Our study seeks to understand more about how geographic location and sociopolitical context shapes experiences of stigma, stress, resilience, and health.

To do so, we collected data in locations that varied in terms of their supports for transgender and gender diverse people and their political landscapes. Below you can find out more about each of the sites and states included in this study.

Our study included 158 participants across the states of Oregon, Michigan, Nebraska, and Tennessee.

Here are a few of the policies that vary across the states in the study (information obtained at the start of the study):

Context InfoOregonMichiganNebraskaTennessee
Housing Non-Discrimination Policy Inclusive of Gender (June 2018)YesNoNoNo
Employment Non-Discrimination Policy Inclusive of Gender (Jan 2019)YesFor public emp. OnlyNoNo
Hate Crimes Policies Inclusive of Gender (Jan 2019)YesNoNoNo
Public Accommodations Protections Inclusive of Gender (June 2018)YesNoNoNo
School Anti-Bullying Policies Inclusive of Gender (Jan 2019)YesNoNoNo
Anti-Discrimination in Public Education Inclusive of Gender (Jan 2019)YesNoNoNo
Transgender Healthcare – Bans on Insurance Exclusions (Jan 2019)YesYesNoNo
Protections Against Conversion Therapy (Aug 2018)Yes, for youthNoNoNo

These states also differed in their political contexts:

Context InfoOregonMichiganNebraskaTennessee
2016 Election ResultsHillary Clinton (D) 50.1%Donald Trump (R) 47.3%Donald Trump (R) 58.7%Donald Trump (R) 60.7%
Senate Info (2019)Jeff Merkley (D) & Ron Wyden (D)Gary Peters (D) & Debbie Stabenow (D)Deb Fischer (R) & Ben Sasse (R)Lamar Alexander (R) & Marsha Blackburn (R)
House Info (R:D; 2019)1:47:73:07:2
Governor Info (2019)Kate Brown (D)Gretchen Whitmer (D)Pete Ricketts (R)Bill Lee (R)
(R = Republican; D = Democrat)


At the state level, Oregon has enacted many legislative protections for transgender people and has pioneered the recognition of trans people more broadly.  For example, in 2017, Oregon became the first state to offer more than two gender options on identity documents. The large concentration of population in progressive dominated urban centers like Portland and Eugene greatly influenced the passage of these state-level laws.  In these urban areas, trans people frequently report feeling safe and accepted.  Most of the state, however, is rural and politically and socially conservative.  This makes it a state of contradictions, with the ongoing legacies of its history as a “whites only” state, and as home of white nationalist groups like the Proud Boys.  Many trans people have faced violence at the hands of these groups even within cities such as Portland.  


Michigan is a state with a mix of progressive and conservative views. The level of protections that transgender people have against things like employment discrimination differ widely depending on the city or location in the state. There are many rural areas in Michigan, which tend to be areas where transgender people report more fears of being targeted. There also is a divide between the western and eastern parts of the state, with the western side being viewed as more conservative with more negative attitudes towards transgender people.


Nebraska is a mostly rural state, with a couple of more urban areas, particularly Omaha and Lincoln. There tends to be less education about transgender people compared to other areas. The state overall tends to lack many legal protections and sometimes has policies up for vote that directly target transgender individuals. Given the rural nature of the state, it also is difficult to find affirming mental healthcare providers and medical providers.


Tennessee is the only southern state in the study. On a political level, there are not many supports for transgender people and there are often policies up for vote that directly seek to limit the rights of transgender people. There is a strong religious and southern influence in the state, with many rural areas. Given the climate here, it is not uncommon to see more overt negative reactions to transgender people.

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