Academics counting trans people

Researchers have tried to count trans people, but not proved particularly good at it.

In 2015, researchers analysed 27 previous studies on how many people are trans. They found there were 9.2 people per 100,000 population who sought surgery or hormones, but the 95% confidence interval was that this figure was between 4.9 and 13.6. It could be as little as half of the headline figure. The headline figure is 0.01% of the population, which is about what I estimated.

The figure that sought hormones or surgery was greater than the figure with a trans-related diagnosis (transsexualism, gender identity disorder or gender dysphoria): that figure was 6.8 (4.6-9.1) per 100,000.

How many people self-report a transgender identity? 355 (144-566) per 100,000. I got this meta-analysis from an anti-trans hate site, which used it to scaremonger about trans women in women’s spaces with those oh-so-scary penises. 2.6% seek surgery. However, that does not indicate what the others do. Not all of us transition. Many of those who report a transgender identity might be firmly closeted, without any intention to present in their true gender except when alone or with one or two trusted friends. Possibly the only trans women in women’s spaces are those who have had, or are seeking, hormones and surgery.

However, the study shows that in order to count trans people you need a specific definition of what a trans person is, because the results for different definitions may range by orders of magnitude.

Six studies only considered people who sought or received genital surgery, and were published between 1968 and 2014, on subjects from the US, Europe and Singapore. A 1968 study estimated one in 100,000 MTFs, one in 400,000 FTMs, sought surgery, but then the concept of trans people was not widely known. There has been a continual increase in the number of people seeking medical transition, by a factor of ten or more since 2000.

A Belgian study asked plastic surgeons how many people had undergone surgery from 1985 to 2003, and found 7.74 trans women per 100,000 women. That is, in 2003 the Belgian figure of those who had had surgery was already approaching the 9.2 figure the meta-analysis gave in 2016 for the number who had had surgery or hormones, or were seeking it. To me, that indicates the 9.2 figure is a substantial underestimate. An Italian study in 2008 found 424 M-F surgeries since 1992, 1.5/100,000, and thought the figure being lower than in other countries could be explained either by missing data or cultural factors. Yet this figure, too, was used to calculate the 9.2 figure.

In 1986, a Singapore study reported 35.2/100,000 M-F. They reported cultural acceptance and established surgical procedures as reasons for the higher figure.

In Iran, between 4,000 and 6,000 gay men and lesbians have been executed for homosexuality since 1979. The Ayatollah Khomeini, however, gave a judgment that some people were transsexual, and between 2002 and 2009 a study identified 281 people having genital surgery. I have heard it suggested that gay people in Iran would transition to avoid execution, but that is not confirmed by the prevalence figure, 0.7/100,000, which is much less than the prevalence elsewhere. The Supreme Leader might have said it’s OK to transition, but that does not mean society will accept it.

Assessing prevalence of transgender identity, it depends what you mean by transgender identity. In 2007-2009 a study in Massachusetts asked, “Some people describe themselves as transgender when the experience a different gender identity from their sex at birth. For example, a person born into a male body, but who feels female or lives as a woman. Do you consider yourself to be transgender?” That gave 500/100,000. “A person born into a male body but who feels female” might never cross-dress at all. The words “For example” make the definition stretchier, and the number larger.

A 2010 survey considered US young adults, asking about sex assigned at birth then gender identity. 26 identified as the other gender, transgender, or other, which is 0.33% (330/100,000).

In 1991, a German study estimated 2.1/100,000 trans people had changed their name to one of the other sex. That would be the number who had socially transitioned, so the number seeking surgery is much the same as the number out and about as trans.

In New Zealand, you can change your passport between M, F and X. By 2008 there had been 385 X. My passport says F, and I would not want an X designation.

The authors write, “With these considerations in mind, the current communication should not be viewed as an attempt to obtain an average measure of transgender prevalence. Rather our analyses aimed to explore patterns of the reported estimates, and to perform an assessment of the extent and sources of agreement and disagreement across studies.” That is, the meta-analysis does not tell us how many trans people there are, or how many seek surgery, but are a comment on the quality of the data. So the hate site is debunked: the authors specifically say that their data should not be used to make such assertions.

The highest figure was 700/100,000 self-reporting transgender identity. This is less than 1%, and does not justify the rage and energy of anti-trans campaigners such as Liz Truss. At the same time it is probably much greater than the number of trans women who ever enter women’s spaces.

I hope the British census will do better.

The meta-analysis is here. The study has been peer-reviewed and published, but I could only access this, which is a pre-print. I did not know what a pre-print was before Covid. I have a new page on various attempts to count trans people.

