The Composition and Demographics of the Growing Trans Population

[Justhadathought]

It seems that every week ( even as reported in just my local tabloid newspaper) the 'transitioning' population increases, and the Transgender Umbrella ( as determined by Stonewall) provides shelter for a very wide range of demographic of people.

Yet it seems to me ( would be interesting to see statistics) that apart from young women ( mainly lesbians) transitioning to male...the largest and most rapidly accelerating group is that of older 'cross dressing' males. Most often heterosexual or married, and quite often having been in, or performed, an archetypal macho or traditionally masculine role or occupation ( been in the military etc).

This is not only as evidenced by the growing number of reports in my local newspaper, but from my own observations on the street and around town: www.liverpoolecho.co.uk/news/liverpool-news/transgender-woman-agreed-cannabis-plot-17604909

Crossdressing is a fetish, a paraphilia in and of itself, statsgeek1. I am neither claiming nor believing that all these men identify as trans, nor that the transvestic fetish of all of these men includes violating women's boundaries. What I am pointing out is that the trans umbrella has grown to include crossdressers not suffering from gender dysphoria who were not previously considered to be trans. And that this might be swelling the numbers. I am surprised that with your user name you are not understanding the difference. Or that far more than just 4 to 6% of males have a paraphilia - transvestism is just one of the more common and pertinent to this debate.

As for your assertion about this being a non-problem and no rise in children identifying as trans among children in care and therefore there is nothing to worry about - when the prevalence of children with gender dysphoria is 6 in 100,000 but a single school in the UK has over 70 children with gender dysphoria and our national services for children who suffer from gender dysphoria are reporting an increase of more than a thousand percent, there is most definitely something going on. (And fyi, the social workers on the ground who are working with our children in care are also reporting an increase large enough that they are sharing their concerns across the country.)

That the absolute numbers remain small for now does not mean we can ignore this. My kid's school has gone from having no children who identify as trans just two years ago to having several. Two children I know privately are now identifying as trans, one of whom is family. I know several parents in this position (and they are not campaigners). These children are being medicalised without first receiving the necessary mental health support.

And as long as just one child is harmed in this way, I will speak out. That's what we do on Mumsnet.

By your weird reasoning, we should also not consider rapes at school to be a problem. They only affect a tiny number of children in care, after all.

To say that it’s not possible to convince someone they’re trans contradicts direct testimony by detransitioners, stats.

You’re not paying close enough attention to the social contagion taking place and being described online amongst tweens and teenagers.

Nor to the hamstringing of therapists who cannot probe why a child believes their trans, because that’s considered conversion therapy.

For some children, the idea that they were born in the wrong body is being offered up, or being grasped at, as the one-size-fits-all reason for their distress — when that distress may well instead be caused by abuse, fear of their own homosexuality, all sorts of issues within the family or school, etc.

There is something called iatrogenesis. In the 80s, it led to many mental health patients being diagnosed with multi-personality disorder. For several years, specialized inpatient MPD clinics opened and MPD therapists made a LOT of money of those so diagnosed. And several people claiming MPD diagnosis became famous, in those days before the internet, on talk shows and magazines.

Now, today, that condition is called Dissociative Identity Disorder and recognized as being extremely rare, and therapists are taught that it’s something that can be iatrogenically induced if they’re not careful in treating patients with certain issues.

If MPD can be iatrogenically induced, then yes absolutely gender identity issues, a sense of oneself in “the wrong body” can be.

And children really really want to please the adults in their lives. That’s what makes them so vulnerable.

Further, you can’t just look at the numbers of children being treated — you have to also include in that examination the extent of harm.

The extent of harm here is very very large: the Tavistock itself has documented a rise in self-harm on children placed on puberty blockers; other researchers have noted as much as a 10-point drop in IQ; endocrinologists are finding that children on puberty blockers miss the window of maturation in which the bones lay down the necessary density for adult skeletal function and now they are seeing women in their 20s with the bone-density of very elderly women — in the States, some of these women are working toward a class-action suit against the drug-maker.

100% of children on puberty blockers go on to cross-sex-hormones, and as a stats person, 100% of anything ought to give you pause. No medical diagnosis is ever 100% accurate across a population.

