LAS VEGAS – Mahina had to sleep under a bridge a couple of nights because she had no other place to go. Both times, she awoke to the sight of men standing over her, looking at her menacingly. On another night, she slept "under the stars" on Las Vegas Boulevard, also known as The Strip, and was awakened by a man asking her to perform sexual favors for $15. Finding a place to use the bathroom is tough. Finding an affordable place to live is harder, especially when one is unemployed. And Mahina, as a transgender woman, recalls that common moment, when she's sitting in a waiting room and someone holding her resume calls out her male birth name. She approaches, and the interviewer says, "Is this you?" with an expression of confusion or distaste. And, after that, the interview almost never goes as hoped, she says.

"We're fetishized. We're not viewed as real people. We have people making laws about using the bathroom – something as simple as using the bathroom" is a daily challenge for transgender people, Mahina (who asked that her full name not be used) says from her temporary home at a Salvation Army-run homeless shelter in Las Vegas. "Every day we walk out the door, we never know what's going to happen."

It's all part of a painful social cycle for many transgender Americans, who suffer disproportionately from homelessness, unemployment, depression, violence, suicide and a host of other problems that build on each other. Family rejection leads to increased homelessness. Fear of being openly transgender makes it difficult to find a job and discourages transgender victims of crime from going to the police. Unemployment leads to more homelessness and with it, danger of sexual assault on the streets. Frequent harassment, public ridicule and ongoing isolation from family fuels anxiety and suicidal tendencies.

Mahina has found support and a community at the Salvation Army shelter, the only homeless shelter in the city that has a special "Safety Dorm" for transgender people. Here, she says, she feels accepted and secure. But out in the world, even one where lesbians, gays and bisexuals have made dramatic gains in changing both laws and public opinion, being transgender is an isolating, and isolated, challenge every day. The "T" at the end of the "LGBT" acronym, transgender people and their advocates say, is being left behind, its members given fewer protections under the law and regarded with puzzlement or scorn from much of the public at large.

While same-sex couples enjoy much greater acceptance and legal protection than before, transgender people are left "on the island of second-class citizenry," Mahina laments.

The statistics on the troubles transgender people face are alarming. According to a 2015 survey conducted by the National Center for Transgender Equality, 29 percent of transgender people surveyed live in poverty, and 30 percent had been homeless at some point in their lives. Their unemployment rate was 15 percent – three times the national average.

Harassment is rampant, the study found, with 46 percent verbally harassed in the year before the survey and 47 percent sexually assaulted at some point in their lifetimes. Despite a dramatic increase in acceptance and accommodation by corporate employers, 30 percent who were employed reported having been fired, denied a promotion or otherwise mistreated in the workplace. One in ten reported being the victim of violence from a family member because of their transgender status, and 8 percent said they were kicked out of the house because of it. Seventeen percent said they left school because of harassment and physical and sexual assault there.

In the month before the survey was taken, 39 percent reported severe psychological stress. Four in ten transgender people have attempted suicide. A third of those who sought medical care said they had either been harassed or denied treatment because of their trans status. Activists count at least 22 people murdered in 2016 because they were transgender and the HRC counts at least 21 so far this year. And activists believe the crimes are vastly under-reported, since local law enforcement might not classify a killing of a transgender person as a hate crime.

All of that exacerbates the very root of transgender people's daily challenge – the struggle to be understood and accepted just for who they are.

"I think one of the reasons why the 'T' takes more time" to reach equality and acceptance "is because in general, transgender people face higher rates of discrimination and violence," says Sarah McBride, national press secretary for the Human Right Campaign, the nation's leading LGBT rights organization. "The prejudice is pretty widespread, and the impact of that is that it makes it much harder for people to come out and to speak out," adds McBride, who was the first openly transgender person to speak at a major party national political convention when she addressed Democrats last year.

