As she closed up the little bookstore in South Station one night, Vivian Taylor sought a quick bathroom break in the station’s public stalls.
But a man blocked Taylor, a transgender woman, from entering the women’s room. Infuriated, the man barked at her: “Where do you think you’re going?”
“It’s a phenomenally frightening and embarrassing thing to be treated that way,” the 28-year-old Taylor said. “If there aren’t public accommodation protections for trans folks, people can really do us harm.”
Nor is imminent harm the only danger. Such distressing moments, a new study has found, can lead to physical and emotional illness.
Sixty-five percent of transgender people surveyed reported experiencing discrimination in a public setting in Massachusetts in the past year, according to the Project Voice report by The Fenway Institute and the Massachusetts Transgender Political Coalition.
The study interviewed 452 transgender people across the state in 2013. To reach a diverse sample, researchers approached participants both in person and online to administer the short survey.
Of the transgender people who reported discrimination, many cited adverse physical symptoms, such as headaches and muscle tension, as well as emotional distress.
‘No one should be made to feel unsafe because of their identity.’
“Discrimination is a matter for public health,” said Sari L. Reisner, the lead investigator of the report. “It needs to be thought of as not just a social justice issue, but as something that impacts public health.”
People experiencing discrimination may internalize stigma, leading to stress-related conditions such as depression, asthma, or gastrointestinal issues, said Reisner, a postdoctoral researcher in epidemiology at Harvard School of Public Health.
“Psychological stressors like we’re talking about today really can cause negative physical health,” he said. “You’re talking about things that impact people’s functioning in the world.”
At its most extreme, discrimination can mean people neglecting their own health care. One in five respondents postponed or did not try to get health care in the past year because of what they described as past mistreatment. Five percent of respondents said they have been denied health care because of their gender identity.
“Maybe people will say, ‘You’re transgender, I don’t know what to do,’ or, ‘We don’t do that here,’ ” Reisner said. “That’s very harmful, because transgender people’s health care is like anybody else’s.”
Transgender people already are less likely to have access to health care, said Sean Cahill, director of health policy research at The Fenway Institute.
He said 17 states ban gender-identity discrimination, including protections in public areas. The Massachusetts Legislature is considering a bill that would place the Commonwealth among them, though it probably will not pass this session.
“We hope this report could possibly give some momentum to that legislative effort,” Cahill said.
Senator Sonia Chang-Diaz, who sponsored the equal access bill, said in a prepared statement that she is disappointed the bill was sent to study.
“People who lived through or have seen pictures of the 1960 civil rights sit-ins at lunch counters will remember that public accommodations are fundamental to equal rights in America,” she said. “No one should be made to feel unsafe because of their identity.”
A lot of discrimination is small-scale yet pervasive, said Lorelei Erisis, a 41-year-old transgender woman living in Ayer.
“It wouldn’t make a big, dramatic story, but it happens to all of us, especially in public places,” she said.
Erisis, a trans rights activist and Rainbow Times columnist, said she has trained herself not to notice people’s reactions to her when in public, while still keeping an eye out for dangerous situations. She wants a statewide law barring discrimination in public areas, as the final version of a 2012 act did not include such protections. It bans discrimination in employment, housing, credit, and public education on the basis of gender identity, but not public spaces.
“It’s kind of absurd that it was excluded from the trans civil rights law that was passed a couple years ago,” Erisis said.
“It creates this situation where, say, a restaurant can’t refuse to hire me as a trans person legally, but they can kick me out as a customer, which is so patently absurd it’s practically the setup for a Monty Python sketch.”
Taylor said she has been harassed in stores and grabbed by men on the street.
“If you don’t know how people are going to treat you under the law, that’s just not a healthy way to live,” she said. “When I’ve had to deal with people getting upset and being awful to me just because I was transgender, I’ve been a lot more liable to get sick.”
Taylor said she lived in danger of rocket attacks when she served in the Army in Iraq from 2009 to 2010. The stress of returning home and transitioning from male to female was, unfortunately, familiar, she said.
“It’s strange to come back and go from dealing with one constant threat to another constant threat,” she said. She now works as executive director of Integrity USA, the national LGBT organization for the Episcopal Church.
She believes there is momentum for change. Her home city, Somerville, banned public accommodation discrimination on the basis of gender identity or expression in late May — the sixth community in Massachusetts to do so.
“It is so important that I be able to walk down the streets of my neighborhood, where I have made my home, where I pay my taxes, and know that I am safe from that sort of threat and violence,” she said.Claire McNeill can be reached at firstname.lastname@example.org.