Trans/nonbinary people have higher rates of disability than cisgender people do. To provide trans-affirming care, service providers can work to ensure that resources are accessible.
Rates of disabilities
“Transgender adults have a higher probability of reporting a disability compared with cisgender men and women. After confounders are controlled for, transgender adults have a 27 percent chance of having at least one disability at age twenty and a 39 percent chance at age fifty-five, which is nearly twice the rate of their cisgender counterparts at both ages.”[1]
Because of the limitations of studies on transgender people, there is little information about types of disabilities. In a 2024 FORGE study, 72% of participants reported a disability, most of those disclosing multiple disabilities.
Note on language: Some people who are neurodivergent or Deaf consider themselves disabled and some do not. While much of the information in this section can apply to these communities, they are discussed with more specificity in their own sections.
Further, many disabled people use the term disabled, while many others use people with disabilities. Service providers should follow the lead of the people they are working with in terms of language and identity terms. There are some in-group terms that may not be appropriate for service providers to use that are not part of that community (such as crip[2]).
Disability and victimization
People with disabilities experience higher rates of victimization than those without disabilities.[3] “People with disabilities are three times more likely to experience rape, sexual assault, aggravated assault, and robbery than those without disabilities.”[4] (See Vera Institute report for more details, not specific to transgender people).
These higher rates happen for several reasons. People with disabilities are targeted more. This happens because they are less valued by society, often more isolated, have increased exposure to possible abusers, and are less likely to be believed about their experiences or have access to support services. People with disabilities face increased criminalization, which leads to more experiences of police and institutional violence.
Violence is often committed by people known to the survivor.
Examples of violence targeting people with disabilities
- Trafficking to obtain a person’s Social Security Disability Insurance (SSDI) benefits
- Destruction of mobility aids or healthcare supplies
- Control of access to interpretation or communication aids
- Neglect (often by a caregiver)
- Sexual abuse
There is little research that specifically looks at the intersection of being transgender and disabled. However, given that both transgender/nonbinary people and people with disabilities experience higher rates of violence, and from the stories of people with lived experience, it is clear that trans people with disabilities experience high rates of violence.
Discrimination impacts people with disabilities after violence.
- People with disabilities are often disbelieved. They may be more likely to be treated as unreliable and unable to make their own decisions.
- Due to systemic barriers, people with disabilities have reduced access to safety supports, including services for victims of crime. Services for trans survivors of violence may not be accessible. Though federally required to provide accommodations, many victim service providers are not experienced with or prepared for working with people with disabilities. A 2018 survey found that only 16% of LGBT community centers had materials and signs in Braille and only 13% offered TTY services.[5]
Barriers to services
- Increased financial instability. People with disabilities are less likely to have financial resources, including sufficient income, reliable transportation, or stable housing. For individuals receiving disability income, the monthly payment amounts are very low. Financial resources impact a person’s ability to access many services – including having internet or phone to contact the service, having transportation to access the service, and having the time and capacity to connect with services. For transgender people, this is compounded by the economic discrimination trans people face.
- Lack of medical resources. Some people with disabilities will have needs for extensive medical care. It can be difficult for individuals to find providers who are willing and able to work with their needs. It is also difficult to find providers who are willing and able to provide trans-affirming healthcare, creating a double bind for trans people with disabilities. After violence or crime, survivors may need further medical care. Survivors may be reluctant to seek out this care if they have had negative experiences in the past.
- May require a caregiver to help access services. Some people with disabilities rely on others in order to access support – whether it’s assistance communicating, being understood, traveling, or leaving the house. Unfortunately, not all people will be comfortable sharing about the abuse with their caregivers. In some situations, caregivers are the ones causing harm. In others the caregiver may not be understanding or affirming.
- Discrimination/not being believed. There is significant stigma and bias against people with disabilities in the United States. People with disabilities are often falsely assumed to not be able to share their own experiences. They are more likely to be disbelieved when reporting violence, often told they do not have the capacity to understand or describe what has happened to them. Further, people with disabilities face discrimination, harassment, and microaggressions, which can deter people from seeking support or prevent them from being able to access services.
- Turned away from services. Survivors may be turned away from services because those services are not accessible to them or because the service provider believes the survivors’ needs are too “complex” for them. For example, a shelter may turn away a person with mobility limitations, citing that the only available bed is a top bunk. A domestic violence program may turn someone away because they say they are not prepared to meet their needs – such as working with a personal attendant, using an oxygen machine, or needing intensive support services. These organizations may not recognize that they are in fact discriminating against a person with disabilities.
