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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 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

To summarize

  • 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 transgender 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.”

an update to this post can be found here
Find out about Psychotherapy when dealing with Gender variance in yourself or someone close to you.

6 Comments Post a comment
  1. Henry Hall #

    The only hard figure I have seen that is even slightly recent and not a matter of psychobabble interpretation is that the Army of Thailand reported in 2006 that about one in 150 Thai citizens with male birth certificates or immigration papers who are of age (late teens) and who would otherwise be required to perform military duty is ineligible due to being Kathoey. In practice this means castrated.

    On one hand a very small proportion of castrated people will not be TG, but likely at least an equal proportion in Thailand will be TG but not castrated. The figures are slightly confounded by the fact that some Kathoeys are excused military service for other reasons so their Kathoey status becomes moot and might not be noted.

    Thus, I think we can reasonably say the prevalence of transgenderism in MTFs is at least 150. And as time passes there is every suggestion that MTF and FTM transsexualism occur in equal numbers, it is just that MTFs are more visible and more diagnosed.

    As to the prevalence of GID, that is probably far rarer, because most transsexual people do not have disordered gender identities, though a very small number do.

    April 1, 2010
  2. There was a survey in New Zealand in the end of 2008 that compared all passportholders to those that had changed their gendermarker on the passport to or from X. ( Their results showed a prevalence of 1:6364, much higher than all those in your table.

    In sweden about 700 people has been “allowed” to change legal gender and undergo SRS, the total releant population (18-65) are ~5M. Which would mean a prevalence of about 1:7140. And the number that ask for this each year are still rising. (Numbers are from offical statistics)

    I also do remeber a UK survey done 2009 that estimated that the lifetime prevalence of TS are ten times higher than the current SRS-prevalence.

    April 6, 2010
  3. Sarah L #

    (June 2009)

    Gender Identity Research and Education Society

    Click to access GenderVarianceUK-report.pdf

    April 7, 2010
  4. I’m a psychologist interested in the incidence of transgender individuals who are identical twins. Specifically, in the case I am working with, the incidence of one twin becoming FtoM trans and the other twin heterosexual. Any statistics on that?

    Claudia Ciano-Boyce

    June 8, 2012
    • This appeared on the WPATH listserve not long ago:

      “One finding in this Finnish twin study is therefore quite interesting (Algars, Santtila, & Sandnabba: Conflicted Gender Identity, Body Dissatisfaction, and Disordered Eating in Adult Men and Women. Sex Roles, 2010;63:118–125). The authors did not focus on the epidemiology of gender identity variants but on body dissatisfaction and eating problems associated with ‘conflicted gender identity’. The interesting part of the paper, in this case, is their description of the subsample formation: “Out of the 9,532 participants in the original data collection, 6.0% (n=571, 349 women and 222 men) reported having felt they were a member of the opposite gender and/or having wished they had the body of the opposite gender.” These were responses to ‘life-time’ questions: ‘have you ever felt…’, and ‘have you ever wished…’ The participants in the original data collection were 18–33-year-old Finnish twins and their over 18-year-old siblings (6,201 women and 3,331 men).

      that’s the only twin study I know of off-hand, but I haven’t done a search on it.

      June 8, 2012
    • What type of therapy did your child urdgneo. My daughter always wanted to be a boy and not knowing much about TG at the time we went down the therapy road. From CBT to psyco analysis to past life regression and more. We were deternined to explore all routes before irrereversible changes were made. We allowed her to dress and express as a boy for over four years she even came out to her friends. At the end of it she now fully accepts her femine self and has no fear or negativity around being female. She also accepts her masculine self and can work with it in balance with her femine self. I get really annoyed when I hear that therapy does not work especially when I hear it from so called support groups. For some it will work and should not be discouraged. Generally trans gender therapists are not the people to go to as they have a very narrow focus, and the criteria set by DSM are not specific enough any Tom boy with low self esteem could fit the criteria.

      June 22, 2012

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