A study co-written by DPhil student Morten Kjær Thomsen provides the first rigorous account of the differing characteristics of transgender individuals at the population level.
Published in Social Science & Medicine, the paper uses Denmark as a case study to investigate economic, social, educational and heath differences between three trans groups.
Using information from Danish population registers, national surveys, and medical and legal data from 2020, the paper identifies three transgender subpopulations: those who have legally changed their sex, those with trans-related medical diagnoses, and those who self-identified as transgender in a survey.
Significant differences are observed in the backgrounds, family, education, labour market characteristics, and healthcare use between these subpopulations.
Individuals who have legally changed their sex or have trans-related medical diagnoses face substantial disadvantages compared to both the general population (people aged 18-64 in January 2020) and individuals who self-identify as trans. These disadvantages include higher psychiatric hospital visits, lower educational attainment, lower annual earnings, and reduced employment rates.
For example, the average number of psychiatric visits for those with trans-related medical diagnoses was seven times that of the general population.
Controlling for educational attainment, earnings and employment rates are consistently lower for the subpopulations that have legally changed their sex or have trans-related medical diagnoses.
While 69% of the general population – and 67% of individuals who self-identified as trans in surveys – were employed, this figure was much lower for those who legally changed their sex (33%) or had trans-related medical diagnoses (29%).
Furthermore, the average annual earnings within the general population was equal to USD $56,970, a figure that was actually higher for those that self-identified as trans in surveys (USD $58,690). On the other hand, average annual earnings of the employed part of the group who had legally changed their sex was equal to USD $35,165; this was even lower for those with trans-related medical diagnoses (USD $31,044).
Individuals with trans-related medical diagnoses were also less likely to be married and less likely to have children.
Morten said:
Our study highlights the importance of using more nuanced methods to identify transgender individuals in research and policy-making, capturing the full spectrum of their experiences and needs.
This approach enables tailored support and fosters further research aimed at addressing inequalities faced by transgender individuals and populations.
The paper also notes that the method used to identify trans individuals in population data greatly impacts the characteristics observed. Survey data does not fully capture the experiences of those seeking medical or legal transitions.
Additionally, high numbers of trans individuals in surveys do not necessarily indicate high demands for gender-affirming treatments or legal sex changes.
Transgender individuals seeking gender-affirming healthcare represent a distinct and significantly disadvantaged group even compared to other transgender subpopulations.
The study notes:
Medical professionals should be aware that their trans patients are likely to face challenges that are much more substantial and inherently different from those that can be discovered in many survey studies, where responses are likely to be dominated by less disadvantaged trans individuals.
While the number of people who openly identify as transgender appears to have increased significantly in recent years in many Western countries, a substantial lack of knowledge remains about the demographic characteristics of this growing population – something this study aims to change.
The paper argues that addressing this knowledge gap is crucial – a lack of accurate data on transgender populations can lead to political neglect, and misinformed political discourse may be wrongly viewed as fact, affecting both the general public and the professional sector, who may then misunderstand the challenges faced by transgender individuals.
Additionally, the historical exclusion of transgender people in research reflects a wider societal neglect that must be addressed.
