As of July 22, 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, ***** 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 **** 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 **** percent were living in a state that 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.

The TransPop study is the first national probability sample of transgender individuals in the United States (it also includes a comparative cisgender sample). A primary goal of this study was to provide researchers with a representative sample of transgender people in the United States. The study examines a variety of health-relevant domains including health outcomes and health behaviors, experiences with interpersonal and institutional discrimination, identity, transition-related experiences, and basic demographic characteristics (age, race/ethnicity, religion, political party affiliation, marital status, employment, income, location, sex, gender, and education). Co-investigators (in alphabetical order): Walter O. Bockting, Ph.D. (Columbia University); Jody L. Herman, Ph.D. (UCLA); Sari L. Reisner, Ph.D. (Harvard University and The Fenway Institute, Fenway Health).

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.

According to a survey conducted in 2024, ** percent of Americans thought that society has gone too far in accepting people who are transgender in the United States. ** percent of white Americans and ** percent of Hispanic Americans also shared this belief, compared to only ** percent of Black Americans.

Given that an estimated 0.6% of the U.S. population is transgender (trans) and that large health disparities for this population have been documented, government and research organizations are increasingly expanding measures of sex/gender to be trans inclusive. Options suggested for trans community surveys, such as expansive check-all-that-apply gender identity lists and write-in options that offer maximum flexibility, are generally not appropriate for broad population surveys. These require limited questions and a small number of categories for analysis. Limited evaluation has been undertaken of trans-inclusive population survey measures for sex/gender, including those currently in use. Using an internet survey and follow-up of 311 participants, and cognitive interviews from a maximum-diversity sub-sample (n = 79), we conducted a mixed-methods evaluation of two existing measures: a two-step question developed in the United States and a multidimensional measure developed in Canada. We found very low levels of item missingness, and no indicators of confusion on the part of cisgender (non-trans) participants for both measures. However, a majority of interview participants indicated problems with each question item set. Agreement between the two measures in assessment of gender identity was very high (K = 0.9081), but gender identity was a poor proxy for other dimensions of sex or gender among trans participants. Issues to inform measure development or adaptation that emerged from analysis included dimensions of sex/gender measured, whether non-binary identities were trans, Indigenous and cultural identities, proxy reporting, temporality concerns, and the inability of a single item to provide a valid measure of sex/gender. Based on this evaluation, we recommend that population surveys meant for multi-purpose analysis consider a new Multidimensional Sex/Gender Measure for testing that includes three simple items (one asked only of a small sub-group) to assess gender identity and lived gender, with optional additions. We provide considerations for adaptation of this measure to different contexts.

As of June 2022, the transgender population was estimated to reach over **** million in the United States. Transgender people aged between 25 and 64 were thought to make up the majority, with an estimated total of ******* trans people belonging to this age group. In comparison, there were also ******* youth between the ages of ** and ** estimated to identify as transgender in that year.

The 2015 U.S. Transgender Survey (USTS) was conducted by the National Center for Transgender Equality (NCTE) to examine the experiences of transgender adults in the United States. The USTS questionnaire was administered online and data were collected over a 34-day period in the summer of 2015, between August 19 and September 21. The final sample included respondents from all fifty states, the District of Columbia, American Samoa, Guam, Puerto Rico, and U.S. military bases overseas. The USTS Public Use Dataset (PUDS) features survey results from 27,715 respondents and details the experiences of transgender people across a wide range of areas, such as education, employment, family life, health, housing, and interactions with police and prisons. The survey instrument had thirty-two sections that covered a broad array of topics, including questions related to the following topics (in alphabetical order): accessing restrooms; airport security; civic participation; counseling; family and peer support; health and health insurance; HIV; housing and homelessness; identity documents; immigration; intimate partner violence; military service; police and incarceration; policy priorities; public accommodations; sex work; sexual assault; substance use; suicidal thoughts and behaviors; unequal treatment, harassment, and physical attack; and voting. Demographic information includes age, racial and ethnic identity, sex assigned at birth, gender and preferred pronouns, sexual orientation, language(s) spoken at home, education, employment, income, religion/spirituality, and marital status. There are no publicly available data files for this study. The naming conventions were maintained from the original pre-ICPSR release and the PUDS file is restricted use along with the qualitative data (MS Excel) file. Before applying for access to these data please refer to the Approved Requests for USTS Data. These abstracts describe work currently in progress, and we provide them to help reduce the risk of duplication of research efforts.