Once these children go from puberty blockers to cross-sex hormones, they are rendered sterile. From there: for girls: elective double mastectomy, with its risks and potential lifelong side effects and, after five years on testosterone, most likely a necessary hysterectomy and removal of ovaries due to atrophy caused by male hormones. One side effect of the T almost never mentioned is the likelihood of, from then on, extremely pain at orgasm. These are lifelong effects arising out of actions begun when the child was too young even to drive.

For boys, orchiectomy and inversion of the penis to create an opening.
Extremely strong possibility of loss of sexual response. Lifelong.

These are major harms. I can’t even begin to guess what an actuary would assign as value of these harms, were a judgment being negotiated in court. Millions of pounds.

Statsgeek - I am working on a purely anecdotal basis and that’s all I can offer! I am on the transport network a lot - ie not just a commute, working all around the city and beyond, so can be on a number of different lines each day. I am struck by how frequently I see trans women (I have only noticed trans men on occasion) and did say once or twice a month not week.

I am not counting who I consider to be non-binary (a probably reasonable response to conformative gender norms). I don’t know who is trans, who is exploring gender etc, but there does seem to me to be an increasing pattern of men who are adhering to societal expectations of what women ‘should’ wear/how ‘women’ should behave and I have noticed it day to day.

Charley,

You are right to say that the umbrella has widened in recent years to include people who would have have otherwise been described as cross dressers or having some form of fetish. That probably dose pose a problem for statistics however, the incidence of being diagnosed as transsexual as per the ICD is still very low. I am a disappointed that you claim I say there has been no rise as that is a misrepresentation of what I wrote. Whether that misrepresentation is malicious or down to a misunderstanding is likely open to debate.

I have not asserted that gender dysphoria is a non problem. The fact that we have a whole section of the NHS dedicated to medical and surgical intervention to make the lives of those with GD more bare able gives rise to the idea that it is a problem and one the UK deems worthy of treating seriously using international standards of care as a guideline. That said both the adult and child services in the UK are regarded world wide as having a very cautious approach to treatment and this in my personal opinion is in line with even now the UK still being quite a socially conservative society albeit one that is slowly dragging itself forward.

When you say children are being medicalised without mental health support that doesn't fit with what I've read on either the GIDS website or the comments of parents with trans children. Perhaps I have the wrong end of the stick but, a common experience I've read seems to be, a child presents over a long period of time with distress. Many of them seem to hide it for a long time due to the not unreasonable fear of family rejection. If and when they do speak up it is likely to result in a trip to a GP of which many will suggest waiting to see what develops. If the symptoms persist they are likely to be referred to camhs and eventually to GIDS. I believe from that referral the current wait for GIDS is between 18 months and 2 years. Quite a long time to be in severe distress in my opinion but it is what it is. Once they arrive at GIDS there is likely to be several appointments over a period of about 18 months before they are considered being seen by a pediatric endocrinologist with regards to the suitability of blockers. I am not endocrinologist or a peadiatrician so I'll leave the blocker debate to others. Personally I feel they benefit a very small number of people and have no particular opposition to their use.

Again to suggest I would infer that rape is not a problem is in my opinion a misrepresentation of my position and does a disservice to your otherwise reasoned arguments. For clarity rape is a heinous crime and the low conviction rate in the UK leaves me with a feeling of disgust. Hopefully that clears that up for you.

Bickerinbattle

I did not say it isn't possible to convince someone, I said it was unlikely. The two statements differ in their meaning but I'm glad I could clear that up for you.

You make a good point about co-morbidities and I'm personally a fan of thorough exploration of medical presentations. That is not to say that I don't believe that GD can co-exist with other conditions for example aspergers. But, having a particular condition shouldn't in my opinion be a justification to ignore GD and hope it goes away anymore than you would disregard a presentation of chest pain in a person with other conditions.

I find it difficult to believe that clinicians are telling children in the UK that they are born in the wrong body. Perhaps a FOI request to GIDS would clear that up. That's not to say somebody isn't saying it and it may well be how some children articulate their feelings at a given time. Personally that particular trope isn't for me but, then I have enough respect to take the child seriously and not rubbish or minimize their feelings at what must be a very difficult time for them.

With regards to using being trans as a cover for homosexuality I find that difficult to understand. Many trans people are in fact homosexual so it doesn't sit easily with me. Coupled with UK society seemingly being more comfortable with gay people than with trans people I personally don't subscribe to your view.

