Zhang Qi, Goodman Michael, Adams Noah, Corneil Trevor, Hashemi Leila, Kreukels Baudewijntje, Motmans Joz, Snyder Rachel, Coleman Eli
Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA.
Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada.
Int J Transgend Health. 2020 Apr 15;21(2):125-137. doi: 10.1080/26895269.2020.1753136. eCollection 2020.
High quality data pertaining to the size of the transgender and gender diverse (TGD) population are scant, however, several recently published studies may provide more reliable contemporary estimates. To summarize the estimated number and proportion of TGD individuals overall and across age groups, based on most accurate data. This systematic review focused on recent studies (published from 2009 through 2019) that utilized sound methodology in assessing the proportion of TGD people in the general population. Publications were included if they used clear definitions of TGD status, and calculated proportions based on a well-defined sampling frame. Nineteen eligible publications represented two broad categories of studies: those that used data from large health care systems; and those that identified TGD individuals from population surveys. Among health system-based studies, TGD persons were identified using relevant diagnostic codes or clinical notes. The proportions of individuals with a TGD-relevant diagnosis or other recorded evidence ranged between 17 and 33 per 100,000 enrollees. In population surveys TGD status was ascertained based on self-report with either narrow or broad definitions. The survey-based estimates were orders of magnitude higher and consistent across studies using similar definitions. When the surveys specifically inquired about 'transgender' identity, the estimates ranged from 0.3% to 0.5% among adults, and from 1.2% to 2.7% among children and adolescents. When the definition was expanded to include broader manifestations of 'gender diversity', the corresponding proportions increased to 0.5-4.5% among adults and 2.5-8.4% among children and adolescents. Upward temporal trends in the proportion of TGD people were consistently observed. Current data indicate that people who self-identify as TGD represent a sizable and increasing proportion of the general population. This proportion may differ, depending on inclusion criteria, age, and geographic location, but well-conducted studies of similar type and design tend to produce comparable results.
然而，关于跨性别者和性别多样化（TGD）人群规模的高质量数据匮乏，不过，最近发表的几项研究或许能提供更可靠的当代估计值。基于最准确的数据，总结TGD个体的总体估计数量以及各年龄组的估计数量和比例。本系统综述聚焦于近期（2009年至2019年发表）在评估普通人群中TGD人群比例时采用合理方法的研究。若出版物对TGD状态使用了明确的定义，并基于明确界定的抽样框架计算比例，则将其纳入。19篇符合条件的出版物代表了两大类研究：一类使用大型医疗保健系统的数据；另一类从人口调查中识别TGD个体。在基于医疗系统的研究中，通过相关诊断代码或临床记录来识别TGD人群。每10万名登记参与者中，有TGD相关诊断或其他记录证据的个体比例在17至33之间。在人口调查中，TGD状态是根据自我报告确定的，定义有狭义和广义之分。基于调查的估计值要高几个数量级，并且在使用类似定义的研究中是一致的。当调查专门询问“跨性别”身份时，成年人中的估计比例在0.3%至0.5%之间，儿童和青少年中的估计比例在1.2%至2.7%之间。当定义扩大到包括“性别多样化”的更广泛表现形式时，成年人中的相应比例增至0.5 - 4.5%，儿童和青少年中的相应比例增至2.5 - 8.4%。持续观察到TGD人群比例呈上升的时间趋势。当前数据表明，自我认定为TGD的人群在普通人群中占相当大且不断增加的比例。这一比例可能因纳入标准、年龄和地理位置的不同而有所差异，但类型和设计相似的精心开展的研究往往会得出可比的结果。
