Commentary by Victoria, January 01, 2008
A question that is sometimes arises at transgender support groups and elsewhere is "How many people are transgendered?" That is, "What is the prevalence (fraction) of transgendered people among the general population?"
While the answer to this is not really that important to *us*, it is important in the context of framing and describing our "relevance" to the general public.
To me, it has always seemed logical to take the number commonly quoted as the fraction of the general population who are "gay" (~10%), and divide by 10, giving a rough estimate of 1/100 persons being transgendered.
The 10% fraction of the population as an estimate of the prevalence of "homosexuality" may itself be an underestimate, when all variations of sexual-identity - bisexual, bi-curious, questioning, etc. - are counted. (An aside, regarding sexual identity: Refer here for an essay that I wrote yesterday regarding sexual/biological identity, sexual orientation/preference, and gender identity.)
This estimate, 1/100 being transgendered, also seems reasonable if we consider all gender-variant variations present among the general population - intersexed, cross-dressers, transgenderists, transsexuals, etc. Even if the actual number is lower by an order of magnitude, the prevalence of transgendered persons among the general population would still be significant, 1 in 1,000 people!
I just did a quick search to back up this "guesstimate," and it seems to be relatively accurate. As you can imagine, it is difficult to collect these statistics, for a number of reasons. Nevertheless, older data / sources had suggested the following:
"II. Epidemiological Considerations. Prevalence.
When the gender identity disorders first came to professional attention, clinical perspectives were largely focused on how to identify candidates for sex reassignment surgery. As the field matured, professionals recognized that some persons with bona fide gender identity disorders neither desired nor were candidates for sex reassignment surgery. The earliest estimates of prevalence for transsexualism in adults were 1 in 37,000 males and 1 in 107,000 females. The most recent prevalence information from the Netherlands for the transsexual end of the gender identity disorder spectrum is 1 in 11,900 males and 1 in 30,400 females. Four observations, not yet firmly supported by systematic study, increase the likelihood of an even higher prevalence: 1) unrecognized gender problems are occasionally diagnosed when patients are seen with anxiety, depression, bipolar disorder, conduct disorder, substance abuse, dissociative identity disorders, borderline personality disorder, other sexual disorders and intersexed conditions; 2) some nonpatient male transvestites, female impersonators, transgender people, and male and female homosexuals may have a form of gender identity disorder; 3) the intensity of some persons' gender identity disorders fluctuates below and above a clinical threshold; 4) gender variance among female-bodied individuals tends to be relatively invisible to the culture, particularly to mental health professionals and scientists."
How many people are transgendered?
(http://www.rainbowresourcecentre.org/documents/Transgendered.doc)
"Twenty-thousand people have now had gender reassignment surgery in North America. It is estimated that two per cent of the population may be transgendered. With this growing recognition of transgendered issues, there is reason for hope. More and more states in the U.S. are passing equity laws that protect transgendered individuals against discrimination.
According to some estimates, 0.25 to 1 percent of the U.S. population is transsexual. But the actual percentage of transsexual people, and especially those who identify under the broader transgender identity, is thought to be much higher."
How prevalent are transgender people?
(http://www.apa.org/topics/transgender.html)
"It is difficult to accurately estimate the prevalence of transgender people in Western countries. As many as 2-3% of biological males engage in cross-dressing, at least occasionally. Current estimates of the prevalence of transsexualism are about 1 in 10,000 for biological males and 1 in 30,000 for biological females. The number of people in other transgender categories is unknown."
Transsexualism - Prevalence (Wikipedia):
(http://en.wikipedia.org/wiki/Transsexual)
"There are no reliable statistics on the prevalence of transsexualism. The DSM-IV (1994) quotes prevalence of roughly 1 in 30,000 assigned males and 1 in 100,000 assigned females seek sex reassignment surgery in the USA. The most reliable population based estimate of the incidence occurrence is from the Amsterdam Gender Dysphoria Clinic.[15] The data, spanning more than four decades in which the clinic has treated roughly 95% of Dutch transsexuals, gives figures of 1:10,000 assigned males and 1:30,000 assigned females.
In September 2007 however, Olyslager and Conway presented a paper[16] at the WPATH 20th International Symposium demonstrating that the data from this and similar studies actually implies much higher prevalence rates, with minimum lower bounds of 1:4,500 assigned males and 1:8,000 assigned females across a number of countries worldwide. They also present other evidence suggesting the actual prevalence might be as high as 1:500 births overall.