With regards to blockers i don't share your concerns but, I'm not going to advocate or speak against their use. As for 100% of children on blockers going on to cross sex hormonal treatment I suspect you a right. What I would ask though is how many are on blockers and are they only the ones who are absolutely steadfast in their belief and persistent in their presentation of GD?

You are right to say that trans healthcare can result in long term effects. I would add to that by saying for many those long term effects result in them having a quality of life that is of a far higher standard than one with the absolute misery that the dysphoria brings. As for a rise in suicidal ideation I'm not surprised. The onset of puberty for many trans people can feel like a prison sentence and is certainly thought to exacerbate the symptoms of dysphoria.

If you believe the NHS is doing harm to trans people by treating them medically and surgically perhaps they would be happy to hear from you. You may know something the experts in the field don't.

Alternatively, if we are going to base the numbers on an anecdotal report influenced by a suspicion/mistrust of trans people I'm not so sure we will get too far

It's difficult to give reliable statistics because they don't exist......even for people referred to GIDS. After treatment they fall off the radar. I learned this on attending the recent event on de-transitioners which was held in Manchester, recently. There is virtually no follow up.

Also the way self reporting on medical, and other forms, is now set up means that it is almost impossible to know who is reporting a gender identity which is in contradiction to their sex.

All we have. therefore, is anecdotal. I live in a large city. I see and come across trans people quite frequently...and this does seem to be increasing in frequency. It's got nothing to do with hatred or prejudice, just a matter of observation. Young women with beards, for example..... middle aged men dressed in female attire getting their nails painted when I'm also in the salon......A male child in a shoe shop, accompanied by female relatives, picking out girls' school shoes.....Trans people turning up outside of meetings and conferences to shout and protest; some of that number actually being invited to attend that meeting - and doing so.......staff in establishments; people on the street......Perhaps I'm just very observant because I'm a keen street photographer.

Also increasing news stories and reports in local newspapers, as well as national newspapers, to the extent that at least a couple appear every week in my local paper. Which is what motivated me to start this thread in the first instance.

The only reliable statistics will be the ones that relate to people with a GRC - but in these days of Self Id that sort of data is no longer possible to collate.

4 to 6% of the adult male population have a transvestic fetish. At the lower end of the estimate, that's about a million men across the UK. They used to be excluded from trans groups, but as they now fall under the trans umbrella, the much larger prevalence of crossdressing rather than that of transsexualism of either form (HSTS or AGP) may explain some of the increase

That is definitely my conclusion. apart from the huge rise in young women ( mainly lesbians) transitioning, it is the steady rise in male cross dressers feeling emboldened to 'come out' and to go 'full time'......

Notturningintopoweranger

I suppose our TFL experiences are different. Variety is the spice of life so it's not a bad thing.

I think you're right about noticing trans women more than men as in general the physical transition for F2M is much more successful on the surface at allowing them to go under the radar. I suspect that is to do with the power of testosterone. I still don't see many though and those that I do see are normally dressed in an effort to blend in. There has definitely been an increase in referrals for GD, personally I'm not overly concerned by that, I'd rather people get help than suffer in silence? I know that is not likely to be a popular opinion here but, it's what I have to offer I'm afraid.

Of course there are cross dressers and tranvestites around too who by their nature are trying to stand out so these do probably muddy the waters a little and I think for many that is the picture in their mind when they think of a transsexual. Of course, reality is very different.

*If you believe the NHS is doing harm to trans people by treating them medically and surgically perhaps they would be happy to hear from you. You may know something the experts in the field don't8

Yes, 'experts in the field' do know.....and there are increasing numbers of whistleblowers.Not just in Britain but across the world. There are numerous reports, and documentaries, available in which experts speak out and discuss their concerns. I mentioned an event I attended in Manchester in my previous post...at which there was a panel of experts -alongside 8 young de-transitioners.

*When you say children are being medicalised without mental health support that doesn't fit with what I've read on either the GIDS website or the comments of parents with trans children8

The GIDs pathway rejects mental health assessments, instead focusing on affirmation. what GIDS says in its promotional material, and what practitioners within GIDS say is the actual culture, are clearly two different things.

Justathought

I see an increase in visibility as positive. It means less are suffering in silence. You are also right about news stories, The Times in particular appear a bit obsessed to the point of stalking. Invariably most of the stories are click bait and paint trans people in a negative light. After all, trans woman / man gets up, goes to work and does their shopping on the way home isn't going to sell papers.

