The transgender population in the United States is difficult to precisely measure, says Harper Jean Tobin, the policy director at the National Center for Transgender Equality in Washington, D.C.

The term “transgender” means different things to different people, for one thing, and people may be reluctant to identify themselves as transgender because of fear of discrimination or other reasons.

But an article from the Williams Institute at the UCLA School of Law cites population studies in estimating that there may be 700,000 transgender people in the United States -- 0.03 percent of the population.

“We’re everywhere,” Tobin said. “Transgender folks are regular folks who have faced a lot of challenges in their lives.”

Among the challenges most commonly cited are violence, poverty and access to health care.

Violence can include attacks or it could be harassment and improper incarceration classifications, said Elroi Windsor, an assistant professor at Salem College and a researcher in transgender health-care issues.

The center for transgender equality says that more than one in four adults have lost at least one job because of bias and more than three-fourths have experienced discrimination.

Employment discrimination has implications for health care because it can mean a lack of insurance, the center said. And even those who have health insurance often must face exclusions on gender-reassignment procedures.

In addition to that, Windsor said, health providers often also lack education and training to respond to the specific needs of transgender people.

Other difficulties relate to legal or other public acknowledgement of transgender identity. For example, there’s the issue of pronoun usage: The transgender-equality center advises journalists to use the pronoun that the person prefers.

Tobin said a lack of understanding is at the root of all the levels of discrimination, though she said the situation has markedly improved in recent years.

When asked what people in the transgender community would most like others to understand, Windsor said: “When a person changes the gender they were socialized to be, this change is pursued after a lot of contemplation and often with tremendous fear. It takes a lot of courage for trans people to live life as truthfully as possible.”

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