Counting trans people

In 2021, the British census will count trans and nonbinary people. In England and Wales, these are the questions people will see:

What is your sex?
A question about gender identity will follow later on in the questionnaire
[ ] Female
[ ] Male

Is the gender you identify with the same as your sex registered at birth?
This question is voluntary
[ ] Yes
[ ] No
(Enter gender identity)

The census put “female” first in 2011. Before, the standard was to put male first, and other forms asking sex or gender usually do; but in other census questions the answers were either alphabetical, or the largest group first, both of which would put female first. So the order was changed.

Possible questions were tested to see how well people understood them, as well as whether they objected. The researchers timed how long it took to pick a response. The second question took five seconds, compared to “What do you consider your gender to be?” which took fourteen. People objected strongly to the word “consider”. I say my gender is female. If I say “I consider my gender is female” that includes the possibility others might disagree.

Gender and sex are synonyms in English, and this introduces a distinction. The report on question development assumes we know what it is. Under definitions, it says “The sex question is binary: female and male”, so DSD people have a sex.

“The gender identity question is about a person’s personal internal perception of themselves.”

I don’t think it helpful to distinguish my “personal internal perception” and reality in this case. I am female. I would not say so if I weren’t. Those who are habitually disbelieved, such as prisoners, might lie, but people generally are truthful about such things.

However we dropped the word “transsexual” for “trans”, for various reasons: “transsexual” sounds impersonal and scientific, sounds like a sexual orientation, when it is different; and puts pressure on people to have genital surgery. “Transgender” is an acceptable word.

The annex says, “the gender category with which a person identifies may not match the sex they were registered at birth”. Most of the readers of this document, and the people answering the questions, are cis, and the writers are explaining to them as well as to us.

They explain trans includes binary and nonbinary trans, and non-gendered identities, and identity may be fixed or variable.

It’s not spelled out that sex means genes, gonads and genitals, and I will answer that my sex is female. Gender has to be wider, to include nonbinary people. When the question asked some variant on “Are you trans?” nonbinary people did not consistently include themselves.

To the cis, the document explains that the sex “question wording and response options are unchanged from the 2011 Census. We will continue to collect this data in a way that is consistent with previous censuses.” Well, I said my sex was female then, too. There are so few of us, that statistics are barely affected.

“The gender identity question is voluntary. It will only be asked to respondents aged 16 years and over.”

The trans question comes at the end of the sociocultural questions. It affects fewer people than race or religion.

In Scotland, the trans question is different. The census will take place in 2022, because of Covid.
3. What is your sex?
[] Female [] Male
4. Do you consider yourself to be trans, or have a trans history?
This question is voluntary
Answer only if you are aged 16 or over
Trans is a term used to describe people whose gender is not the same as the sex they were registered at birth
Tick one box only
[] No
[] Yes, please describe your trans status (for example, non-binary, trans man, trans woman):
[Space to write in answer]

The National Records of Scotland explained their question testing. They tested a nonbinary sex question- male, female, Other- write in. The Scottish Parliament rejected the “Other” option for sex, though the NRS research showed that the questions, including the “other” sex option, were publicly acceptable, and would produce good data. Stakeholders preferred a nonbinary sex question, which produced fewer non-responses. Their aim was “to allow inclusive questions which all respondents can answer with ease”. They found putting the sex and trans status questions together made respondents understand better.

In Northern Ireland, the census will only include a binary sex question, and none on gender identity.

In England, the guidance on how to answer the sex question will read,

If you are considering how to answer, use the sex recorded on one of your legal documents such as a birth certificate, Gender Recognition Certificate, or passport.

That’s fine for me, but I would resent it if I had no GRC. I would ignore it, and tick F anyway. The ONS explains their reasons for the guidance here.

Estimates of the results will be published in March 2022 and the full data set in March 2023.

How many trans people?

Are 3% of Belgians really trans or nonbinary?

Eva Van Caenegem, Katrien Wierckx and others asked about 4600 people from Flanders whether they agreed with the statements “I feel like a woman” and “I feel like a man”. 1832 answered on a five point scale from 1, totally agree, to 5, totally disagree. They considered a person gender ambivalent if they gave equal responses to both, and gender incongruent if they gave a higher score for the opposite sex. They found 2.2% of men to be gender ambivalent and 0.9% gender incongruent, and 1.9% of women ambivalent, 0.6% incongruent.

The research team tried to find LGB people who did not identify as lesbian, gay or bi, by asking who people had sex with, and about whom they fantasised.

When 2472 lesbian, gay and bisexual people answered the same questions, 1.8% of men were ambivalent, 0.9% incongruent, and 4.1% of women ambivalent, 2.1% incongruent.

