Prevalence of Transgender Depends on the “Case” Definition: A Systematic Review

Abstract

Background We conducted a systematic review and meta-analysis to evaluate how various definitions of “transgender” may affect prevalence estimates. Methods PubMed, Embase, and Medline were searched to identify studies reporting prevalence estimates of transgender in a population. All studies were grouped based on the case definition applied to the numerator. Summary estimates were derived using a random-effects model for total prevalence of transgender and for male-to-female (MTF) and female-to-male (FTM) subgroups. Overall and stratum-specific meta-prevalence estimates (mPs) and 95% confidence intervals (CIs) were accompanied by tests for heterogeneity, and meta-regressions to assess sources of heterogeneity. Results A total of 32 studies met the inclusion criteria for the systematic review. Of those, 27 studies provided necessary data for a meta-analysis. Overall mP (95% CI) per 100,000 population was 9.2 (4.9, 13.6) for surgical or hormonal gender affirmation therapy and 6.8 (4.6–9.1) for transgender-related diagnoses. Among studies assessing self-reported transgender identity, the mP was 871 (95% 519, 1224); however this result was influenced by a single outlier study. After removal of that study, the mP changed to 355 (95% CI 144, 566). Significant heterogeneity was observed in most analyses. Conclusions The empirical literature on the prevalence of transgender highlights the importance of adhering to specific case definitions because the results may range by orders of magnitude. Standardized and routine collection of transgender data is recommended.

Health of Transgender Adults in the U.S., 2014–2016

“…6 Third, most extant population-level studies did not have adequate samples to examine the health of transgender subpopulations: transgender women (male-tofemale, MTF); transgender men (female-to-male, FTM); and gender-nonconforming (GNC) people. 7 This gap in the literature is significant, as the lived experiences of these populations can be markedly different, both in exposure to interpersonal and structural cissexism (discrimination and stigma against TGNC people), and the amount and quality of engagement with the healthcare system. 3 For example, the National Transgender Discrimination Survey found that GNC people faced more discrimination in medical care and worse health than other transgender groups.…”

Oestrogen and anti-androgen therapy for transgender women

“…4 Unfortunately, because of limitations of the study design, the researchers were unable to comment on whether these people were all transgender women; however, the veteran population tends to be predominantly men. In a 2016 systematic review of 29 studies, 5 the prevalence of transgender women was roughly 5–20 per 100 000 when diagnostic codes or requests for medical treatment were used, or as high as 521 per 100 000 people if based on self-identification.…”

Does the status quo have to remain? The current legal issues of transsexualism in Poland

“…The prevalence of clinically established transsexualism varies from 0.7/100,000 in Iran to 100/100,000 in Iceland, with a mean value of 9.2/100,000. [3][4][5] However, a meta-analysis of studies about transsexualism epidemiology, which were based on self-reported transgender identity, revealed a much higher transgender occurrence of 355/100,000. 4 Therefore, it may be suspected that gender incongruence is highly underdiagnosed.…”

“…[3][4][5] However, a meta-analysis of studies about transsexualism epidemiology, which were based on self-reported transgender identity, revealed a much higher transgender occurrence of 355/100,000. 4 Therefore, it may be suspected that gender incongruence is highly underdiagnosed. Most of the studies report a higher number of MTF transsexuals than of FTM.…”

“…Most of the studies report a higher number of MTF transsexuals than of FTM. 4 The process of diagnosing transsexuality is long and complicated. The gender identity has to exist for at least 2 years and no chromosomal anomalies should be present.…”