Estimating the Prevalence of Transgenderism

With regard to population estimates of transsexuality, Tsoi (1988) has noted that, "A... problem confounding an epidemiological survey is that transsexuals tend to congregate in cities and in certain parts of cities, and most of them do not want to be identified." Much of our own research work has further substantiated this phenomenon. Nonetheless, Tsoi (1988) has also noted that, in Singapore (where sexual reassignment surgery [SRS] is well established and transsexuals are not "suppressed") diagnosed transsexualism is more than eight times more prevalent than in any other country for which estimates exist. Witten (2002a, 2003) has pointed out that estimates of the number of individuals claiming to have "alternative gender identities" in the United States, as well as in other countries, are confounded by the lack of a control group by which to test prevalence and incidence estimates. Even so, in an international random survey performed by Witten and Eyler (1999b), approximately 8% of the 300 respondents identified their gender self-perceptions as something other than 100% male or 100% female. Taking only the international estimates for postoperative transsexuality as a basis (1-3%) (Godlewski, 1988; Hoenig & Kenna, 1974; Langevin, 1983; Sigusch, 1991; Tsoi, 1988; van Kesteren et al., 1996; Walinder, 1971a,b; Weitze & Osburg, 1996), and using the approximate estimate of 300 million people for the U.S. population, this would imply that there are potentially 3-9 million potential postoperative transsexuals in the United States. While this estimate seems overly surprising, Witten (2002a, 2003) has discussed the rate of gender reassignment surgeries currently performed in the United States and Europe with some of the more prominent surgeons worldwide. A number of these surgeons indicate that they are performing two surgeries per day, 48 weeks per year, 4-5 days per week. Some state that they have waiting lists of upwards of 2 years. In France, the surgical waiting time is now 5 years. If we allow for the broader interpretation of transgender as including non-surgical and cross-dressing individuals, the estimates increase to approximately 20 million people, depending upon definitional criteria. Others claim that the estimates for MTF prevalence are 1 in 1,000 to 1 in 30,000, while FTM prevalence estimates are significantly lower at 1 in 100,000. There are simply no statistically significant data from which one can draw strong conclusions. It is also important to recognize that each of these individuals touches numerous others in his or her life—family, friends, employers, employees, acquaintances, and random individuals on the street. Consequently, support services may well be necessary for many other individuals other than just the actual transgendered persons. This insight identifies the impact of the transgendered population and its needs as being significantly larger than the immediate population of the transgendered alone.

For brevity, in the upcoming discussion, the term transgenders will be used to signify the entire gender community, unless otherwise specified. It should also be pointed out that many indigenous peoples recognize genders other than male and female. For example, Tewa adults identify as women, men, and kwido, although their New Mexico birth records recognize only females and males (Jacobs & Cromwell, 1992). See also Elledge (2002) and his discussion of transgender myths from the Arapaho to the Zuni, as well as the work of Matzner (2001) discussing Hawaii's mahu and transgender communities. Persons with such "non-Western" gender identities will also be considered as belonging to the gender community.

Pregnancy And Childbirth

Pregnancy And Childbirth

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