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Among all the gay rights battles, transgender people face the most discrimination and suffer the most adverse economic consequences, according to studies. (AP Photo/Charles Dharapak)

Want to feel the swift hand slap of discrimination and the sting of devastating economic consequences? Go from living your life as a man to coming out as a woman.

Perhaps no other group experiences the level of overt discrimination and direct adverse economic setbacks as do transgender people. And it all begins when they come out.

This is an image from the TransCentralPA website.

"These people are facing a tremendous amount of discrimination and economic pressure," said Jeanine Ruhsam, president of TransCentralPA Transgender Education Association, an LGBT Center of Pennsylvania board member and a transgender person.

"And why is this?" Ruhsam asked rhetorically. "It is just incredible discrimination against these people for their gender nonconformity."

And within the transgender community, no one suffers this kind discrimination and its resulting economic hardships more than transgender women -- biological men who identify, come out and live as women.

"We live in a patriarchal culture," said Rushsam, who is a transgender woman. "So as a group, you are going to find gay men doing better than the lesbian community. And behind them, the trans community is lagging well behind the gay and lesbian community."

And with no laws in Pennsylvania protecting against employment and housing discrimination based on gender identity, expression and orientation, transgender people -- and most especially transgender women -- have been summarily "fired, demoted and discriminated against," Ruhsam said.

And there is very little anyone can do about it.

"Trans women are in trouble," said Ruhsam, who hears the torment at monthly transgender support groups she attends and helps lead.

"I could tell you stories, and it's just amazing," she added. "And they happen weekly. A lot of our people are crashing and burning. It is not about taking hormones and being happy in your new gender. It is being rejected by society, and even your own family and friends."

Yet, not to come out and identify with what they feel as their true gender would be to deny their own sense of self, their very existence as human beings. So transgender people do it, and they suffer the consequences.

"Trans people are in this odd little place," Ruhsam said. "How we see ourselves in the world is at opposite ends from the physical sex we were born with. But we can't take getting split in half."

Ironically, the same-sex marriage issue that is all the rage in gay rights is most remote to the lives of transgender people. Many are married to an opposite sex partner before they come out.

But once they transition to what they believe is their true gender, often everything they have built, including their relationships, begins to crumble. And most of destruction does not come from ramifications from inside their lives and relationships, but rather from the relentless discrimination they, their partners and their families face from outside.

This is an image from the TransCentralPA website.

"Trans people tend more likely to be married once," Ruhsam said. " But once we change legal (gender) status, does my marriage change? Is my marriage now invalid? That will come up. So (the Defense of Marriage Act) does mean something to us. But we're all about just trying to survive. And based on what has happened to this community, you don't think about marriage when you are struggling to survive, period."

This is not hyperbole.

An astounding 41 percent of the transgender community attempts suicide, compared with 1.6 percent of population, according to a study called the National Transgender Discrimination Survey. Nearly 6,500 transgender people participated in the wide-ranging and revealing study.

The researchers also found extreme poverty: Transgender people were four times more likely to have household incomes of $10,000 or less vs. the general population as a whole.

And while just about 20 percent to 25 percent of transgender people undergo some form of gender reassignment surgery, the community requires specialized medical attention as many are on hormone therapy.

But without medical benefits -- and with few doctors adroit at these specialized treatment requirements -- transgender people often go without proper care, said Philip K. Goropoulos, president and CEO of Alder Health Services in Harrisburg, which offers sliding rate health care to many in the gay, lesbian and transgender community.

"We've seen a lot of transgender people who were making a very, very good living before they came out who lost everything," said Goropoulos. "And not because they lost their skills overnight."

Ironically, transgender men -- those biological women who identify and come out to live as men -- sometimes see the reverse. Their employment prospects and financial standing can actually increase as men, Ruhsam said.

"The great loss of income is among trans women," she said. "Most trans men have moved up in the world. They are regarded as men, and there is less discrimination against them. We need to do that study."

Indeed, a lot of things are needed in this community. But most of all, it is state legislation, such as House Bill 300, that would end employment, housing and public accommodations discrimination based on gender identity, expression and orientation, Ruhsam said.

"It's stigma, discrimination and insecurity," she said of the societal and financial hurdles facing her community.

This is an image from the TransCentralPA website.

"Without any protections in place, there is a loss of earnings that most trans persons undergo," Ruhsam explained. "A large percentages of existing marriages fail when the trans partners makes the full change. And a lot of that is the stigma and the discrimination."

In other words, the transgender community remains in crisis. And the root cause is legislated inequality and legal discrimination that begets enormous financial pressures that grind down transgender people and their families.

"These are people who are discriminated against solely because they are gender nonconforming," Ruhsam said. "So we all become caretakers. We are providing support to fragile people who are just barely clinging to life and sanity."

Look for more posts laying out the economic costs of gay inequality, along with personal stories of gays who tell of the price they paid when they came out.

All this week on PennLive.