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Capping off a year of high-profile battles over transgender rights, a landmark study out today reveals widespread patterns of harassment and assault faced by many of the estimated 1.4 million American adults who don’t identify with their birth sex.

The 2015 US Transgender Survey is the largest-ever examination of the daily lives of trans people in the United States. Researchers from the National Center for Transgender Equality asked more than 27,000 participants from all 50 states last year what it was like to navigate family life, schools, job interviews, doctor’s offices, and yes, bathrooms. That’s up from about 6,500 participants in the organization’s last survey in 2011.

Based on the survey’s findings, here’s a taste of what it’s like to be trans in America:

What it’s like to come out to parents and siblings

Of those who opened up to their family about their gender identity, 1 in 12 were kicked out of the house, and 1 in 10 ran away from home.

Those with supportive families were less likely to experience homelessness or attempt suicide.

Attend school

Twenty-four percent said they were physically attacked while they were in elementary or high school, and 13 percent were sexually assaulted because of their gender identity.

Seventeen percent dropped out because of mistreatment.

What it’s like to hold a job

Nearly 1 in 3 people said they were fired, denied a promotion, or mistreated at work over the past year because of their gender identity.

About the same proportion, 29 percent, were living in poverty—that’s twice the rate for the general US population.

Find housing

About 1 in 3 had experienced homelessness at some point in their life. Roughly 1 in 8 were homeless within the past year.

Of those who went to a shelter, 7 in 10 said they were mistreated—some got harassed, faced sexual assault, or were kicked out for being trans.

Seek health care

One-third of respondents who saw a health care provider over the past year had a negative experience—from being refused treatment to facing physical assault during their doctor’s visit.

More than half of those who sought insurance coverage for transition-related surgery over the past year were denied, while a quarter of those seeking coverage for hormone therapy were denied. Both treatments are considered life-saving for many trans people.

Or show an ID to get into an event

More than two-thirds of people said none of their IDs listed their preferred name or gender (in some places it’s hard to change identification documents). Nearly a third of those respondents who showed one of these old IDs were verbally harassed, denied benefits or a service, asked to leave, or assaulted.

What it’s like to be stopped by a cop or Call 911

More than half said they were mistreated by police, including verbally harassed, referred to as the wrong gender, assaulted, or forced to have sex with an officer to avoid arrest. Many respondents said police assumed they were sex workers.

More than half said they’d be uncomfortable asking the cops for assistance if they needed to.

Of those who were held in jail, prison, or juvie, about a quarter had been physically assaulted by staff or other inmates over the past year. Trans people were over nine times more likely to be sexually assaulted by other inmates than the general US prison and jail population.

Or need to pee when you’re out running errands

About 1 in 10 were denied access to a bathroom in the year prior to the survey—and that was before North Carolina passed its anti-transgender bathroom law. More than half of respondents had avoided bathrooms because they were worried about possible harassment or violence.

About 1 in 3 tried not to eat or drink very much so they wouldn’t need to use the bathroom. Eight percent reported having a urinary tract infection, a kidney infection, or another kidney-related problem over the past year from holding it.

Why it can be daunting to get through a normal day

Nearly half have been sexually assaulted during their lifetime. About 1 in 10 had been physically attacked over the past year.

More than half had gone through an abusive romantic relationship.

Forty percent had attempted suicide at some point—about nine times the rate in the general US population.

Especially for trans people of color

Nineteen percent of black trans women are living with HIV, compared with 1.4 percent of trans people overall and 0.3 percent of the US population.

Trans people of color face higher rates of violence—check out some of Mother Jones‘ previous coverage.

Trans people of color are much more likely than white trans people to be jobless; the unemployment rate for Middle Eastern trans people is as high as 35 percent. (For reference, the US unemployment rate is 5 percent.)

There were a few bright spots in the survey, including growing acceptance of trans people among family members, colleagues, and classmates. And many trans people are ready to fight for change at the polls. Of those who are eligible to vote, 54 percent cast a ballot in the 2014 midterm election, compared with 42 percent of the US population.

But they’ll likely face an uphill battle with the Trump administration. Some of the president-elect’s cabinet picks have campaigned in the past against LGBT rights, including Ben Carson, the nominee for secretary of housing and urban development. In July, Carson said a transgender person was similar to someone who wakes up one day after watching a movie about Afghanistan and suddenly decides she’s Afghan; the retired neurosurgeon added that he was “disturbed” that “secular progressives” were trying to make trans issues a “civil rights issue.” Trump’s pick for health secretary, Tom Price, described the Obama administration’s guidelines to protect trans people in schools and health care settings as an “absurd” overreach of federal power.

It’s not quite clear where the president-elect himself stands on all this. In May, he vowed to do away with the Obama administration guidelines—before adding that the government had a responsibility to “protect all people” and that he looked forward to learning more about the push for trans rights. In October, he said it was “ridiculous” for the Pentagon to allow trans men and women to serve openly in the military. “Despite policy improvements over the last several years,” the National Council for Transgender Equality wrote in its report about the survey, “it is clear that there is still much work ahead to ensure that transgender people can live without fear of discrimination and violence.”