Being transgender: what it is, how many people, what medicine says

Being trans is not a sexual orientation, but it is covered here because the questions people ask are similar: is it a choice, an illness, a fashion? How many people are concerned? Since when? What science knows, what it does not, and the words to talk about it.

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What it is

A trans person is someone whose gender identity — the inner sense of being a man, a woman, or neither — does not match the sex assigned at birth. It is not a sexual orientation (whom one desires), not cross-dressing (wearing the other sex's clothes), and not intersex (being born with atypical sex characteristics). The feeling most often appears in childhood or adolescence, sometimes later, and is stable: people who "detransition" exist — around 1 to 8% depending on the study, most often for social or family reasons — but remain a minority.

How many people

Recent surveys give 0.3 to 0.6% of adults identifying as trans (United States: 0.6%, Williams Institute 2022; England and Wales: 0.5% at the 2021 census, a figure since questioned by the statistics office; Canada: 0.33% at the 2021 census), far more than the few tens of thousands in medical care. The proportion is much higher among 18–24-year-olds (2 to 3% in the US), and the direction of transitions has reversed: until the 2000s requests came mostly from male to female; since 2010, adolescents born female are the majority in clinics, which feeds the debates about minors.

What science knows, and does not

Two researchers examine brain MRI scans on a lightbox in a laboratory
Subtle differences have been observed in some brain structures, but no single cause has been found.

No single cause has been found. Twin studies show a share of heritability; subtle differences have been observed in some brain structures and in prenatal hormone exposure; no parenting factor — not the mother, not divorce, not the internet — has been demonstrated. What is known for certain is that neither persuasion nor "conversion therapy" changes gender identity, and such therapy is banned in Canada (2022), New Zealand (2022), Victoria and the ACT, and some twenty US states; England announced a ban in 2025. The WHO removed being trans from mental disorders in ICD-11 (2019, applied since 2022), listing "gender incongruence" under sexual health; the American DSM-5 (2013) speaks of "gender dysphoria" for the distress that sometimes accompanies being trans, not for being trans itself.

A little history

Muxes in traditional Tehuana dress dance in a festive street in Juchitán, Mexico, at nightfall
The muxes of Juchitán (Oaxaca, Mexico) have been recognised as a third gender in Zapotec culture for centuries.

People who lived in the other gender exist in every era and culture — the hijras of India, the two-spirit people of North America, the muxes of Mexico, the fa'afafine of Samoa, the Chevalier d'Éon in the eighteenth century. Modern medicine begins in Berlin at Magnus Hirschfeld's Institute of Sexology, where Dora Richter (1931) and the Danish painter Lili Elbe (1930–31) had the first operations; the Nazis destroyed the institute in 1933. Christine Jorgensen, a former American soldier operated on in Denmark in 1952, made headlines worldwide; in Britain, Roberta Cowell (1951) and the model April Ashley, operated on in Casablanca in 1960, whose 1970 divorce case (Corbett v Corbett) fixed British law on sex as biological for thirty years, until the Gender Recognition Act 2004 followed the European Court of Human Rights (Goodwin, 2002). The term "transsexualism" is Harry Benjamin's (1966); "transgender" spread in the 1990s.

Children and adolescents

A multidisciplinary team of clinicians talk around a table in a hospital department
Professionals agree on one point: long, multidisciplinary follow-up, without haste and without refusal on principle.

This is the most debated point. A child who expresses a different gender identity does not transition medically: social transition (name, clothes) involves no treatment, and most pre-pubertal children who express the feeling do not keep it into adolescence (60 to 90% in older, disputed cohorts). At puberty, puberty blockers may be prescribed to "pause" development during reflection, then hormones of the claimed gender; surgery is reserved for adults almost everywhere (chest surgery from 16–17 in a few countries). The Dutch protocol that inspired all this is being re-examined: the Cass Review (April 2024) found the evidence "remarkably weak", the NHS closed the Tavistock clinic and England banned puberty blockers outside clinical trials indefinitely in December 2024; Sweden, Finland, Norway and Denmark restricted them; the Netherlands concluded in July 2026 that its outcomes were favourable; 27 US states ban all care for minors, and the Supreme Court upheld Tennessee's ban in June 2025; Canada and Australia (bar Queensland's 2025 pause) continue. Professionals agree on one point: long, multidisciplinary follow-up, without haste and without refusal on principle.

Violence and mental health

A volunteer with a headset listens closely to a call in a helpline office in the evening
Association helplines receive hundreds of reports of transphobia every year.

Trans people suffer rates of violence, harassment, unemployment and attempted suicide far above average — 40% of American trans adults report a suicide attempt in their lifetime — and these rates fall markedly with family acceptance and access to care. Galop records hundreds of transphobic hate crimes a year in the UK, where police recorded 4,700 in 2023–24. In part of the world, being trans means prison, beatings or death: the page Rights by country tours it.

The words

The section Transgender gathers the pages on rights, health, couples and dating; the page Sexual orientation deals with the neighbouring question of desire.

Sources

  1. Transidentité : prise en charge de l'adulte — Recommandations — has-sante.fr, 2025 (in French)
  2. Gender identity, England and Wales: Census 2021 — UK Government (GOV.UK), 2023
  3. How Many Adults and Youth Identify as Transgender in the United States? — williamsinstitute.law.ucla.edu, 2025
  4. Gender incongruence and transgender health in the ICD — World Health Organization (WHO), accessed 2026
  5. ICD-11 2022 release — World Health Organization (WHO), 2022
  6. New restrictions on puberty blockers — UK Government (GOV.UK), 2024
  7. The Report of the 2015 U.S. Transgender Survey — transequality.org, 2016

Official or institutional documents this page relies on, consulted on 12 October 2026. Links open in a new tab.

Page checked in . The data cited can change.

Text prepared with artificial intelligence, reviewed and checked by the AffectionPlus team (method and sources: About). This content does not replace medical or legal advice. Spotted an error? Write to us.

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