Systematic Review and Meta-Analysis of Worldwide Prevalence Estimates of Transgenderism and Gender Non-Conformity Open Access

Collin, Lindsay Jane (2015)

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BACKGROUND: Evidence-based care of transgender persons requires better data on the prevalence of transgenderism and gender non-conformity in the general population.. We conducted a systematic review and meta-analysis of the current state-of the science on prevalence estimates the effects of various definitions, methodological study characteristics, and differences across countries.

METHODS: PubMed, Embase and Medline were searched to identify relevant studies. We evaluated studies reporting prevalence estimates of transgenderism and grouped them based on the case definition applied to the numerator. Summary estimates were derived using a random-effects model. Overall and stratum-specific meta-prevalence estimates (mPs) and 95% confidence intervals (CIs) were accompanied by tests for heterogeneity, and meta-regressions to assess possible sources of heterogeneity.

RESULTS: A total of 29 studies met the inclusion criteria for the systematic review and a further 24 studies provided necessary data summary analyses produced overall mP estimates for total transgender prevalence, and for male-to-female (MTF) and female-to-male (FTM) prevalence estimates. Overall mP for studies reporting gender confirmation therapy was 13.0 (95% CI, 0.4-24.7) and among transgender-related diagnoses 6.7 (95% CI, 4.5-9.0). Significant heterogeneity was observed across both of these groups (I2 >99.9%, p < 0.01). Among studies reporting gender non-conformity the mP was 453 (95% CI, 381-525) with I2 of <1% . Similar results were observed for MTF and FTM prevalence estimates in each of the groups.

CONCLUSIONS: The literature on prevalence of transgenderism highlights the importance of adhering to specific case definitions because the results may range several hundred-fold depending on how the numerator was ascertained.

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