As of February 10, 2025, the majority of the transgender population aged 13 and over in the United States were living in a state with no ban on transgender people's use of bathrooms or facilities. However, 10 percent of the transgender population were living in a state which banned transgender people from using bathrooms and facilities consistent with their gender identity in K-12 schools only, while eight percent were living in a state which banned transgender people from using bathrooms and facilities corresponding to their gender identity in all government-owned buildings and spaces, including schools, colleges, and more. A further seven percent were living in a state which restricted transgender people from using bathrooms and facilities consistent with their gender identity in K-12 schools and at least some government-owned buildings as well. Anti-education legislation Statewide legislation affecting LGBTQ+ people in the U.S. has been on the rise recently, especially in K-12 schools. Many states have taken legal action to restrict schools from teaching topics of racism, sexism, gender identity, sexual orientation, and systemic inequality to students. However, studies show that Americans typically remain politically divided over how these topics should be taught; in 2022, the majority of Democratic parents were found to believe that children should be taught that the legacy of slavery still affects the position of Black people in American society today while the majority of Republican parents thought that children should be taught that slavery is a part of American history but does not affect the position of Black people in American society today. Book bans Censorship of these topics has also been seen in K-12 libraries, with book bans occurring in multiple states throughout the country. As of 2022, Texas had the highest number of books banned in the U.S., followed by Florida. Florida's Parental Rights in Education Act, which is often referred to as the "Don't Say Gay" law, has been particularly controversial as it aims to prevent discussion of gender identity or sexual orientation and remove books featuring LGBTQ+ characters in K-12 schools and libraries. Along with potentially harming LGBTQ+ students, K-12 teachers have also highlighted how these laws and debates over what topics should be taught in the classroom may negatively impact their ability to do their job.

As of April 2024, 55 percent of the LGBT population lived in the 50 states and the District of Columbia where private health insurance service providers weren't allowed to deny coverage for transgender-related health care services, such as sex reassignment surgery. However, only 40 percent lived in states where health insurance protections included sexual orientation and gender identity.

LGBT Americans The share of Americans self-identifying as lesbian, gay, bisexual or transgender has grown in recent years. This suggests that insurance protections which cover LGBT-related health care services will also continue to grow in importance. The prevalence of younger Americans self-identifying as LGBT when compared with older generations confirms this. Millennials and Gen Xers are much more likely to personally identify as LGBT than previous generations were. Growing acceptance and tolerance in wider society means that more people are willing to be open about their gender identity and sexual orientation. For instance, support for same-sex marriage in the U.S. underwent a huge shift over the past two decades with the majority of Americans being in favor of it since 2011.

Stats NZ introduced questions on sexual identity and gender to HES for the year ended June 2021, to help provide a more accurate and inclusive picture of New Zealanders that, amongst other dimensions, would reflect the diversity of genders and sexual identities in Aotearoa.

A survey conducted in 2021 found that around **** percent of people assigned male at birth still identify as male, while *** percent identified as female, and *** percent identified as transgender.

Most transgender people realize that the gender they were assigned at birth did not match their own gender identity in their childhood and adolescence in all European countries. On average, 73 percent realized before the age of 18, with this being highest in Luxembourg, at 90 percent, and lowest in Hungary, at 62 percent.

Germany and the Netherlands are the two countries in Europe with the greatest share of transgender people indicating that they have changed or are in the process of changing their legal gender, with 39 percent of respondents in both countries. Changing their gender on legal documents can be a huge milestone for many trans people, as it makes it easier for them to be identified identified according to their gender identity.

Trans people may experience great difficulties when going through the process of changing their legal gender, as many countries require medical and psychological evaluations before proceeding with the process. In such cases, where trans people do not trust public authorities to treat them in a non-discriminatory manner, very few transgender people go through the process to legally change gender, such as in Bulgaria, Lithuania, and Croatia, where less than five percent of respondents indicate they have done or are doing so.

