It is now backed by hard evidence: For transgender people, bathrooms are a source of real, physical harm.

The data comes from the 2015 US Transgender Survey, which surveyed trans people in the US:

59% have avoided bathrooms in the last year because they feared confrontations in public restrooms at work, at school, or in other places. 12% report that they have been harassed, attacked, or sexually assaulted in a bathroom in the last year. 31% have avoided drinking or eating so that they did not need to use the restroom in the last year. 24% report that someone told them they were using the wrong restroom or questioned their presence in the restroom in the last year. 9% report being denied access to the appropriate restroom in the last year. 8% report having a kidney or urinary tract infection, or another kidney-related medical issue, from avoiding restrooms in the last year.

The takeaway is clear: When trans people are scared to use the bathroom, they do things that can literally hurt their health.

Now, these responses were taken before North Carolina passed its sweeping anti-LGBTQ law, which, among other changes, prohibited trans people from using the bathroom for their gender identity in schools and public buildings. Since that law drew huge national attention, there’s a good chance that trans people’s fears of bathrooms were increased as a result of the law and the nationwide controversy it sparked.

The survey was conducted over four weeks in August and September 2015, reaching nearly 28,000 adult respondents. The full survey will be released later this year.

For more about anti-transgender bathroom hysteria, read Vox’s full explainer.

Watch: Why everyone should stop freaking out about transgender people in bathrooms