Transgender EuroStudy – Legal Survey and Focus ... - ILGA Europe

13 April 2008
How Many Trans People are
There
There has been much speculation estimating the number of transgender and transsexual
people and the conclusion is that there is simply no publicly available statistical data on which to
make a firm statement. Estimates range from about 1 in 11,000 to as many as 1 in 20 in the male
population and the ratio between those assigned male at birth seeking gender reassignment and
those assigned female, is estimated at 3:1 (van Kesteren et al 1996). One of the problems is the criteria
by which the population is measured – those who have had surgery Those who are on hormone
replacement therapy What about trans people who do not seek medical diagnosis and treatment
What we can claim is that the evidence from this report strongly suggests that the trans population is
growing exponentially and the ratios between those assigned male and female at birth are probably
as near as 1:1. This is explored in more detail in this report.
In this research project we have endeavoured to be as inclusive as possible of different ‘types’ of
trans-identified people. However, the members of the population who seek to be reassigned 3 to their
preferred gender are the most apposite to this report as the process of undergoing gender
reassignment involves frequent contact with health service professionals. Indeed, a trans person has to
be ‘diagnosed’ as transsexual by health practitioners in order to gain access to gender reassignment
treatment. Although trans people have recently been included with the Lesbian, Gay and Bisexual
(LGB) population routinely in policy and research on ‘LGBT’ healthcare, there are differences between
the groups.
The Medicalisation of Trans
The most significant issue is that trans people (who wish to undergo gender reassignment) have
to gain access to medical treatment in order to realise their identities. This places trans people in a
position with healthcare providers which has all the hallmarks of a difficult relationship: power and
control; desire and need coupled with vulnerability; pathologisation and protocol. The findings of this
report document the consequences of this problematic configuration.
Further, transsexualism is classified as a mental disorder. This is found in the Diagnostic and
Statistical Manual (DSM) IV for the American Psychiatric Association (APA); the International
Classification of Diseases and the World Health Organisation (WHO), although it is acknowledged that
the symptoms improve with hormone treatment and surgery. The location of transsexualism in the
category of mental disorder further mars the relationship between trans patients and practitioners, as
the qualitative findings of this report illustrate.
3
Gender reassignment
refers in an indirect way
to the fact that every
person has their gender
‘assigned’ at birth –
usually by a cursory
glance at the genitals to
see if there is a presence
or absence of a penis. To
have one’s gender
‘reassigned’ means
undergoing a legal or
judicial process where
the State formally
recognises one’s ‘new’
gender. In many
European States this
process is only possible
after bodily
reassignment by
surgery.