Meerwijk Esther L, Sevelius Jae M
At the time of the study, Esther L. Meerwijk was with the Department of Family Health Care Nursing, University of California, San Francisco. Jae M. Sevelius is with the Department of Medicine, University of California, San Francisco.
Am J Public Health. 2017 Feb;107(2):e1-e8. doi: 10.2105/AJPH.2016.303578.
Transgender individuals have a gender identity that differs from the sex they were assigned at birth. The population size of transgender individuals in the United States is not well-known, in part because official records, including the US Census, do not include data on gender identity. Population surveys today more often collect transgender-inclusive gender-identity data, and secular trends in culture and the media have created a somewhat more favorable environment for transgender people.
To estimate the current population size of transgender individuals in the United States and evaluate any trend over time.
In June and July 2016, we searched PubMed, Cumulative Index to Nursing and Allied Health Literature, and Web of Science for national surveys, as well as "gray" literature, through an Internet search. We limited the search to 2006 through 2016.
We selected population-based surveys that used probability sampling and included self-reported transgender-identity data.
We used random-effects meta-analysis to pool eligible surveys and used meta-regression to address our hypothesis that the transgender population size estimate would increase over time. We used subsample and leave-one-out analysis to assess for bias.
Our meta-regression model, based on 12 surveys covering 2007 to 2015, explained 62.5% of model heterogeneity, with a significant effect for each unit increase in survey year (F = 17.122; df = 1,10; b = 0.026%; P = .002). Extrapolating these results to 2016 suggested a current US population size of 390 adults per 100 000, or almost 1 million adults nationally. This estimate may be more indicative for younger adults, who represented more than 50% of the respondents in our analysis.
AUTHORS' CONCLUSIONS: Future national surveys are likely to observe higher numbers of transgender people. The large variety in questions used to ask about transgender identity may account for residual heterogeneity in our models. Public health implications. Under- or nonrepresentation of transgender individuals in population surveys is a barrier to understanding social determinants and health disparities faced by this population. We recommend using standardized questions to identify respondents with transgender and nonbinary gender identities, which will allow a more accurate population size estimate.
跨性别者的性别认同与他们出生时被指定的性别不同。美国跨性别者的人口规模尚不清楚，部分原因是包括美国人口普查在内的官方记录不包括性别认同数据。如今的人口调查更频繁地收集包含跨性别者的性别认同数据，并且文化和媒体的长期趋势为跨性别者创造了一个相对更有利的环境。
估计美国当前跨性别者的人口规模，并评估随时间的任何趋势。
2016年6月和7月，我们通过互联网搜索在PubMed、护理及相关健康文献累积索引和科学网中搜索全国性调查以及“灰色”文献。我们将搜索范围限制在2006年至2016年。
我们选择了采用概率抽样并包含自我报告的跨性别认同数据的基于人群的调查。
我们使用随机效应荟萃分析来汇总符合条件的调查，并使用元回归来验证我们的假设，即跨性别者人口规模估计会随时间增加。我们使用子样本和留一法分析来评估偏差。
我们基于涵盖2007年至2015年的12项调查的元回归模型解释了模型异质性的62.5%，调查年份每增加一个单位有显著影响（F = 17.122；自由度 = 1,10；b = 0.026%；P = 0.002）。将这些结果外推到2016年表明，美国目前每10万人中有390名成年人，即全国近100万成年人。这个估计可能对年轻人更具代表性，在我们的分析中，年轻人占受访者的50%以上。
未来的全国性调查可能会发现更多的跨性别者。用于询问跨性别认同的问题差异很大，这可能是我们模型中残余异质性的原因。公共卫生影响。跨性别者在人口调查中的代表性不足或没有代表性是理解该人群面临的社会决定因素和健康差距的障碍。我们建议使用标准化问题来识别具有跨性别和非二元性别认同的受访者，这将使人口规模估计更准确。
