It seems like nothing has changed, unfortunately. As the United States seems to be progressing with regard to gay rights, transgendered people are still facing the brunt of discrimination in the LGBT (lesbian, gay, bisexual, transsexual) community. According to a new report, these societal pressures have led 41 percent of the transgender community to attempt suicide.

Researchers analyzed data from the National Transgender Discrimination Survey (NTDS), looking for “links between minority stressors and suicidal behavior among transgender and gender non-conforming individuals,” said Jody L. Herman, of the University of California, Los Angeles Law School Williams Institute, in a statement. “This is a critical first step in efforts to address the negative mental health impacts of anti-transgender discrimination.”

The survey asked more than 6,400 transgender people about any experiences with discrimination and abuse while at work, school, home, or in public — it also looked at the effects these acts had on the person. Astoundingly, 78 percent of respondents who said that they experienced sexual or physical violence at school also said that they’d tried to commit suicide. When it came to those who experienced the same discrimination at work, 65 percent said they had tried to kill themselves.

But physical and sexual abuse is only part of the problem. Transgender people face various problems, all of which contribute to a harder life to live. Their gender-change can cause confusion and disapproval in family, friends, and those around them, causing added stress. The simplest tasks, like going to the restroom, become difficult — should they go in the men’s or women’s? — as they risk discrimination from anyone inside.

Finding a job is also difficult because of a risk of bias on the interviewer’s side, and once they have that job, the risk of losing it because of discrimination is generally high too, at 47 percent. At that, transitioning from one gender to another while already having a job puts it at risk. “If there isn’t a clause like an anti-discrimination rule, people can be let go if they transition,” clinical psychologist Gail Knudson, medical director of the Transgender Health Program at Vancouver Coastal Health, told LiveScience.

Still, many transgender people must go through with their transition in order to be happy, Knudson told LiveScience. Once they’ve dealt with medical expenses — insurance rarely pays for it — and gone through guidelines known as Standards of Care, which first require them to live and present themselves as their preferred gender for many months, they can get the surgery. Even with all the trouble, they become happier and substance abuse lessens. “For their lives to go forward they need to transition,” Knudson told LiveScience. “A lot of the health care providers that work in the field see transitioning as a medical necessity — not as something people chose to do, but as something they need to do to lead productive lives.”

Source: Haas A, Rodgers P, Herman J. Suicide Attempts Among Transgender and Gender Non-Conforming Adults. American Foundation for Suicide Prevention. 2014.