While lesbians, gays and bisexuals surely face their share of discrimination, trans people have added complications in their lives. Someone transitioning at work, for example, isn't going to be able to hide it, even if he or she wanted to, whereas an individual could keep one's sexuality private. Getting health care can be more stressful, especially if a person's health records show a different gender than the one with which they identify. They deal with perverse fascination about their genitalia, with people wanting to know if they've had body parts removed or restructured (transgender people may or may not have surgery, and say they do not see the presence or absence of male or female genitalia as dictating their gender identity).

And gender is so deeply ingrained in culture, starting with identifying a fetus as a boy or a girl when a woman is pregnant. Infants might be clad in pink or blue baby clothes according to gender, and toys are often labeled as being reserved for boys or girls. In adolescence and adulthood, the demarcations and divisions continue to locker rooms and bathrooms. While melting-pot America is able to see ethnicity or race as fluid or mixed, gender is not viewed the same way, advocates say. Transgender people may indeed see themselves as born in the wrong body. But others simply don't identify strictly as male or female at all, and that's a challenging concept for cisgendered (non-trans) people to digest, activists say.

All of that makes transgender people more fearful to come out as such, says Harper Jean Tobin, director of policy at the National Center for Transgender Equality. "Large majorities of Americans will say they know someone LGB. Most Americans will say they don't personally know someone who is transgender. That makes a big difference," says Tobin. Fueling discrimination and violence is "a belief that there is something morally wrong with being transgender or admitting you are transgender or being open to the fact you are transgender."

Conservative and some religious-oriented groups have rejected the very notion of being transgender, saying that God and nature define sex in the womb, and nothing can undo it. The "Family Research Council (FRC) affirms what has been accepted as both normative and indisputable: the truth about sexual differences is objectively knowable and that redefining it will be harmful," the group says in a paper on the topic.

But the fight for acceptance goes far beyond predictable culture wars involving sex and sexuality, activists say, with transgender people lagging behind in gaining acceptance and understanding. While 63 percent of Americans in a Pew Research Center poll last year said gays and lesbians should be accepted by society, just 46 percent in an August Quinnipiac University poll said greater acceptance of transgender people would be "a good thing for society."

"People think we're freaks, we're oughta-bes" says Blue Montana, a transgender man who is the transgender program manager at The Center, a support center for LGBT people in Las Vegas. Montana's own father, he says, still refers to him as his daughter, unable to accept that the former U.S. Marine is transgender.

Blue Montana, the transgender program manager at The Center, a support center for LGBT people in Las Vegas (Mikayla Whitmore for USN&WR)

At a recent support group meeting, transgender and transitioning people discussed their struggles, both profound and practical. A number had no permanent home. (Montana says 9 out of 10 of the transgender people he counsels and assists are homeless). Others discussed being rejected by their families and cut out of their lives. There are the day-to-day issues, such as finding appropriate clothes (The Center has a clothing bank for just that purpose) and a "breast binder" to flatten the chest. They talk about the complications and cost of legally changing one's name or sex on a birth certificate (easier now in Nevada, which recently passed laws making it less onerous to change one's sex identification on a birth certificate, and removing the requirement that name changes be published in the newspaper). They joke about finding a beautician who can perform the least-painful facial waxing for transgender women. They complained that politicians and much of the public reduce their struggles to whether or not they can use the public bathroom of their choice – but then also complain about the difficulty of finding a public restroom where they won't be castigated for going into the "wrong" door. (One of the groups' favorite features of The Center is that its bathroom is for everyone, complete with stalls with doors and changing tables for infants.)

And even those at peace with their transgender state find they still experience a kind of social isolation. A transgender woman at the support group, married to a man and working at a university, says people at work wrongly assume she must be constantly conflicted and supremely unhappy, even though she is content and secure in her life.

And while all attendees find support at the meeting, each has his or her own experience. For a trans person, "coming out" does not mean any change in the body or even one's wardrobe has yet happened. It's merely a disclosure that the person does not feel that he or she is the gender assigned to them because of their reproductive organs. "Transitioning" is a process, and it differs by individual. Some of the group "presented" as a different gender than their birth sex, meaning they dress differently, adopt a different name and pronoun, and perhaps bind breasts or wax facial hair. Many take hormones to accelerate the process. Some have had surgery to remove breasts or to reconstruct genitalia.