Supplementary file 1: Data for serum/plasma laboratory tests with sex-specific reference intervals performed on patients with sexual orientation/gender identity (SOGI) field differences for legal sex/sex assigned at birth (SAAB)/gender identity (GI) in the electronic medical record (EMR) at the University of Iowa Hospitals and Clinics from January 1, 2021 to December 31, 2021. The data elements include: deidentified patient number, age (years) at time of laboratory testing, location type (outpatient, inpatient, or emergency department) at time of specimen collection, legal sex in EMR, SAAB in EMR, GI in EMR, presence of SOGI mismatch (yes/no), change of legal sex in EMR, gender-affirming gonadectomy (yes/no), GI from chart review, gender-affirming hormone and route of administration, values for tests for 17 laboratory tests, and how the values of these 17 laboratory tests were relative to age-matched reference intervals for cisgender men and women. Assays details and reference intervals are summarized in Supplemental file 3. Chart review for SOGI fields previously reported [1]. There are a total of 1,166 unique patients (all 18.0 years or older) and 7,530 laboratory tests.

Supplementary file 2: Data for plasma creatinine performed for patients 18.0 years or older taking gender-affirming estradiol or testosterone at the University of Iowa Hospitals and Clinics from January 1, 2021 to December 31, 2021. The data elements include: deidentified patient number, age (years) at time of laboratory testing, location type at time of specimen collection, legal sex in EMR, SAAB in EMR, GI in EMR, GI from chart review, gender-affirming hormone and route of administration, self-declared race in EMR (African-American or not), plasma creatinine (mg/dL), estimated glomerular filtration rate (eGFR) calculation using female sex and the 2021 CKD-EPI equation without race refit, eGFR using male as sex, and chronic kidney disease (CKD) stage using either female or male as sex. eGFR equation and CKD stages are from references 2 and 3, respectively. There are a total of 620 unique patients and 1,469 plasma creatinine values.

Supplementary file 3: Includes Supplemental Table 1 with details on laboratory assay and Supplemental Table 2 with reference intervals for the laboratory tests analyzed.

Data tabs for Supplemental Files 1 and 2 include one for primary data and another defining abbreviations.

[1] N.G. Hines et al, Patterns of gender identity data within electronic health record databases can be used as a tool for identifying and estimating the prevalence of gender-expansive people, JAMIA Open 6 (2) (2023) ooad042. DOI: 10.1093/jamiaopen/ooad042.

[2] C. Delgado et al., A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease, Am J Kidney Dis 79 (2) (2022) 268-288 e261. DOI: 10.1053/j.ajkd.2021.08.003.

[3] Kidney Int Suppl (2011) 3 (1) (2013) 5-14.

In a global survey conducted in 2023, ***** percent of respondents from 30 countries identified themselves as transgender, non-binary/non-conforming/gender-fluid, or in another way. In Switzerland, around *** percent of the respondents stated to identify themselves with one of the listed genders.

The IPUMS Contextual Determinants of Health (CDOH) data series includes measures of disparities, policies, and counts, by state or county, for historically marginalized populations in the United States including Black, Asian, Hispanic/Latina/o/e/x, and LGBTQ+ persons, and women. The IPUMS CDOH data are made available through ICPSR/DSDR for merging with the National Couples' Health and Time Study (NCHAT), United States, 2020-2021 (ICPSR 38417) by approved restricted data researchers. All other researchers can access the IPUMS CDOH data via the IPUMS CDOH website. Unlike other IPUMS products, the CDOH data are organized into multiple categories related to Race and Ethnicity, Sexual and Gender Minority, Gender, and Politics. The CDOH measures were created from a wide variety of data sources (e.g., IPUMS NHGIS, the Census Bureau, the Bureau of Labor Statistics, the Movement Advancement Project, and Myers Abortion Facility Database). Measures are currently available for states or counties from approximately 2015 to 2020. The Sexual and Gender measures in this release include the proportion of a state's population identifying as LGBTQ+ in the U.S. Census Bureau's Household Pulse Survey, Phases 3.2 (07/21/2021-10/11/2021), 3.3 (12/01/2021-02/07/2022), 3.4 (03/02/2022-05/09/2022), and 3.5 (06/01/2022-08/08/2022). To work with the IPUMS CDOH data, researchers will need to first merge the NCHAT data to DS1 (MATCH ID and State FIPS Data). This merged file can then be linked to the IPUMS CDOH datafile (DS2) using the STATEFIPS variable.

