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The Health of the Transgender Community: Out, Proud, and Coming Into Their Own

Posted: February 06, 2017

The following is an excerpt from an article on by Stewart Landers, JD, MCP, and Farzana Kapadia, PhD, MPH:

One factor limiting the ability to address transgender health, as well as other sexual minority health issues, was the lack of population-based data. While convenience surveys and anecdotal data indicated that the LGBTQ community experienced health disparities, the findings from such studies were limited in their scientific validity. In a classic chicken-and-egg dilemma, advocates for LGBTQ health argued that if population-based surveys, primarily administered by government agencies, did not add questions about sexual orientation or gender identity, valid data could not be produced. Government officials responded with concerns about the lack of validated measures to assess either sexual orientation or gender identity.

Two crucial efforts to address the lack of validated measures provided the necessary support to various expert panels deliberating on how to ask valid questions on these surveys about sexual orientation1 and gender identity.2 As of 2016, many state and federal health and nonhealth (such as the General Social Survey) surveys now include measures of sexual orientation, and a growing number are also adding measures of gender identity. Thus, through science and advocacy, population-based data on gender identity or transgender status have become increasingly available in the past five or so years.

These population-based data provide an opportunity, for the first time, to assess the size of the transgender population within a larger swath of the US population, as Crissman et al. do in this issue (p 213) by using Behavioral Risk Factor Survey System data across multiple states. These findings, published here for the first time in a peer-reviewed journal, echo those reported by the Williams Institute, a national leader on LGBTQ issues. Next, a systematic review by Meerwijk and Sevelius (p 216) reviews data on prevalence of transgender persons among college-age individuals, incarcerated persons, and the general population. Using the two analyses found in this journal, data converge around a lower estimate of 0.4 and an upper estimate of 0.53 of the adult US population. The adult population in the United States was estimated by the US Census Bureau at 242 470 820 in 2013. Using the two estimates results is an estimated population size of transgender adults in the United States between 969 883 and 1 285 095 or roughly between 1 and 1.3 million. With more population-specific data on transgender persons, more accurate information regarding their health, mental health, and social services needs and strengths can be identified. These data can in turn be used to support the development of evidence-informed information and training programs for professionals in each of these fields, and, ultimately, improved health status and well-being for the transgender population.

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