Increase in the number of people identifying as transgender in the UK - UCL research from GP records

[IwantToRetire]

The research, published in BMJ Medicine, is the first large-scale study in the UK to estimate the number of people whose gender identity is different to their sex assigned at birth.

To do this, the team reviewed anonymised data from 7 million individuals aged 10 to 99 years, from IQVIA Medical Research Data, a UK primary care database, between 2000 and 2018.

Researchers looked for diagnostic codes that suggested patients had spoken to their GP about gender dysphoria (a state of stress or unhappiness that one’s gender does not match their sex at birth).

They found that overall, the number of people whose records suggested they were transgender was very low. However, there was nevertheless an increase over the last two decades – rising from about one in 15,000 in 2000, to just over one in 2,500 in 2018.

The number of individuals with a health record of being transgender increased in all age groups.

Rates were highest amongst people aged 16 to 29. In 2018, around one in every 2,200 people aged 16 to 29 were recorded as transgender.

https://www.ucl.ac.uk/news/2023/nov/increase-number-people-identifying-transgender-uk

Not really surprising given current social contagion, but as a study presumably it will be widely quoted to prove any number of things.

Not forgetting that "overall, the number of people whose records suggested they were transgender was very low"

Not a bad guess FlowerBarrow:

How common is gender dysphoria?

According to the DSM-5, among individuals who are assigned male at birth, approximately 0.005 percent to 0.014 percent are later diagnosed with gender dysphoria. Among individuals who are assigned female at birth, approximately 0.002 percent to 0.003 percent are later diagnosed with gender dysphoria. Because these estimates are based on the number of people who seek formal treatment—including hormone therapy and gender confirmation surgery—these rates are likely an underestimate.

Those numbers would be heavily contested now because gender dysphoria has become an umbrella term and these days is pretty much something that one can self-identify into.

But you have to think. If, say, the prevalence of meaningful gender dysphoria is 0.01%, and the prevalence of "trans" is 0.5%, then only 2 trans people out of a 100 have meaningful gender dysphoria. What about the other 98?

Or even people whose personality doesn't match their height.

I have a tall personality. I struggle with being short because people don't see the true me. They react to me badly because i don't meet their expectations of short people, but if they saw my true tall self they would accept me.

I need to be accomodated by tall women's clothes shops stocking 28" leg trousers, getting the front seat in the because I need the extra legroom. Also as a tall person I expect to earn 5% more than my shorter peers, so I need transheight opportunities at work.

Once the researchers have isolated the set of people who meet their conditions for being transgender, they go on to look at the codes for the treatment received to try to determine which members of the cohort might be male to female or female to male.

Couldn't this same treatment data be used to determine the subset of people who went on to things like puberty blockers, cross sex hormones or surgery?

This approach would give some indication as to how many of the group solely socially transitioned or changed their minds.

I used to once know about the high level nhs datasets but that was a while ago. But there might be restrictions on doing too much cross-referencing as that may lead to the data becoming identifiable.

It would be useful to have breakdowns by whether people were/are 'looked after children'.

Matthews, T., Holt, V., Sahin, S., Taylor, A. and Griksaitis, D., 2019. Gender Dysphoria in looked-after and adopted young people in a gender identity development service. Clinical Child Psychology and Psychiatry, 24(1), pp.112-128.

https://journals.sagepub.com/doi/10.1177/1359104518791657?

There's currently a steady year-on-year increase in 'looked after children' (which includes unaccompanied young refugees/asylum seekers).

https://www.communitycare.co.uk/2023/11/20/15th-rise-in-care-population-england/

@RethinkingLife Is your thought here that transgender identifying children are more likely to be fleeing persecution in the original countries and so represent a higher percentage within the Refugee population?

The follow on question would be - are these numbers big enough to skew the statistics when added to the general UK population?

I wasn't thinking that this "research" would provide proper answers as it is based on (as others have pointed out) records that are not kept in a consistent way.

And quite honeslty given how haphazards record keeping is in the NHS, ie every 3 months lets start another online / compuerised service, I cant think that there will be a rush to agree a method of recording this.

Added to which, as has already been said, this only represents those who actually talked to a doctor rather than all those who just "identify" as part of their social grouping.

But it did start me thinking that maybe it is time that we are able to talk about gender identity as a social practice, and gender dysphoria as a medical condition that might need support from health professionals.

The article uncritically refers to the % of trans identified people in the recent census. I know it can take time for research articles to get published so maybe it's not entirely their fault, but by now the BMJ and researchers must know that's a discredited statistic and the National Statistics Office have had to review it. The NSO put out a rather pathetic defence but it was hardly convincing, and if the researchers were without bias they would have taken note that the census data isn't robust.

There are no codes for desistance/detransiton. You could make the code 'inactive' but ime that will not consistently have happened. You can search on gender codes and then look for interventions but you miss the ones on referral waiting lists. If they change their NHS gender marker, and redact notes, then it becomes really difficult - a man taking testosterone or a woman oestrogen is not uncommon. A patient getting private treatment with no shared care will not appear on gp list if they didn't ever present to gp or weren't coded when they did (particularly relevant for <18yos).

It is time consuming manual work and only realistic at practice not population scale.