated going into that situation, and then to get all of that, I was like I’d rather turn around and go back, figure this out a whole ‘nother way."

Worries about physical and emotional safety are common for transgender people and can stop them from getting food even when it's available, said Maria Roman-Taylorson, vice president of The TransLatin@ Coalition, a nonprofit created by trans Latina women that serves trans and gender nonconforming people. It can range from cultural disrespect, which she called "microaggression," to physical violence.

"We see a lot of clients that go to social services, food banks or shelters and they're turned away, mistreated not only by the people that work there but also by the other patrons that are accessing the services," she said.

The consequences of a lack of food go beyond an empty stomach. The Trevor Project, the largest suicide prevention and crisis services organization for young LGBTQ people, found that LGBTQ people who said they felt food insecurity in answering its 2021 national mental health survey were more than twice as likely to have reported attempting suicide than those who didn't face food insecurity (25% vs. 11%).

"Food is so central to all that we do, both for physical health and mental health," said Amy Green, The Trevor Project's vice president of research. "When individuals have to go periods of time without eating … they're exposed to the psychological toll of the stress of having to struggle for food but also the physiological experience of hunger."

Trans data, COVID-19 and the future

Little research has focused exclusively on food insecurity among transgender people, and the Williams Institute report is the first to analyze a nationally representative sample (338,125 qualifying respondents). The pulse survey, set up in April 2020 after the start of the pandemic, didn't give respondents the chance to identify as transgender until July 2021, Conron said.

That lack of earlier survey data makes it hard to determine trends during the pandemic, Conron said, although an earlier Williams Institute report found LGBTQ people faced higher levels of poverty – and likely food insecurity – than the overall population before COVID-19. Transgender people experienced the highest poverty rate.

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"It's great the federal government added these questions, but they really should have been in there from the inception of the pulse survey. Then we would have been able to look at how the pandemic influenced food insufficiency" over its entire course, Conron said.

Food insecurity, lack of housing and poverty have been "an ongoing issue for trans people, especially trans people of color," said Taylorson, whose organization provides food, housing and other services in Los Angeles and has chapters throughout the country.

"COVID-19 has brought this to light (for the general public), but it's something that we see the people in our community going through every day. It's great that we now have data to back this … because without data sometimes you can't get funding and resources."

Besides endorsing more data collection, the report recommends that discrimination protections based on sexual orientation and gender identity be enforced throughout food production and distribution services; that any barriers to public benefits, including the Supplemental Nutritional Assistance Program (SNAP), be removed; and that more financial support go to local programs that have the trust of the transgender community.

For all that's still needed, having the data on transgender people provided by the pulse survey represents a major step forward, Conron said.

"It's an important opportunity to show the public that marginalization has a price," she said. "And here, it's a very tangible one: not having enough to eat."

Corrections & Clarifications: An earlier version of this story misspelled the name of Kathryn K. O’Neill, a co-author of a Williams Institute report on food insufficiency among transgender adults during the COVID-19 pandemic.

This article originally appeared on USA TODAY: Transgender adults face higher food insecurity during COVID pandemic