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US Sex Reassignment Surgery Market Size 2024-2028

The US sex reassignment surgery market size is forecast to increase by USD 137 million at a CAGR of 10.87% between 2023 and 2028.

The sex reassignment surgery market in the US is experiencing significant growth due to several key factors. The number of individuals undergoing gender reassignment surgeries is on the rise, driven by an increasing acceptance and recognition of the transgender community. Additionally, heightened awareness among this population about the availability and benefits of sex reassignment surgeries in addition to non-surgical cosmetic procedures is contributing to market expansion.
However, the market also faces challenges, including the potential side effects and complications associated with these procedures. Despite these challenges, the market is expected to continue growing as more individuals seek to align their physical appearance with their gender identity.
This trend is likely to persist, fueled by ongoing social and cultural shifts towards greater acceptance and understanding of transgender individuals.

What will be the size of the US Sex Reassignment Surgery Market during the forecast period?

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The sex reassignment surgery market in the US continues to evolve, driven by the growing recognition and acceptance of transgender individuals seeking gender dysphoria treatment. Transgender males and females, representing a diverse and expanding cohort, increasingly seek gender dysphoria transition and sexual wellness through various gender-affirming procedures. Self-identified gender and gender identity are increasingly prioritized, leading to an uptick in demand for genital reconstructive procedures, chest surgery (mastectomy), facial feminization surgery, and other gender-confirming surgeries. Clinicians play a crucial role in providing mental health support and guiding patients through the decision-making process. A recent national inpatient sample study revealed temporal trends indicating a steady increase In the number of gender dysphoria-related hospitalizations.
Hormone therapy remains a common component of the transition process, further fueling market growth. The market is expected to continue expanding as societal attitudes towards transgender individuals evolve and access to healthcare improves.

How is this market segmented and which is the largest segment?

The market research report provides comprehensive data (region-wise segment analysis), with forecasts and estimates in 'USD million' for the period 2024-2028, as well as historical data from 2018-2022 for the following segments.

Type

  Male to female
  Female to male


End-user

  Hospitals
  Clinics


Geography

  US

By Type Insights

The male to female segment is estimated to witness significant growth during the forecast period.

Sex reassignment surgery, also known as gender confirmation surgery, is a medical procedure that facilitates the physical transition of transgender individuals from their identified gender to the opposite sex. This process primarily involves male-to-female (MTF) and female-to-male (FTM) transitions. MTF surgeries aim to create a neo-vagina and feminine appearance, often preceded by hormone therapy. Associated procedures include vaginoplasty, facial feminization surgery, breast enhancement, and orchiectomy. In MTF surgeries, the original penis is utilized to construct a sensate neo-vagina, while testicles are removed in an orchiectomy. The labia are formed from the scrotal skin. Transgender females and males, particularly the young population, undergo gender dysphoria transition, which is a critical part of their self-identified gender identity journey.

The transfeminine population and transmasculine population seek gender-affirming care, including genital reconstructive procedures, to align their bodies with their gender identity. The US healthcare landscape has seen continuous innovations in gender-affirming surgical procedures, with clinics like Mount Sinai Hospital and institutions such as the Transgender Surgery Institute offering specialized services. The Affordable Care Act (Obamacare) and Medicaid program have expanded coverage for transgender beneficiaries, enabling more equitable access to gender-affirming care. Gender-affirming surgeries, including hysterectomy, salpingo-oophorectomy, mastectomy, metoidioplasty, phalloplasty, scrotoplasty, chest masculinization surgery, and facial feminization surgery, have become increasingly common. These procedures aim to improve patients' satisfaction, mental health, and overall well-being, while addressing societal stigma and perioperative complications. The market for gender-affirming surgical procedures is expected to grow, driven by the increasing awareness and acceptance of transgender issues.