Selected socioeconomic characteristics of the transgender or non-binary population aged 15 and older, by age group. Marital status, presence of children under age 12 in the household, education, employment, personal income, Indigenous identity, the visible minority population, immigrant status, language(s) spoken most often at home, place of residence (population centre/rural), self-rated general health, and self-rated mental health. Estimates are obtained from combined cycles of the Canadian Community Health Survey, 2019 to 2021.

Important notice

The Office for Statistics Regulation confirmed on 12/09/2024 that the gender identity estimates from Census 2021 are no longer accredited official statistics and are classified as official statistics in development.

For further information please see: Sexual orientation and gender identity quality information for Census 2021

These datasets provide Census 2021 estimates that classify usual residents aged 16 years and over in England and Wales for gender identity by sex, gender identity by age and gender identity by sex and age.

Gender identity

Gender identity refers to a person's sense of their own gender, whether male, female or another category such as non-binary. This may or may not be the same as their sex registered at birth.

Non-binary

Someone who is non-binary does not identify with the binary categories of man and woman. In these results the category includes people who identified with the specific term "non-binary" or variants thereon. However, those who used other terms to describe an identity that was neither specifically man nor woman have been classed in "All other gender identities".

Sex

This is the sex recorded by the person completing the census. The options were "Female" and "Male".

Trans

An umbrella term used to refer to people whose gender identity is different from their sex registered at birth. This includes people who identify as a trans man, trans woman, non-binary or with another minority gender identity.

Trans man

A trans man is someone who was registered female at birth, but now identifies as a man.

Trans woman

A trans woman is someone who was registered male at birth, but now identifies as a woman.

Usual resident

A usual resident is anyone who on Census Day, 21 March 2021, was in the UK and had stayed or intended to stay in the UK for a period of 12 months or more, or had a permanent UK address and was outside the UK and intended to be outside the UK for less than 12 months.

Notes:

• To ensure that individuals cannot be identified in the data, population counts have been rounded to the nearest five and counts under 10 have been suppressed.

• Percentages have been calculated using rounded data.

Important notice

The Office for Statistics Regulation confirmed on 12/09/2024 that the gender identity estimates from Census 2021 are no longer accredited official statistics and are classified as official statistics in development.

For further information please see: Sexual orientation and gender identity quality information for Census 2021

These datasets provide Census 2021 estimates that classify usual residents aged 16 years and over in England and Wales for gender identity by sex, gender identity by age and gender identity by sex and age.

Gender identity

Gender identity refers to a person's sense of their own gender, whether male, female or another category such as non-binary. This may or may not be the same as their sex registered at birth.

Non-binary

Someone who is non-binary does not identify with the binary categories of man and woman. In these results the category includes people who identified with the specific term "non-binary" or variants thereon. However, those who used other terms to describe an identity that was neither specifically man nor woman have been classed in "All other gender identities".

Sex

This is the sex recorded by the person completing the census. The options were "Female" and "Male".

Trans

An umbrella term used to refer to people whose gender identity is different from their sex registered at birth. This includes people who identify as a trans man, trans woman, non-binary or with another minority gender identity.

Trans man

A trans man is someone who was registered female at birth, but now identifies as a man.

Trans woman

A trans woman is someone who was registered male at birth, but now identifies as a woman.

Usual resident

A usual resident is anyone who on Census Day, 21 March 2021, was in the UK and had stayed or intended to stay in the UK for a period of 12 months or more, or had a permanent UK address and was outside the UK and intended to be outside the UK for less than 12 months.

Notes:

• To ensure that individuals cannot be identified in the data, population counts have been rounded to the nearest five and counts under 10 have been suppressed.

• Percentages have been calculated using rounded data.

In 2022, 21 percent of transgender adults and 28 percent of transgender people of color reported that in the past year, providers had refused to provide them with reproductive or sexual health services due to their actual or perceived gender identity. Overall, transgender people of color in the U.S. experienced a higher rate of health care refusals from providers in comparison to white transgender people.