Unfortunately the question can mean totally different things to different people. If you think gender stereotypes are merely oppressive, you might totally agree that you feel like your assigned sex, because you belong to that sex, even though you don’t fit the stereotypes. Alternatively you might totally disagree, asserting that you simply are of one sex or the other, and feelings are irrelevant. If you do not fit stereotypes at all, you might transition, or you might assert your sex and campaign against stereotypes- or you might pretend to conform, try to fit in, because the challenge was too difficult.

Some who are gender incongruent might be in denial. Many trans women have fought to make men of ourselves before accepting we are trans, and transitioning. When in the Army, my friend might have claimed to completely agree that she felt like a man. Now transitioned, she would say the opposite.

I want the question to find out how many people have a trans or gender nonconforming nature. Finding those in denial, or who conform because of social pressure, is difficult. They are the most oppressed by the stereotypes.

The figures for gay and lesbian people seem low. In my experience they fit the stereotypes less than straight people do, but fewer gay men presented as ambivalent than straight men. This could be the gay men feeling more oppressed, and less willing to admit to ambivalence.

I wonder why more than twice as many queer women as queer men were ambivalent or incongruent. It could be different effects on men and women of the stereotypes. Male privilege is desirable. You lose it if you present as unmasculine. In Britain, gay men who were camp had precarious acceptance, in times of worse homophobia. Amused contempt is a better reaction from your community than widely condoned violence. Some feminists find feminine gender stereotypes merely oppressive and don’t believe anyone fits them comfortably.

A small minority of those incongruent people might transition. It is a great effort, and takes courage. I found the social rejection terribly painful, and my own internalised transphobia made it far worse. Others might cross-dress. Some might find partners and social groups where they could be gender nonconforming.

Who is trans?

How many trans people are there? That depends on who you call trans. The Conference of European Statisticians prepared a paper on counting trans people, which said it is too early to make firm recommendations. It even felt the need to point out that gay rights or acceptance are not the same as trans rights or acceptance. This is what the report says:

Gender has a range of possibilities, and trans and nonbinary are distinct. Some cultures recognise gender diversity, such as the Fa’afafine of Samoa. Sometimes “gender” is used as a synonym for sex, sometimes as something separate- German has only one word for both. “Gender identity” is the inwardly-felt aspect of being male, female or something else. “Gender expression” is how one presents.

In most research literature, “transgender” or “trans” is defined as having a gender (identity or expression) that is different from the person’s sex as determined at birth. Note that the word “different” is used rather than the word “opposite”. In this sense, it includes all people with non-binary gender. The opposite of transgender is called “cisgender”.

But sometimes “trans” just refers to binary transgender. And some sources call “transgender” a separate gender. Several countries have binary gender recognition, and Canada is considering the possibility of recognising nonbinary gender. In Germany there is a third category. We need statistics on trans to monitor inequality and develop policy to benefit trans people, but we still need data on sex at birth. In English, the terms are in flux and vary even between different organisations within one country.

Australia uses the label “other”, which I find unattractive. New Zealand and Canada include “gender diverse”, which could produce a higher response, as it could include people who don’t fit standard binary gender but have not decided to do anything about it. But in New Zealand, “gender diverse” includes binary trans people, while in Canada it only means nonbinary. Canada specifically defines “sex” as “sex assigned at birth”.

People have the human right to privacy. Asking a gender identity question should only be done when the benefits of having the information outweigh privacy concerns. So the Gender identity question will be voluntary.

The 2014 Behavioral Risk Factor Surveillance System in the US asked 300,000 people “Do you consider yourself to be transgender?” Half did not answer the question. Of those who did, 0.52% said yes. The researchers said this meant 0.6% of the US population was transgender.

The California Health Interview Survey of 2015-16 asked sex at birth, then “Do you currently describe yourself as male, female or transgender?” 0.35% were identified as trans from the two questions, including some who said one sex for the first question, the other gender for the second. That is, there were 85 participants identified as trans.

Some surveys use networking or awareness campaigns to find trans people. Some countries have surveyed trans people on what questions to ask. Asked our gender or sex, we might respond simply with our acquired gender, so there needs to be a separate question about trans status. Despite this, the report recommends one question on gender, offering “male, female, another gender” as the options (though I consider male means sex, masculine means gender). There could be two questions, one on gender and a second on gender variant status.

There can be false positives, response errors distorting the figures; non-response bias and variability of samples. Before conducting the census, statistics bodies are trialling different questions. They want, they say, to “measure the full transgender population”, but some people are too scared to reveal, or are in denial. However if 0.1% of people are trans, but 1% of cis people make a mistake, the result would give a figure ten times the actual number of trans people. Unfamiliar terms could cause cis people to make errors.