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The male to

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.

In 2022, ** percent of transgender adults and ** 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.

A survey conducted in 2024 found that male respondents were more likely to think that society had gone too far in accepting transgender people. On the other hand, women were more likely to think that society had not gone far enough.

According to a survey conducted in 2022, ** percent of transgender people in the United States said that none of their identity documents (IDs) list the gender they wanted. ** percent also reported that none of their IDs listed the name that they wanted. In that year, transgender people in the United States were also negatively affected by anti-trans laws, such as banning access to bathrooms, healthcare, or sports, with ** percent agreeing that they have considered moving away due to such state action.

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

This layer shows Household Pulse Survey data on gender identity and sexual orientation. Gender identity is the internal perception of gender, and how one identifies based on how one aligns or doesn’t align with cultural options for gender. This is a different concept than sex assigned at birth. Sexual orientation is the type of sexual attraction one has the capacity to feel for others, generally labeled based on the gender relationship between the person and the people they are attracted to. This is not the same as sexual behavior or preference.Learn more about how the Census Bureau survey measures sexual orientation and gender identity. This page includes nation-wide characteristics such as age, Hispanic origin and race, and educational attainment. Also read some of their findings about experiences during the COVID-19 pandemic, such as lesbian, gay, bisexual, or transgender (LGBT) adults experiencing higher rates of both economic hardship and mental health hardship. See the questionnaire used in phase 3.2 of the Household Pulse Survey.Source: Household Pulse Survey Data Tables. Data values in this layer are from Week 34 (July 21 - August 2, 2021), the first week that gender identity and sexual orientation questions were part of this survey. Top 15 metros are based on total population and are the same 15 metros available for all Household Pulse Data Tables.This layer is symbolized to show the percent of adults who are lesbian, gay, bisexual, or transgender (LGBT) as well as adults whose gender or sexual orientation was not listed on the survey (LGBTQIA+). The color of the symbol depicts the percentage and the size of the symbol depicts the count. *Percent calculations do not use those who did not report either their gender or sexual orientation in either the numerator or denominator, consistent with methodology used by the source.*Data Prep Steps:Data prep used Table 1 (Child Tax Credit Payment Status and Use, by Select Characteristics) to perform tabular data transformation. SAS to Table conversion tool was used to bring the tables into ArcGIS Pro.The data is joined to 2019 TIGER boundaries from the U.S. Census Bureau.Using the counties in each metro according to the Metropolitan and Micropolitan Statistical Area Reference Files, metro boundaries created via Merge and Dissolve tools in ArcGIS Pro.In preparing the field aliases and long descriptions, "none of these" and "something else" were generally modified to "not listed."

In 2023, around ** 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 ** and ** percent, respectively.

In 2022, around 80 percent of transgender people in the United States had considered suicide, while around 40 percent had attempted suicide. There has been an upward trend in both the considered and attempted suicide rate since 2000, when 61 percent of transgender people considered committing suicide and 28 percent had attempted it.

Sample sociodemographic characteristics, Canadians age 14 and over.

QAS frequencies for main problem types identified in cognitive interviews.

In 2022, eight percent of LGBQ respondents, including ** percent of LGBQ people of color and ** percent of LGBQ+ transgender respondents reported that in the past year, they have experienced refusal by a health care provider to treat their family member, including a child or a same-sex spouse or partner. The statistic illustrates the share of U.S. LGBTQ+ adults who experienced various types of health care refusals by health care providers in the past year in the U.S. as of 2022, by sexuality and race.