On the Science of Changing Sex

How Many Trans Folk Are There, Really?

Posted in Transsexual Field Studies by Kay Brown on July 19, 2019

female_scientistIf we are to meaningfully discuss the impact of trans people in society and public policy recommendations we need to know how many transfolk there are.  For this we need to define who we mean and who we don’t.  This is a topic I’ve explored before, but it is worth going into greater detail.  I’ve remarked before that we need to have very clear definitions and about the problems that occur when we don’t.

The media and the press often talk as though “transgender” = “transsexual”.  That is to say, that there is an assumption that those who identify as transgender are all socially transitioning from one social sex to the other, prescribed cross-sex hormones, and either have or would strongly consider, if affordable, surgical interventions.  Nothing could be further from the truth, as the vast, in fact, a super-majority, of such self  identified transgender people have not, nor do they wish to, permanently socially transition, nor are they gender dysphoric.

We also need to know how many people fall into each category, as it directly effects policy and politics, from school bathroom use to potential medical transition services demand in the military.

In a 2016 paper exploring this very issue, spelling it out in the title, “Prevalence of Transgender Depends on the “Case” Definition”, paraphrasing their results,

“27 studies provided necessary data for a meta-analysis to evaluate the epidemiology of transgender and examine how various definitions of transgender affect prevalence estimates and to compare findings across studies that used different methodologies, in different countries, and over different periods.  Overall estimates per 100,000 population were 9.2 for surgical or hormonal gender affirmation therapy and 6.8 for transgender-related diagnoses. Of studies assessing self-reported transgender identity, the estimate was 871; however, this result was influenced by a single outlier study. After removal of that study, the estimate changed to 355.”

transmapThese numbers tally very well with those from another study using US Census and Social Security data in which name and sex were changed in various US states.  In that study no state had more than ~10 per hundred thousand.  Note that this study was not included in the meta-analysis conduced by Collins, et al.

These numbers also tally with the several order of magnitude larger estimates of those who self identify as “transgender”.

One of the most enlightening results of the Collins study was that though there was a slight increase in the number of gender dysphoric cases in a given clinic over time, there was no increase in prevalence over all.  That is to say, there is no “epidemic” of gender dysphoria.

Given that we can’t demand that people who self identify as transgender stop doing so, I recommend that we as a community and in science studies differentiate gender dysphoric individuals by resurrecting and reclaiming the old fashioned, but very useful term, “transsexual”.  Only those who permanently social transition with some medical interventions should be so designated.  Those who wish to conduct sociological studies of non-gender-dysphoric people who self identify as “transgender” should so specify in their publications.  Given the large disparities in the numbers, without an operational definition of “transgender” or “transsexual”, a given study is almost assured to be about non-gender-dysphoric people.

Further Reading:

The New Math:  Using US Census and Social Security data to estimate the number of transsexuals in the United States.

Getting Lost In The Crowd:  The problem of conflating self identity as “transgender” with prevalence of gender dysphoria.

Reference:

Lindsay Collin, Sari L. Reisner Vin Tangpricha, and Michael Goodman, “Prevalence of Transgender Depends on the “Case” Definition: A Systematic Review” (2016) Journal of Sexual Medicine
http://doi.org/10.1016/j.jsxm.2016.02.001

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