Canada’s two questions ask sex at birth, male or female, then gender, male, female, “Or please specify your gender”. England is testing two questions, “Is your gender the same as the sex you were registered at birth?” and “Do you consider yourself to be trans?” with the option “prefer not to say”. They think “prefer not to say” will be trans people.

The report recommends allowing people to write in their gender rather than just tick “other gender”. They don’t address the possibility that someone might want to transition but be too frightened to- that’s the figure that, more than any other, shows the depth of need of trans people. It worries that in very detailed tables, such as for individual towns, giving a number of trans people could mean those people could be identified.

0.6% of the population is a lot more trans people than I thought, and I still don’t think they are all transitioning. And yet I feel gender stereotypes oppress and restrict far more people than would ever say in a census that they are transgender. That would mean the census might help with specific health-care needs, but not with policy around gender stereotypes. Still, that, and 0.35%, are the only concrete figures the report gives. The report recommends other countries start counting trans people, and report to the UN how they get on.

These questions don’t address the question I want to: how many people identify as trans but have decided temporarily or permanently not to transition? I know people like that, and people who have waited many years before starting their transition journey. That statistic would show how hard it is to be trans.

From In depth review of measuring gender identity.

How many trans people seek medical treatment?

“Transgender support organisations estimate that only 20% of trans people seek medical transition (hormonal or surgical).” This trans-excluder lie is used to create fear of trans people. That means 80% of trans women are “male-bodied”, with those oh so scary penises. The figure I had was 60% want genital surgery. I wondered where the lie came from. That article cited a pdf from GIRES.

That document is from 2011, and extrapolates from a report done about 2007 figures. The 20% figure comes from this sentence: So far, as stated above, only 12,500 adults have presented for treatment but a further 50,000, or even 90,000, may do so. 12,500 is 20% of (50,000+12,500).

However that 12,500 figure is of those who have “sought medical treatment”, which could be seeing a specialist gender psychiatrist or could just be discussing the matter with a GP. Seeing a psychiatrist does not mean you get hormones or surgery. Later, the document says only 7,500 have undergone transition, which is 60% of those who have sought treatment. So the 20% figure does not relate to transition. Most of those 62,500 people would be muddling along in their gender assigned at birth.

The document says 500,000 “experience some degree of gender variance”. That is far greater than the number who transition. Such people might see it entirely differently, saying “I am trans but I can’t transition in this prejudiced society” or “Gender stereotypes are oppressive”, or they might not think about it. That 1% figure is also in Stonewall’s page “The Truth about Trans”, but it says 600,000 “might identify as trans, including those who identify as non-binary”. That is different from being conscious of gender variant. The Government Equalities Office in 2018 said, “We tentatively estimate that there are approximately 200,000-500,000 trans people in the UK.”

In 2007, 1500 people presented for treatment. If 60% of them transitioned, that would be 900. GIRES does not say there what they mean by “transition”- I mean starting to live full time in our true gender. That’s Stonewall’s use of the word.

In 2011, GIRES stated an increase of 11% a year. After 2005 we have the figures for the number of gender recognition certificates granted. Here they are:

2005/6: 1,181,  2006/7: 532,  2007/8: 392,  2008/9: 241, 2009/10: 239, 2010/11: 260, 2011/12: 263, 2012/13 236, 2013/14 318, 2014/15 244, 2015/16 332, 2016/17 318, 2017/18: 354, 2018/19: 323, 2019/20: 364. The total to December 2019 is 5,629.

I got them from a spreadsheet downloaded from a government statistics page, the Official Statistics “Tribunal Statistics Quarterly”, and a document called “Main Tables”. In 2005/6, and possibly in 2007/8, there would be a backlog, of people who had transitioned before the act came into force.

Now for some extremely crude numbers. If 900 people transitioned, and 239 got GRCs, that means about a quarter of people who transition get a GRC. So if the total with a GRC in December 2019 is 5,539, very roughly 21,000 people would have transitioned. That contrasts with the figure of 40,000 I came up with, last time I tried.

Gender stereotypes are oppressive, and everyone is oppressed to an extent. I think probably far more than 1% of people are chronically distressed by gender stereotypes. However, only about 0.03% of the population decide to transition to the other gender.

How many of those seek hormones or surgery? Between 2000 and 2009, 865 trans people had “state funded surgery to change sex”, only twelve of them trans men. This means genital surgery. That was out of 6000 who had transitioned, according to this document I found on Bournemouth Council’s site. That’s 14%. But many more paid for surgery, in Britain or abroad. GIRES said at the time 80% of transitioners were M-F, so 18% of trans women had NHS genital surgery.

