Epidemiology of Gender Identity Disorder: Recommendations for the Standards of Care of the World Professional Association for Transgender Health

International Journal of Transgenderism 05/2009; 11(1):8-18. DOI: 10.1080/15532730902799946


Formal epidemiological studies on the incidence and prevalence of gender identity disorder (GID) or transsexualism have not been conducted. Accordingly, crude estimates of prevalence have had to rely on indirect methods, such as parental endorsement of behavioral items pertaining to GID on omnibus questionnaires for children and youth or the number of adult patients seeking contra-sex hormonal treatment or sex-transformative surgery at hospital- or university-based gender clinics. Data from child and adolescent parent-report questionnaires show that the frequent wish to be of the other sex is quite low but that periodic cross-gender behavior is more common. In the general population, cross-gender behavior is more common in girls than it is in boys but boys are referred to gender identity clinics more frequently than are girls. Prevalence estimates of GID in adults indicate that it is higher in natal males than in natal females although this may be accounted for by between-sex variation in sexual orientation subtypes. Prevalence estimates of GID in adults based on clinic-referred samples suggest an increase in more recent cohorts. It remains unclear whether this represents a true increase in prevalence or simply greater comfort in the seeking out of clinical care as professionals become more attuned to the psychosocial and biomedical needs of transgendered people.

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    • "To date, research on prevalence rates have tended to focus on people, typically in the adult population, who present for gender transitionerelated care (e.g., for sex reassignment surgery or for hormone therapy) at specialist gender clinics [10], where rates have been as low as 1:2,900 to 1:400,000 [11]. However, Olyslager and Conway [12] estimated that the number of people who identify as transgender is likely to be at least 1:100. "
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    ABSTRACT: To report the prevalence of students according to four gender groups (i.e., those who reported being non-transgender, transgender, or not sure about their gender, and those who did not understand the transgender question), and to describe their health and well-being. Logistic regressions were used to examine the associations between gender groups and selected outcomes in a nationally representative high school health and well-being survey, undertaken in 2012. Of the students (n = 8,166), 94.7% reported being non-transgender, 1.2% reported being transgender, 2.5% reported being not sure about their gender, and 1.7% did not understand the question. Students who reported being transgender or not sure about their gender or did not understand the question had compromised health and well-being relative to their non-transgender peers; in particular, for transgender students perceiving that a parent cared about them (odds ratio [OR], .3; 95% confidence interval [CI], .2-.4), depressive symptoms (OR, 5.7; 95% CI, 3.6-9.2), suicide attempts (OR, 5.0; 95% CI, 2.9-8.8), and school bullying (OR, 4.5; 95% CI, 2.4-8.2). This is the first nationally representative survey to report the health and well-being of students who report being transgender. We found that transgender students and those reporting not being sure are a numerically small but important group. Transgender students are diverse and are represented across demographic variables, including their sexual attractions. Transgender youth face considerable health and well-being disparities. It is important to address the challenging environments these students face and to increase access to responsive services for transgender youth.
    Journal of Adolescent Health 01/2014; 55(1). DOI:10.1016/j.jadohealth.2013.11.008 · 3.61 Impact Factor
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    • "Nevertheless, it is controversial as to whether these conditions occur as comorbid disorders, or whether the behaviors associated with gender dysphoria are simply atypical manifestations of RRBI. While in non-clinical samples males are more often referred to clinics for treatment of gender identity disorders than females (Zucker and Lawrence 2009), it has been suggested that prevalence among the general population may in fact be almost equal between males and females (Landén et al. 1996). The only published empirical report investigating this comorbidity, to our knowledge, found that more males with ASD suffered from such complications than affected females (de Vries et al. 2010). "
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    ABSTRACT: This paper reviews the literature exploring gender differences associated with the clinical presentation of autism spectrum disorders (ASD). The potentially mediating effect of comorbid psychopathology, biological and neurodevelopmental implications on these gender differences is also discussed. A vastly heterogeneous condition, while females on the lower-functioning end of the spectrum appear to be more severely affected, an altered clinical manifestation of the disorder among high-functioning females may consequently result in many being un or misdiagnosed. To date, there is strong bias in the literature towards the clinical presentation of ASD in males. It is imperative that future research explores gender differences across the autism spectrum, in order to improve researchers', clinicians' and the publics' understanding of this debilitating disorder.
    Journal of Autism and Developmental Disorders 03/2013; 43(11). DOI:10.1007/s10803-013-1811-1 · 3.06 Impact Factor
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    • "Given the very nature of GID, such trials, or even unblinded trials with random assignment to treatment groups, are not likely to be forthcoming due to a lack of feasibility and/or ethical concerns . In addition to the lack of evidence of the highest quality relevant to the treatment of GID, GID is widely believed to be a rare phenomenon (Zucker & Lawrence, 2009) 1 and likely to fall short of the SCPG's criterion for prevalence. The Task Force, therefore, decided to consider whetheravailable evidence, together with clinical consensus, constitutes a sufficient basis to support the developmentthe treatment recommendations, broadly defined, in addition to assessing the quality of evidence relevant to the potential development of APA Practice Guidelines, as defined above. "
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    ABSTRACT: Both the diagnosis and treatment of Gender Identity Disorder (GID) are controversial. Although linked, they are separate issues and the DSM does not evaluate treatments. The Board of Trustees (BOT) of the American Psychiatric Association (APA), therefore, formed a Task Force charged to perform a critical review of the literature on the treatment of GID at different ages, to assess the quality of evidence pertaining to treatment, and to prepare a report that included an opinion as to whether or not sufficient credible literature exists for development of treatment recommendations by the APA. The literature on treatment of gender dysphoria in individuals with disorders of sex development was also assessed. The completed report was accepted by the BOT on September 11, 2011. The quality of evidence pertaining to most aspects of treatment in all subgroups was determined to be low; however, areas of broad clinical consensus were identified and were deemed sufficient to support recommendations for treatment in all subgroups. With subjective improvement as the primary outcome measure, current evidence was judged sufficient to support recommendations for adults in the form of an evidence-based APA Practice Guideline with gaps in the empirical data supplemented by clinical consensus. The report recommends that the APA take steps beyond drafting treatment recommendations. These include issuing position statements to clarify the APA's position regarding the medical necessity of treatments for GID, the ethical bounds of treatments of gender variant minors, and the rights of persons of any age who are gender variant, transgender or transsexual.
    Archives of Sexual Behavior 06/2012; 41(4):759-96. DOI:10.1007/s10508-012-9975-x · 3.53 Impact Factor
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