A new survey of more than 7,000 trans people in the US says that 41 per cent have tried to kill themselves.

The research, carried out by the National Center for Transgender Equality and the National Gay and Lesbian Task Force, also found than 19 per cent had been refused medical care because of their trans status.

Twenty-eight per cent said they had experience harassment in hospitals or doctors’ surgeries, while two per cent said they had been violently assaulted in medical settings.

Half of those surveyed said they had to educate their doctors about being transgender and a quarter said they had misused drugs or alcohol because of the stress of coping with being trans.

Forty-one per cent said they had tried to kill themselves, compared to the national average of 1.6 per cent of the population.

Trans people also reported higher levels of HIV infection. The survey found that 2.64 per cent were HIV-positive – four times the national average.

Respondents who were ethnic minorities, unemployed or involved in activities such as prostitution were the most likely to have been abused, refused care or suffer health problems.

Although only a minority of trans respondents said they had had genital surgery, the majority said they hoped to have surgical treatment one day. This, the report’s authors said, was why legal rights for trans people should not be dependent on whether they had undergone surgical transition.

The report said that trans people “bear the brunt of social and economic marginalisation due to their gender identity” and their needs are often dismissed or discounted.

Mara Keisling, executive director of the National Center for Transgender Equality, said: “From our experience working with transgender people, we had prepared ourselves for high rates of suicide attempts, but we didn’t expect anything like this.

“Our study participants reported attempting suicide at a rate more than 25 times the national average.”

Rea Carey, executive director of the National Gay and Lesbian Task Force, said: “These shocking and disheartening numbers speak to the urgency of ending bullying in our nation’s schools and ending discrimination in our nation’s workplaces.

“We know from the recent rash of suicides among young people who have been bullied just how critical it is that we act now and act decisively to save lives.”