As reported by the most recent Canadian census data, 0.3 percent of the Canadian population aged 15-19 were non-binary. While gender non-binarity concerns a small portion of the population, this proportion is much higher than among Canadians over 35. A similar observation can be made regarding transgender people: while the trans population represents only 0.19 percent of Canadians, 0.44 percent of 15-19 year olds were transgender men or women, compared with 0.13 percent among 50-54 year olds.

Population and percent identify transgender or gender non-conforming by Service Planning Area (SPA) from California Health Interview Survey (CHIS), 2015-2021 and 2019-2021 pooled years.Symbolized on the Equity Explorer by % Adults Transgender or Gender Non-conforming, years 2015-2021 (field = tgi_adult_pct_2015_2021).

The US gender reassignment surgery market is experiencing robust growth, driven by increasing societal acceptance of transgender individuals, advancements in surgical techniques resulting in improved outcomes and patient satisfaction, and expanding access to healthcare coverage for gender-affirming care. The market's Compound Annual Growth Rate (CAGR) of 12.50% from 2019-2024 suggests a significant expansion, indicating a substantial and growing demand for these procedures. This growth is fueled by a rising transgender population seeking medical transition, coupled with increased awareness and advocacy efforts promoting access to gender-affirming surgeries. The market segmentation reveals a substantial portion dedicated to male-to-female (MTF) surgeries, encompassing procedures like feminizing vaginoplasty, augmentation mammoplasty, and facial feminization. Female-to-male (FTM) surgeries, including phalloplasty and hysterectomy, also contribute significantly, though potentially with a slightly smaller market share. The primary end-users are hospitals and specialized clinics equipped to handle the complex nature of these procedures, reflecting the need for experienced surgeons and advanced medical facilities. While precise market figures for the US are unavailable in the provided data, based on the global CAGR and considering the significant US healthcare market, a reasonable estimate for the 2025 US market size could be in the range of $500 million to $750 million, assuming a proportionally larger US market share compared to other regions. The key players in the US market comprise a mix of specialized transgender healthcare centers and established cosmetic surgery practices. This competitive landscape drives innovation and improvements in surgical techniques, further stimulating market growth. However, factors such as high procedure costs, limited insurance coverage in certain areas, and the potential for lengthy wait times due to high demand could act as restraints. Future growth will depend on continued progress in surgical techniques, expanded insurance coverage, legislative changes increasing access to care, and ongoing efforts to destigmatize gender transition. Geographic variations in access to care and societal acceptance will also influence the growth trajectory across different regions within the US. The forecast period of 2025-2033 promises a substantial expansion, projecting a larger market size in 2033 due to the continued influence of the factors mentioned above, further solidifying the position of gender reassignment surgery as a significant segment within the broader healthcare landscape. Recent developments include: April 2023: Governor Murphy signed Executive Order No. 326 establishing New Jersey as a safe haven for gender-affirming health care by directing all state departments and agencies to protect all persons, including health care professionals and patients, against potential repercussions resulting from providing and receiving assisting in providing or receiving, seeking, or traveling to New Jersey to obtain gender-affirming health care services., September 2022: The World Professional Association for Transgender Health (WPATH), headquartered in the United States, updated its Standards of Care and Ethical Guidelines for health professionals. Among the updates is a new suggestion to lift the age restriction for youth seeking gender-affirming surgical treatment, in comparison to the previous suggestion of surgery at 17 or older.. Key drivers for this market are: Growing Burden of Gender Dysphoria, Rising Government Initiatives and Reimbursements. Potential restraints include: Growing Burden of Gender Dysphoria, Rising Government Initiatives and Reimbursements. Notable trends are: Facial Feminization Procedures Segment is Expected to Have Significant Growth in the Market Over the Forecast Period.

Weighted descriptive statistics by marital status and gender, transmen.

In 2023, around 48 percent of the Black people interviewed in the United States thought transgender people face a great deal of discrimination. In comparison, the share of Hispanic and white people who shared this view was about 45 and 40 percent, respectively.

According to a survey in 2023, more than two thirds of Americans believed that transgender people were discriminated against at least to some extent in the United States. Meanwhile, only ten percent felt transgender people did not receive discrimination.

Estimated odds ratios and 95% CIs from logistic regression models predicting suicidality, transwomen.