But all shared the same conclusion as Montana, who says he began to feel like himself as soon as he started taking hormones. "For a lot of us, transitioning saved our lives. If I didn't transition, I'd be dead," Montana says.

No one is sure how many transgender people live in America, since the U.S. Census Bureau does not ask the question. The Williams Institute estimates that 0.6 percent of the U.S. population (1.4 million people) are transgender. A 2015 study of a Social Security document by a Census Bureau economist found that since the Social Security Administration's inception in 1936, 135,367 individuals changed their name or sex-coding in ways that are consistent with a gender transition. Of that group, 89,667 were alive during the 2010 Census, the report said.

"Trans folks are in the crosshairs," says transgender activist Riki Wilchins, author of "TRANS/gressive: How Transgender Activists Took on Gay Rights, Feminism, the Media & Congress...and Won!" "I think it takes longer for trans people [to gain acceptance] because there are fewer of us. There's no transgender section of town where you can see all your friends."

Increased public attention to trans people has been a mixed bag, advocates say. In popular culture, transgender people say, shows like "Transparent" have done a lot to demystify and humanize the transgender condition. But Caitlyn Jenner, who was very public about her transition, has become something of a caricature, some transgender people complain – not to mention inexorably linked to the Kardashian media machine that has drawn its own form of derision.

"We have seen a dramatic increase in transgender representation in popular culture, entertainment, politics and business. That representation is a powerful tool in opening hearts and changing minds," McBride says. "Any time a person comes out publicly, that creates a point of conversation for people across the country – people who may not realize they've ever met a trans person, and for whom that story might be the first story they've heard. That is vital in bridging the empathy divide we have," she adds.

But it has also led to showdowns in state legislatures, city councils and school boards over how to deal with the bathroom issue. According to the Human Rights Campaign, just 19 states and the District of Columbia ban discrimination in public accommodations against people based on their gender identity or sexual orientation (two more ban such discrimination based only on sexual orientation, which does not protect transgender individuals). In the 2017 state legislative session, 16 states have considered legislation to restrict locker room or restroom access to that associated with one's birth sex, according to the National Conference of State Legislatures. Six states considered legislation to prohibit localities from passing their own anti-discrimination laws, and 14 have considered legislation that would limit transgender students' rights at school, the NCSL reported.

The Trump administration has reversed two Obama-era policies protecting transgender people, one involving schools and the other, the military. The recent ban on transgender people in the military means Riley Dosh, a West Point graduate denied a commission after she came out as transgender in 2016, has little hope for a reversal of the decision to exclude her.

"I've wanted to be in the military since I was in 7th grade," Dosh says, adding that she developed an expertise at West Point in countering ICBMs. "But from the standpoint of the military, despite all the training and money they spent on me, I am not fit to be an officer."

The Trump administration in February reversed Obama-era rules that required schools to allows transgender students to use the bathroom of their choice (schools may make that choice on their own, but are not required to do so).

Elishia Featherston, whose 17-year-old daughter, Mac, is transgender, says the girl has dealt with everything from harassment from fellow students to being told by a school trip chaperone that she was wrong to use the girls' restroom. Mac's school has been "pretty good," Featherston says, but state lawmakers have been trying to restrict public restroom access for transgender people. "We're going backwards in time, at this point," Featherston says.

Still, transgender advocates take solace in major progress they have made in the private-sector. The HRC's 2017 Corporate Equality Index found that 82 percent of Fortune 500 companies have gender identity policies as part of their non-discrimination policies. Half of Fortune 500 firms (and nearly ¾ of all the companies the HRC ranked) offer transgender-inclusive health care coverage – up from zero in 2002 and six times as many businesses as five years ago.

Big corporations have also pressured state governments to abandon so-called "bathroom bills" and other measures seen as hostile to the trans community, activists note, since it's good for business. The companies want to attract good talent and make sure their employees feel safe and accepted in their work locations, Tobin says, and also want to appear to be good corporate citizens.