What Does It Mean to Be Transgender in Hawaii?

What Does It Mean to Be Transgender in Hawaii?

Data suggest that Hawaii’s transgender youth face many obstacles.

In 2018, the Hawaii State Department of Health (DoH) made waves when it released the first-of-its-kind report on the health of local transgender teens. Titled “Hawaii Sexual and Gender Minority Health Report 2018: A Focus on Transgender Youth,” it details both troubling statistics facing this community, as well as transgender voices that offer perspectives of hope.

Among the many items highlighted in the report are the troubling health concerns for all of Hawaii’s transgender community—youth and adult alike—as well as misunderstandings from the public about who this group is and how to help. Lance Ching, PhD, MPH, one of the report’s authors and the Epidemiologist for the Chronic Disease Prevention and Health Promotion Division at the DoH gives further insights into Hawaii’s transgender population and lessons from the report.

Gender and sexuality aren’t the same thing
Many people in Hawaii and around the globe think of gender and sexuality in absolute terms. You can be a boy or girl, heterosexual or homosexual—and there isn’t any latitude for people who don’t neatly conform to those roles. In actuality, sexuality identity and gender identity can be fluid and don’t always fit neatly into preconceived categories. So, what do these terms mean?

  • Gender Identity: Gender is usually thought of as binary, either male or female. These roles are often culturally informed with specific stereotypes or ideals. The binary notion of gender is antiquated, though, and fails to acknowledge those who may feel both male and female, don’t associate with any gender, or have different cultural or personal feelings on gender. According to the DoH report, “gender identity describes an individual’s personal sense of their gender.” One’s gender identity may or may not match their sex assigned at birth. For example, a person can be labeled as “male” at birth based on physical and/or chromosomal presentation but may personally identify as female. That person’s gender identity would then be female. Those whose gender identity does not match their sex assigned at birth are transgender, while people who identify as the same gender as their sex assigned at birth are cisgender.
  • Sexual Identity: This describes who someone is attracted to, which may or may not be sexual attraction. Those who are primarily attracted to the opposite sex are considered heterosexual, while those who are primarily attracted to the same sex are homosexual. People attracted to both sexes are bisexual. Others may not be attracted to any sex or feel the terms “heterosexual,” “homosexual,” and “bisexual” don’t adequately describe their sexual identity.

More than two genders
In several cultures around the world, including Hawaii, there are more than two genders. In pre-contact Hawaii, mahu were respected members of society who inhabited a middle gender. One could either be mahu kane or mahu wahine. Both were accepted and often played a key role in cultural practices. After missionaries and other colonial influences came to the islands in the 19th century, mahu became taboo and the word itself was used as a slur.

Today, the Hawaiian cultural renaissance has brought a resurgence of mahu. Community leaders like Kumu Hina (Hinaleimoana Wong-Kalu), who was a contributor to the DoH report, are trying to normalize the term and practice. Mahu are certainly present in Hawaii. About 8 percent of Native Hawaiians or Pacific Islanders identify with the third gender.

Outside of Hawaii, other Polynesian cultures also recognize the word and concept of mahu including Tahiti and Marquesas. Similarly, Samoa have faafine and Tonga have fakafefine or fakaleiti that inhabit a middle gender.

By the numbers
Given the cultural history and significance of gender fluidity in Hawaii and other Polynesian islands, it’s perhaps not surprising that the Aloha State has the largest percentage of transgender individuals in the nation. According to 2016 estimates by the Williams Institute at the UCLA School of Law, approximately 0.8 percent of Hawaii residents are transgender. Nationally, about 0.6 percent of adults identify as transgender.

In addition, the DoH report on transgender youth showed that just over 3 percent of Hawaii’s public high school students identify as transgender. “It's probably likely an underestimate of the true number of transgender youth in our state,” says Ching of the numbers. Likely there are more transgender youth who didn’t feel comfortable self-reporting, and the DoH did not get responses from Hawaii’s large private or charter school population.

Of the transgender youth who responded, there were stark differences between their population and cisgender teens. Nearly half of Hawaii’s transgender youth suffer housing instability, whereas 94 percent of their cisgender peers live at home. Unstable housing, in particular, feeds into other health issues. As Ching explains, “that carries on to downstream factors, including their overall risk for things such as drugs and other risky behavior. Having an unstable housing situation is likely to lead to higher mental health issues, which can increase their risk for suicidality.”

The report also revealed that transgender youth are more likely to use drugs, alcohol, smoke, or vape than their cisgender peers. They are also more likely to have been bullied in the past year, experience sexual violence or have been physically forced to have sex.

It’s a stark comparison that highlights how many difficulties this community faces in Hawaii. While the report focused on youth, Ching notes that the problems aren’t specific to transgender youth. “You can take the word youth out and just apply it generally to transgender,” he says. Ching continues: “It's not simply being transgender that puts you at risk, it's the factors that a person experiences as a result of being transgender.”

Community support
While the DoH report may seem dismal, Ching actually sees it as a way to highlight the community’s resiliency. “What we try to show through the report is that these are the statistics and the data, but this is not the path that you have to follow, that there is help out there, that there are resources out there and that you're not defined by your gender identity,” he says. 

Ching also sees this type of data collection and reporting as vital to understanding and supporting Hawaii’s transgender population. “When you don't ask the questions around sexual orientation or gender identity, you are in effect making this community invisible.”

There are resources available throughout Hawaii for transgender youth and adults such as the Hawaii LGBT Legacy Foundation. To read the DoH report in full, visit their website.

Medically reviewed in June 2019.