Transgender Scoreboard

Back in 2014, I made some estimates of transgender population numbers based on observed population frequencies. Looking back at them and thinking about they are recently changing, I believe that they can help us understand some of the medical and social issues for transgender people, particularly non-transitioning transgender people. These issues include whether the large number of non-transitioning transgender people have particular needs that are not being met. They also touch on controversial issues such as rapid onset gender dysphoria (ROGD) and the “desister/persister” claims that being transgender does not continue into adulthood. Finally, they raise issues about the effects of demographic changes in transgender people.

More groups provide trans education.

Back then, I estimated that the total number of trans women in the U.S. was 1,540,000 and trans men was 64,000 or approximately 1,600,000 transgender people. The number of trans women given was a lower bound of 1% of the population, researchers did not rule out that the actual percentage was 2% and some surveys have supported this higher estimate.

Since then, the number of trans men has been increasing towards parity with trans women particularly in younger trans populations. One recent study revealed that the frequency in younger populations (middle school) was 1.2% for both trans women and trans men. This means that the total number of transgender people is on the rise with a large contribution from emerging trans men. There are probably several reasons for the rise of the number of trans men. One is that we now have treatments for teenage transkids. These treatments have the potential to reduce the irreversible body changes done by sex hormones during puberty. Improvements in transgender genital plastic surgery and the realization of penile transplants are probably minor but positive considerations.

Renaissance was founded in 1987.

Back in 2014, I estimated from research evidence that 10% of trans women and 5% of trans men had started transition. At the time, the estimate for transitioning trans women (130,000) was in line with historical estimates. Transition had been offered for about 50 years by that point. Given that hormone therapy can now be given with only informed consent from almost any doctor, we are witnessing an increase in the numbers of people beginning transition. Truth be told, transgender people were managing to get hormones without prescriptions. Where there are backlogs or barriers for medical/mental health assessments as I in the UK, estimates are that 20-40% of trans people start do-it-yourself hormone treatments. There are places in the world where sex hormones do not require a prescription. Moving to hormones with informed consent is actually safer because some medical supervision and hormone-level testing occurs.

The first issue and the most glaring one is the exposure of large numbers of non-transitioning transgender people in the population and the realization that they are a population with special needs. We are talking approximately 2 million people here, who may crossdress in private or occasionally go out to support groups or trans-friendly bars and restaurants. Many suffer the effects of secrecy, including higher mental workload to keep their secret and negative health effects. For them, being transgender may interfere with social relations. When they go to get medical treatment, many have to lie to their providers which may interfere with their care. They are stressed by the constant risks of losing families, friends and jobs. Sharing their secrets is as toxic to their friends as keeping themselves.

I know all too well about their situation because I was one. For about 45 years. I isolated myself from friends and members of my family.

Recently, we have started an effort to study these non-transitioners and validate their needs for medical and mental health providers. Hopefully, some of my non-transitioner friends and provider organizations will be rolling out surveys targeting this population to first obtain demographics and then to identify issues of concern. I will do all I can to help them. You can expect that I will let you know about these on TgForum to encourage survey participation.

A second issue has to do with the endless speculation about why these increases in total transgender population occur and especially those with regard to increases in teenage trans men. Were transgender people there all along in large numbers? Is there something in the water that causes these increases? Is it caused by social contagion on the Internet?

Let me assure you that the increases are not due to biology. There are populations of organisms that alter the ratio of males to females because of gestation temperature or chemicals but there are no subhuman organisms that change gender. Gender is a wholly human affair since it is social constructed by humans. It does change over time but by human decisions not by biological mechanisms like genetic evolution.

Well, is it due to social contagion from friends and the Internet as some non-accepting parents and the supporters of rapid onset gender dysphoria or ROGD? These folks try to associate the increase in teenage trans men with anorexia, witchcraft, fads and the like. The fact that parents are rejecting is probably a factor in kids getting information from other sources. In the ROGD case, many the kids had already been through the rejection wringer with formal diagnosis of lesbian homosexuality with their parents. The ROGDers try to foment panic about their young girls being taken away by nefarious providers when, in fact, providers are oriented to safeguard their children. In fact, the affirmative treatment that the ROGDers attack is designed to be conservative, precisely in order to avoid precipitous conclusions about transition. At each step, decisions are made by parents with consultation with providers, and the steps are ordered with the most reversible first. The rejecting parents just do not like what they are hearing. What they are witnessing is the numbers of trans men catching up in numbers to trans women.

No, I believe that these increases are due improved tolerance and acceptance by the population, even if the government lags behind. In large part, this has been due to transgender people pulling themselves up by their own bootstraps. While providers and allies may have helped, transgender people have done the hard work since the 1970s in terms of organizing peer support groups, and courageously coming out and becoming more visible. They were quietly rooted on by the large number of non-transitioning transgender people who were unable to participate. Which brings me to my next issue.

A third issue is why are we not seeing more transgender people coming out after the age of 30. It has been argued that as transkids mature and experience social pressure, they stop their transgender behavior. The pathological and somewhat scornful term they use is that transgender people “desist”.

Well is it not obvious that given the large number of non-transitioning transgender people in the closet, that many transgender people are forced into secrecy during teenage and early adult years? I know I was. By early adult years, these people have jobs, educations, friends and families that they do not want to lose. Many try to “cure” themselves with marriage or military flight but now have families to support and obligations to duty of job or service. Providers do not seem to want to understand that the transitioning people they see are just the tip of the iceberg. For them, non-transitioners are out-of-sight, out-of-mind. This is similar to the early estimates of transgender people by mental health professionals that obtained until 2000-2003 when Lynn Conway did her ground-breaking work to estimate populations frequencies by going out and actually collecting data. The previous estimates were based on who came through the doors of gender clinics, not the real population. Of course, those who are in the closet were not and are not able to contest these lower estimates.

A fourth issue is whether we will see an increase or decrease of transgender people and their categories due to changes in population demographics. The older transgender people seem to be more in the non-transitioner category but the younger ones are very open and may be more likely to transition. Younger cisgender populations seem more accepting of transgender people as they experience them personally.

I want to believe that larger numbers of transgender people will appear because of increased tolerance and acceptance by the general population. More and more will not just survive but flourish. We have 50 years of momentum now which will be hard to stop.

Tags: featured, science, Transgender

Category: Transgender Body & Soul