Ways to understand disability
When serving people with disabilities it can be helpful to assess what you have learned about disability from cultural assumptions. In the United States, disability is often described as a medical problem – something meant to be fixed. In popular culture, such as movies and books, people with disabilities are often depicted as villains or as someone who is more noble or moral particularly for “overcoming” disability.
People with disabilities relate to their disabilities in a variety of ways. Many have complex feelings about being disabled. Many also focus on the ways that society could change to become more accessible to people with disabilities.
The social model of disability is one way to understand disability. In this model disability is a result of the environment more than the person’s body or brain. For example, in the United States, many people wear glasses. Though eyecare could certainly be more affordable, most people are able to obtain prescriptions. Without glasses or contacts, many of these people may not be able to do many of their daily activities – reading, driving, shopping, etc. Yet, because glasses are fairly readily available, needing glasses is rarely considered a disability. On the other hand, many buildings have stairs, almost all cars require the use of at least one foot, and not all areas have paved sidewalks – meaning that people who use wheelchairs or other mobility aids have less access to daily activities than people who are consistently able to walk and use their legs.
Accessible services
Service providers can assess their services and programs for accessibility. Services should be accessible to people with multiple forms of disability. By increasing access for people with disabilities, service providers will also be improving access for transgender survivors, since so many trans people experience disability.
All providers can ask survivors what would help make services more accessible to them and if they would like any accommodations. Further, organizations can ensure that staff and volunteers are trained to work with people with disabilities.
Communication access
- Interpreters and assistive communication. Ensure staff are familiar with working with interpreters. Provide access and encourage the use of Augmentative and Alternative Communication devices (AAC). Survivors should be able to communicate in their preferred method.
- Plain language. Use plain language in all communications – written and verbal.
- Multiple forms of communication. Many survivors, with and without disabilities, benefit from accessing communication in multiple formats. Verbal information can also be shared in writing. Written documents may have pictures to help illustrate key points. Staff can be prepared to repeat information as often as is needed for a survivor.
- Ability to access services without a phone call. Many survivors struggle with making phone calls. Services can provide ways for survivors to access services via email, text message, or online chat. Service providers can review safety information for all modes of communication.
Physical access
Physical access to spaces includes designing for people with a wide range of body sizes, mobility capabilities, and aids. While many programs think about doorways and ramps, it is also useful to think about all other areas and equipment that might be used in a space. This includes tables, bedrooms, kitchens, and shared spaces. Include plans for:
- Wheelchairs
- Rollators
- Larger bodies
- Hygiene access
- Kitchen
- Storage
Services can also clearly label materials and spaces:
- Use large print
- Signs with clear, simple pictures
Meaningful services
Another way to support trans survivors with disabilities is to ensure that services are useful and meaningful to survivors. This involves listening to survivors about their wants and needs and adapting services to meet those needs. Meaningful services will:
- Work with the person’s capacity – providing the level of support wanted and needed by the survivor.
- Share information clearly – using plain language and multiple forms of communication.
- Create actionable plans. Safety plans or any other plans created with a survivor should be crafted so that the survivor can put them into action.
- Consider safety needs.
- Address barriers.
Respectful services
Trans people with disabilities are very likely to have experienced some form of harassment or discrimination, likely by a person in a position of authority or power. It is critical that service providers demonstrate that they are trustworthy through showing care and respect for survivors.
- Believe the survivor
- Listen and learn from the survivor
- Use an empowerment-based approach
The Vera Institute has created an assessment guide for organizations serving people with disabilities. Measuring Capacity to Serve Survivors with Disabilities
End Abuse of People with Disabilities has a large resource library: End Abuse of People with Disabilities resource library
Activating Change has resources on the trafficking of people with disabilities: Left Behind
[1] Smith-Johnson, M. (2022). Transgender adults have higher rates of disability than their cisgender counterparts. Health Affairs, 41(10), 1470–1476. https://doi.org/10.1377/hlthaff.2022.00500
[2] Calling Up Justice. (n.d.). Crip. https://callingupjustice.com/crip/
[3] Vera Institute of Justice. (2017). How safe are Americans with disabilities? https://www.vera.org/publications/how-safe-are-americans-with-disabilities
[4] Vera Institute of Justice. (2017). How safe are Americans with disabilities? https://vera-institute.files.svdcdn.com/production/downloads/publications/How-safe-are-americans-with-disabilities-web.pdf
[5] Movement Advancement Project. (2019). LGBT people with disabilities. https://www.lgbtmap.org/file/LGBT-People-With-Disabilities.pdf