[image-1] A new survey shows many members of Charleston’s LGBTQ community report continued challenges at home, work, with doctors, and in public, even as cultural fluency around gender identity and sexual orientation becomes more common.

The Tri-County Area LGBTQ Community Needs Assessment Report, released on Thursday by the Alliance for Full Acceptance, provides a snapshot of the forces working against LGBTQ residents from within the Charleston community. See the full report below.

Working with College of Charleston’s Community Assistance Program and MUSC’s College of Health Professions, AFFA conducted an online survey of 1,436 respondents last year and followed up with targeted focus groups in January and February 2019. The research is a first-of-its-kind assessment of the “unique experiences, assets, and needs” of the Charleston area’s LGBTQ community.

At home, the survey found that more than half of respondents experienced criticism from their families for their LGBTQ identity. A full 40 percent of transgender people have few or no family members who know their gender identity.

Perhaps some of the study’s most striking results came from questions surrounding work life and health care.

Over half of those surveyed say they felt like they can’t be themselves at work. Nearly 20 percent worry they will be fired for their LGBTQ identity, and 11 percent say they were told specifically not to reveal their sexual identity at work.

“When you think about employee retention and quality of work — if an employee feels that they cannot bring their whole selves to work, how does that affect job performance? How does that impact whether or not someone wants to stay in that job?” asks Chase Glenn, AFFA’s executive director. “Inequality and the lack of acceptance in the workplace is bad for business.”

The findings are especially relevant this week, days after Trump administration prosecutors argued before the United States Supreme Court that the Civil Rights Act does not provide protection against discrimination based on sexual orientation and/or gender identity.

“Our survey shows that a significant portion of our community carries the emotional burden that if they are open and honest about their sexual orientation or gender identity, it could mean getting fired,” says Glenn.

Tri-county LGBTQ respondents also reported a lack of access to quality and fully informed health care. Half of non-cisgender respondents say their doctors do not know their gender identity. (For the survey, “non-cisgender” referred to multiple identity categories: transgender, genderqueer, nonbinary, and nonconforming.) A third of local respondents say they felt like their doctors couldn’t answer their questions.

“I don’t think I’ve ever had a doctor proactively ask me about my sexual orientation or gender identity,” one respondent is quoted in the report. “If they don’t ask for this basic information, how can they know how to treat me?”

On top of all those challenges, over half of all respondents report struggles with sadness or depression, with a quarter having considered suicide. About 14 percent of participants say they’ve been physically or verbally attacked in public, and 30 percent have said they’ve considered moving from the Charleston area because they do not feel welcome.

In an effort to create a more equitable community for LGBTQ residents, the survey also breaks down several recommendations for key decision makers: Business leaders are advised to institute LGBTQ-inclusive benefits policies; politicians should pass inclusive non-discrimination laws and ban conversion therapy; and LGBTQ community leaders themselves should engage communities of color in and elevate the standing of existing groups.

“With our survey results in hand, we now have a baseline understanding of what life is like for our LGBTQ neighbors,” Glenn added in a press release. “From here, we can create meaningful, positive change in our communities.”