As for people falling off the radar after treatment I don't think this is unusual. Most trans people will visit their GP once a year or so post surgery to have their bloods done and have their medication titrated appropriately if required. That the majority go on to lead a reasonably happy life is supportive of them after years and years of trying other things to try and align the mind with the body they've arrived at a point where the current pathway appears to suggest they've had much more success in aligning the body to the mind.

Of course, the voice of detransitioners (ones that have been diagnosed and treated) are important ones. I'm not sure the de transition rate is any higher than any other surgical regret? The only reliable information I can find suggests it is between 1 and 2 percent. De sisters should also be heard but, to allow desisters(ones that were never diagnosed or treated) a loud voice in trying to influence the medical treatment of those that really do need it would in my opinion be unfair.

I know self Id is the subject of debate but, I didn't know that it had been passed into law? Self ID appears to have been around in name for decades. I personally don't think it should change apart from reducing the cost and changing the spousal veto to a position where neither party can keep their spouse in a marriage that they don't want to be in or foyer either party to be in a position to delay the granting of a GRC. Otherwise, I think the current system works well even if it s a bit cumbersome.

I see affirmation as believing and listening to the child rather than casting doubt on or minimizing their experience. I would be very surprised if those appointments at GIDS do not explore the child's feelings and just sit there affirming them without question. But, if you have it on good authority that is what happens then I'm not in a position to cast doubt. But, for my own peace of mind I'll make some enquiries and see if I can get it from the horses mouth.

Your information is a good five or ten years out of date, statsgeek1. The majority of children now presenting to GIDS did not experience distress for a long time, the new and entirely atypical* cohort of children presents as post-adolescents across the entire Western world.

And we wouldn't have a court case against the Tavistock alleging malpractice (including insufficient psychological support) and asking for the experimental treatment with puberty blockers and cross-sex-hormones on underage children to be stopped and we wouldn't have countless medical professionals, including a professor of evidence-based medicine stating that informed consent is not possible if what you say were true.

And no, the UK is not known for a conservative approach to gender dysphoria. As the UK has adopted a Memorandum of Understanding that holds that counselling which seeks to explore the underlying reasons for a diagnosis of gender dysphoria and to reconcile the sufferer with their body is conversion therapy, the UK unlike most countries in the world is following an affirmation model.

Having abandoned the successful Watchful Waiting approach, which seeks to minimise iatrogenic harm by delaying any medical transition, we are now in a place where children are affirmed and socially transitioned long before a diagnosis, and referred for medical transition without adequate psychological counselling.

As this is of course incredibly harmful to children, 35 psychologists have resigned from the children's service in the last three years because the affirmation model means they cannot do their jobs properly and they cannot protect their patients. That's an unusually high staff turnover, even for a high pressure environment like GIDS.

I am honestly surprised you are unaware of these developments.

*atypical in that 50+ years of research and empirical data into the condition have not only suggested a much lower prevalence rate than what is currently happening (6 in 100,000) but also atypical in the timing and manner of their first presentation.

What I have seen is a number of self described experts who hold GC views speaking very loudly against trans healthcare whilst most involved in it are quietly going about their business of trying to make lives a bit more bareable.

On the other hand if you've arrived at a point where you can confidently say you've found a better treatment pathway to relieve gender dysphoria than the present one you need to speak to somebody in a senior position in the NHS and share your revelations, they may thank you.

I saw the panel of experts in Manchester. It's constituents didn't surprise me and I wouldn't have described them as experts in trans health care. There was a conference in Rome last year that probably would have been a bit more accurately described as experts in trans health care involving clinicians and surgeons from across the world.

That is not to say de transitioners and even de sisters shouldn't be heard. They could be a very important cog in driving the satisfaction rate from 98/99% to 100%. Many areas of health care would bite off their own fingers for such a success rate.

Perhaps the lack of interest is a result of Brexit being everywhere or perhaps as a nation we've just begrudgingly become more accepting of difference.

I find this comment disingenuous given the fact that the Government has had to speak out against the culture within universities, that journalists wont tough this subject with a bargepole for fear of retribution, and that womens meetings have been met with bomb threats.

People are scared to speak out.

I won't go through all that you're failing to understand statsgeek1 except to deal with this:

So her we go, TFL says the support about 5 million journeys per day by tube. You personally see one or two trans people per week.