The Office for National Statistics do not estimate the number of trans people in the UK. In their position paper linked to on that page, they say that there are difficulties in definition- trans includes cross-dressers, transitioners, and androgynous people. They use the word to mean “anyone who experiences gender variance”. This is a private matter, and they thought it hard to get an accurate figure.

In 2016, this Guardian article reported around 4,500 adult referrals and 1576 child referrals to GICs. 80-90% of the adults went on to take hormones. The adult figure is a tripling from the 2007 figure. So we have a much greater rise in referrals than in grants of GRCs. 60% of trans women wanted genital surgery. Charing Cross had 1892 referrals. However in February 2020 alone, it had 290 referrals, which would be nearly double the 2015 figure. If the number on hormones was a constant proportion of the number of referrals, there might be 50,000 adults transitioned in total- though some might be on hormones but not living full time transitioned.

The number of GRCs has gone up far more slowly than the number of referrals, and in part this is because the waiting times are going up. In December 2019 there were 13,500 on the waiting lists for GRCs.

How many transitioned people? Anyone’s guess; but I still don’t think there are more than around 50,000 people living transitioned to the other gender in the UK. Of those, almost all will be on hormones, and 60% of trans women will want or have had genital surgery. The 20% surgery figure cited by trans-excluders is completely bogus, unrelated to any actual figures on transition. That gives a figure of 0.1% of the adult population. Where there are no better figures, that 0.1% figure might be applied to other countries- 0.1% of the population is desperate or determined enough to transition. There is a steady increase: the Interdepartmental Working Group report in 2000 estimated the figure at 2000-5000, so the number has grown by an order of magnitude since then.

In 2012, the EU Agency for Fundamental Rights (FRA) did an LGBT survey. Of 93,000 respondents, 7,000 identified as trans, which is 7.5%. In 2019, the FRA did another survey: of 140,000 respondents, 20,000 identified as trans, which is 14.3%, nearly double the proportion. Possibly that indicates some increase in the number of trans people across the EU, though all sorts of considerations might affect the proportion of respondents who were trans. An increase in the number identifying as trans might indicate that transition was easier, so people were more inclined to risk it.

I fear numbers are boring. I delve down into them, to find the truth behind them, a truth I am satisfied of because the evidence backs it up.

Added: when the British government consulted on self-declaration of trans people, it considered estimates of our numbers. The problem they had was the definition. “People who experience some degree of gender variance” might be appalled at the thought of actually transitioning. That definition includes a lot of anti-trans campaigners. But based on that definition they put the number of trans people at 200,000-500,000. The line “this estimate may include some nonbinary people” shows a complete failure to grasp the issues.

The Office for National Statistics research concerned gender identity. I consider people who are not seriously considering transition will not claim to have a gender identity different from their birth sex. Many will call gender meaningless and oppressive, saying only sex matters. A “gender identity” question would at least identify nonbinary people.

Christians and Divorce

File:John Everett Millais, The Somnambulist.jpgDo Christians divorce more than atheists? They should stay together because they are religious and good- or split, because they are deluded. Research will tell you what you want it to tell you.

Here’s Valerie Tarico on how atheist marriages last longer. Any Evangelical who says that atheists are amoral should look at her Wisdom Commons site.

From the off, there were Evangelicals challenging the research, on various grounds. Here, George Barna is quoted denying that the divorces of Christians occurred before their conversion, or because one partner was Christian and the other not.

The Gospel Coalition found new arguments. Evangelicals who worshipped regularly had lower divorce rates: the divorce rates were among those Evangelicals who did not go to church. The factor making the most difference is religious commitment and practice. Evangelicals who divorce are likely to be backsliders in other ways too. The article differentiates serious disciples from mere “church members”.

Post hoc propter hoc? Why would someone who does not go to church self-identify as an Evangelical? The researchers can only say a responder to their survey is Evangelical if they claim to be so. The answer is that they still believe. Perhaps they do not go to church because it is too much bother; or perhaps because they have been uncomfortable there, as a divorced or remarried person.

The reason these soi-disant Evangelicals divorce is that they are not “serious disciples” says the Gospel Coalition. This goes against Biblical teaching about what people are like: we would not need forgiven seventy times seven times if we could be Good all the time. Here is Open Bible on Compassion: a hundred verses like Be kind to one another, tenderhearted, forgiving one another, as God in Christ forgave you. Here is Romans 3:10: No-one is righteous, not even one. Self-righteous, on the other hand…