Changes in Size and Demographic Composition of Transgender and Gender Non-Binary Population Receiving Care at Integrated Health Systems

Qi Zhang; Willi Rechler; Andrew Bradlyn; W Dana Flanders; Darios Getahun; Timothy L Lash; Courtney McCracken; Rebecca Nash; Leonidas Panagiotakopoulos; Douglas Roblin; David E Sandberg; Michael J Silverberg; Vin Tangpricha; Suma Vupputuri; Michael Goodman

doi:10.1016/j.eprac.2020.11.016

Changes in Size and Demographic Composition of Transgender and Gender Non-Binary Population Receiving Care at Integrated Health Systems

Endocr Pract. 2021 May;27(5):390-395. doi: 10.1016/j.eprac.2020.11.016. Epub 2020 Dec 15.

Authors

Affiliations

¹ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
² Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Emory University, School of Medicine, Atlanta, Georgia.
³ Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, Georgia.
⁴ Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California.
⁵ Emory University, School of Medicine, Atlanta, Georgia.
⁶ Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland.
⁷ Susan B. Meister Child Health and Evaluation Research Center, University of Michigan Medical School, Ann Arbor, Michigan.
⁸ Division of Research, Kaiser Permanente, Northern California, Oakland, California.
⁹ Emory University, School of Medicine, Atlanta, Georgia; The Atlanta VA Medical Center, Atlanta, Georgia.
¹⁰ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia. Electronic address: Mgoodm2@emory.edu.

PMID: 33678315
DOI: 10.1016/j.eprac.2020.11.016

Abstract

Objective: To examine temporal changes in the number and demographic composition of transgender/gender non-binary (TGNB) population using data from integrated health care systems.

Methods: Electronic health records from Kaiser Permanente health plans in Georgia and Northern and Southern California were used to identify TGNB individuals, who sought care from January 2006 to December 2014, and the data were analyzed by year, site, age, and sex assigned at birth.

Results: In 2006, the number of TGNB people (and corresponding 95% CI) per 100 000 population were 3.5 (1.9, 6.3) in Georgia, 5.5 (4.8, 6.4) in Southern California, and 17 (16, 19) in Northern California. In 2014, these frequencies increased to 38 (32, 45), 44 (42, 46), and 75 (72, 78) per 100 000 population, respectively. When analyzed by age, the most rapid increase was observed among persons 18 to 25 years old, and this increase accelerated after 2010. The ratio of transmasculine to transfeminine persons also changed from 1:1.7 in 2006 to 1:1 in 2014 overall and from 1:1 in 2006 to 1.8:1 in 2014 among persons <18 years of age.

Conclusion: This analysis confirms previous observations that the proportion of TGNB people is growing, especially among young adults. The composition of the TGNB population is also changing from predominantly transfeminine to roughly 1:1 overall and to predominantly transmasculine in children and adolescents.

Keywords: epidemiology; general endocrinology and metabolism; transgender persons.

MeSH terms

Adolescent
Adult
Child
Delivery of Health Care, Integrated*
Demography
Gender Identity
Humans
Transgender Persons*
Transsexualism*
Young Adult