Exhibit A:

I see affirmation as believing and listening to the child rather than casting doubt on or minimizing their experience. I would be very surprised if those appointments at GIDS do not explore the child's feelings and just sit there affirming them without question

the questioning tends to go along the lines of " How long have you felt/realised that you were assigned the wrong sex/born in the wrong body". Affirmation without further exploration of what may be driving the distress.

Several of the young female detransitioners I mentioned spoke of how before 'they decided/realised they were trans' they had been suffering from anorexia...and how the feelings and symptoms around bodily dysphoria were exactly the same with anorexia and 'being trans'. However, none of this was explored in the GIDs interviews and sessions. It was all just positive affirmation - and literally within a few sessions they were put on treatment programmes.

I think it may be more accurate to say that the majority of trans folk are not open about their distress for a long time. Many will have a personal battle for years and the moment of opening up about their distress is often the point where they have decided that they are going to do something about it and seek help. It's not surprising that to many it's viewed as a rapid onset as for those around them it's all a surprise and very new but the person themselves has often battled it for years.

I am aware of the current case with respect to GIDS. I find it sad that people would want to take care away from such a small group of patients however, the U.K. exported its discomfort of trans people around its colonies for years, particularly to India so I suppose old habits die hard. I find it odd to request a judge has to give the okay for medical treatment. A judgement of that nature will go way beyond treating trans children and even rip up the convention of Gillick competence altogether. That would be a sad day in my opinion.

The U.K. approach to GD is certainly conservative in it's treatment and timescales. You won't find too many on the current NHS pathway getting through the service from GP referral to surgeons table in less than 5 years.

The photo is of a trans person I assume. A bit rude and disrespectful to post it but, I'm not surprised I suppose. If you don't mind me asking though, what relevance does the photo have to the incidence of trans people using the TFL network?

On the other hand if you've arrived at a point where you can confidently say you've found a better treatment pathway to relieve gender dysphoria than the present one you need to speak to somebody in a senior position in the NHS and share your revelations, they may thank you.

You've got this backwards.

The best pathway to relieving gender dysphoria in children, which is what we are discussing, is watchful waiting. We have both the empirical data and the longitudinal studies to show it works and prevents iatrogenic harm to children by maintaining their right to an open future.

There is no such data proving the efficacy of the affirmation approach, nor any longitudinal studies showing it offers a better outcome than the watchful waiting approach.

I'm not surprised at this either - the expertsat the Dutch clinic who developed the medical treatment approach that included the use of puberty blockers designed it to be used only in connection with intense counselling aiming to reconcile the child with its birth sex. That is unfortunately not what is happening.

And while this experimental treatment may be an excellent way to alleviate the stress puberty causes, it also interferes with the natural process that leads to gender dysphoria resolving in the typical cohort of children who identify as trans.

And no, it is not possible to gauge from the severity of a child's gender dysphoria whether it will grow up to identify as trans as an adult. The available research shows that children with mild cases often persist while children with severe cases often desist. Which is precisely why the watchful waiting approach was developed.

It's not surprising that to many it's viewed as a rapid onset as for those around them it's all a surprise and very new but the person themselves has often battled it for years

The 'rapid onset group' tends to be the young female transitioners......often occurring at around age 14...and frequently amongst groups of friends.....many of these girls have prior mental health issues, or have recently come out as 'lesbian'.

I think most journalists won't touch it with a barge poll because it just isn't on the radar of most people. The ones that do, Pink News excepted are generally negative with their opinions of transsexual people. That negativity at times manifests itself in their ability to stick to the facts resulting in a small apology a few days later somewhere in the corner of page 35.

That said, the GC position has a mouthpiece. They have several holding prominence in most of the national press and are regularly given a free run on Sky News often without question or challenge. I must say though, I was pleasantly surprised when Piers Morgan called out Caroline Farrow on her tweets to Mrs Green.

You are right about the girls, that is an interesting development and definitely one for research. It's like the tables have completely turned and a general increase in acceptance alone would not explain it away.

The ones that do, Pink News excepted are generally negative with their opinions of transsexual people

It is not considered neither respectful nor correct, perhaps even transphobic, to use the word 'transsexual' these days.......certainly in trans circles. I guess because it implicitly acknowledges sex.

I think we are all aware and sensitive to the very small numbers of 'genuine' severely dysphoric people for whom surgery and full medical transition was the only way they could cope.......and most of whom have a GRC.