Other data presented in the paper implies that the U.S. population of assigned males having already undergone reassignment surgery by the top three U.S. SRS surgeons alone is enough to account for the entire transsexual population implied by the 1:10,000 prevalence number. This of course ignores all other U.S. SRS surgeons, the popularity among U.S. transsexuals of obtaining their surgery in other countries such as Thailand where the cost may be less prohibitive, and the high proportion of transsexuals who have not yet had reassignment surgery or have not yet even sought help for their condition, making that figure (1:10,000) clearly untenable."
References cited:
[15] van Kesteren, P.J., Asscheman, H., Megens, J.A. and Gooren, L.J. (1997) "Mortality and morbidity in transsexual subjects treated with cross-sex hormones." Clinical Endocrinology 47(3): 337-342.
[16] Olyslager, Femke; Lynn Conway (2007). "On the Calculation of the Prevalence of Transsexualism." (http://ai.eecs.umich.edu/people/conway/TS/Prevalence/Reports/Prevalence of Transsexualism.pdf; also saved here)
The Wikipedia article mentions the latest, most credible estimate / answer, that of Olyslager and Conway:
On the Calculation of the Prevalence of Transsexualism
By Femke Olyslager and Lynn Conway, September 6, 2007
(http://ai.eecs.umich.edu/people/conway/TS/Prevalence/Reports/Prevalence of Transsexualism.pdf; also saved here)
Paper presented at the WPATH 20th International Symposium, Submitted for publication in the International Journal of Transgenderism
Abstract: The most-cited estimates of the prevalence of transsexualism are based on counts of gender reassignments in European clinics many years ago. Observing that reassignments have been in a start-up transient , we extend those results by recalculating prevalence from the accumulating incidence data, taking into account birth, reassignment and death rates and then, based on age-distributions of reassignment data, we determine the inherent number of persons who at some point in life will undergo reassignment.
From this reanalysis of those early reports, we determine lower-bounds on the prevalence of the underlying condition of transsexualism to be between 1:1000 and 1:2000, using those reports own data.
We then present more recent incidence data and alternative methods for estimating the prevalence of transsexualism, all of which indicate that the lower bound on the prevalence of transsexualism is at least 1:500, and possibly higher.
See also:
Thank goodness Lynn Conway could not believe these low numbers. Lynn is a noted computer scientist and distinguished professor emerita of engineering who transitioned from male to female in the 1960s and then lived "stealth," or closeted about her transgender status, before coming out in 2000 (more about "stealth," and Lynn, in upcoming columns). Shortly after her coming-out, Lynn turned her highly analytical brain toward understanding the statistics.
Her skepticism was based on simple reasoning. If the psychiatrists were right, there would be only three or four thousand MTFs in the United States who had ever sought surgery. Under the optimistic assumption that only 20% or so would have been able to afford or attain surgery, there would be fewer than 800 postoperative women in the country today. Impossible, she cried, given that the top sex-reassignment surgery surgeons in the United States alone perform that many MTF SRS operations every single year.
Lynn then extended her logic to come up with much more realistic and believable numbers for transsexuals and then the entire transgender population, revealing large errors in the psychiatrists' old claims. All of Lynn's reasoning and estimates are detailed on her tremendously valuable Web site, www.lynnconway.com.
Why don't we have better "official numbers?" Lynn postulates that (1) psychiatrists don't question the numbers because they don't see the significant number of transsexuals who manage to transition without their "help," and (2) because more accurate numbers showing a much larger prevalence would be bad for the psychiatry business - and its bias toward marginalizing transsexualism as an extremely rare "mental illness."
So what about statistics for female-to-male trans people? The old official stats imply that there are less than a third as many FTMs as MTFs. I used to believe that. After all, when I first started attending transgender conferences, the attendees were overwhelmingly individuals presenting as females. And then one day, wanting to know more about the seemingly elusive FTMs, I read Jamison Green's fabulous book, Becoming a Visible Man. ... [continued] ..."
So, how does this affect you, us, and society?
Although our (transgendered) numbers are small, they are not insignificant - perhaps 0.1% - 1% of the general population - and they are magnified several-fold when family members, friends, colleagues and allies are included. Assuming a multiplicative factor of 10, this means that perhaps 1% - 10% or so of the general population is affected by transgender-related issues. (Once again, if this number is off - over-estimated - by a factor of 10, I'd be surprised.)
Among our allies, I consider the *millions* of wonderful people represented by the more than 360 GLBT organizations represented by organizations such as UnitedENDA.org, plus countless others represented by local, regional and non-advocacy GLBT support groups. Thus, it's not at all difficult to imagine that perhaps 25% of the general population is affected in one form or another - however minor, and whether or not they are fully aware - by the transgendered population.
I propose that this provdes a "useful benchmark" for framing our "relevance" to society. As we work to advance our demands for respect, freedoms and protections, the end results will benefit *all* of society, not just the transgendered!
Sincerely,
Victoria
January 01, 2008