The Prevalence of Transgenderism
Someone asked me recently “what is the prevalence of transgenderism”, so I thought I’d take a stab at finding out.
An article on questions of prevalence and epidemiology of GID appears in the International Journal of Transgenderism in its special issue: “Toward Version 7 of the World Professional Association for Transgender Health’s Standards of Care” (Volume 11, number 1, 2009). The article was written by (the arguably controversial pair) Kenneth Zucker and Anne Lawrence, and was summarized by Eli Coleman in his introduction to the special issue:
“Formal epidemiological studies on gender identity disorder in children, adolescents, and adults are still lacking and no strong conclusion about its prevalence or incidence can be drawn. The current prevalence estimates that are cited in the DSM-IV and the WPATH SOC(1) are based upon data over 20 years old. They [Zucker and Lawrence] note, however, that between the 1960’s and 1990’s, there appears to be at least a threefold increase (and as high as eightfold increase) in patients presenting to clinics in Western Europe. This could be due to increased awareness and seeking of transgender services. There is also the problem of whom to count. Individuals who undergo surgical sex reassignment are only an extreme end-point of a continuum of cross-gender identification. We are more and more aware of the myriad of individuals who identify as transgender or gender queer and who represent individuals along the broad spectrum of cross-gender identification.”(p. 5)
This is from the Zucker, Lawrence article itself:
“As is the case with children and adolescents, there are also no formal epidemiological studies on GID in adults. The most common indirect method that has been used to gauge the prevalence of GID in adults has been to rely on the number of persons who attend specialty hospital and university-based clinics serving as gateways for surgical and hormonal sex reassignment.” (p. 13)
They then present a table of data from 25 such clinics and try and estimate prevalence. I’m listing 7 lines from their table (of 25) where the period reported falls somewhere between the year 1990 and the present and where prevalence estimates where made:
|Author||Period Reported||Country||Incusion Criteria||N||MtF : FtM||Prevalence|
|Weitze & Osburg (1996)||1981-1990||Germany||Granted legal change of name or gender status||1047||2.3 :1||MtF:1 : 42,000 FtM:1 : 104,000|
|De Cuypere et al. (2007)||1985-2003||Belgium||Completed sex reassignment surgery||412||2.4 :1||MtF:1 : 12,900 FtM:1 : 33,800|
|Bakker, van Kesteren, Gooren, & Bezemer (1993)||1986-1990||Netherlands||Receiving hormone therapy||713||2.5 :1||MtF:1 : 11,900 FtM:1 : 30,400|
|Gomez Gil et al. (2006)||1996-2004||Spain||Diagnosis of Transsexualsism||161||2.6 :1||MtF: 1 : 21,000 FtM: 1: 48,100|
|Wilson, Sharp, & Carr (1999)||circa 1998||Scotland||Gender Dysphoria||273||4 : 1||MtF:1 : 7,400 FtM:1 : 31,200|
|Wilson, Sharp, & Carr (1999)||circa 1998||Scotland||Receiving Hormone therapy or post-surgery||160||3.8 :1||MtF:1 : 12,800 FtM:1 : 52,100|
- There are some estimates based on indirect methods and counting those seeking treatment specifically some form of surgery & we know that this is a small percentage of overall people with gender variance.
- no direct studies on prevalence of GID have been done
- doing an accurate count is complicated by the fact that those counted are those who are “out” as being transgendered and seeking some form of treatment, and also those who have transitioned may not wish to be counted.
Also – this is a subject very much on the minds of researches in the field now (its been a lively topic of conversation on the WPATH email list for several months).(1) – prevalence cited in DSM-IV: “Data from smaller countries in Europe with access to total population statistics and referrals suggest that roughly 1 per 30,000 adult males and 1 per 100,000 adult females seek sex-reassignment surgery.” (p. 535). This data was probably drawn from Hoenig and Kenna (1974) “The prevalence of transsexualism in England and Wales, British Journal of Psychiatry, 124, 181-190. And we know that only a fraction of transgendered individuals actually seek sexual reassignment surgery.