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Zhang Q, Rechler W, Bradlyn A, Flanders WD, Getahun D, Lash TL, McCracken C, Nash R, Panagiotakopoulos L, Roblin D, Sandberg DE, Silverberg MJ, Tangpricha V, Vupputuri S, Goodman M. Changes in Size and Demographic Composition of Transgender and Gender Non-Binary Population Receiving Care at Integrated Health Systems. Endocr Pract 2021; 27:390-395. [PMID: 33678315 DOI: 10.1016/j.eprac.2020.11.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/04/2020] [Accepted: 11/15/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine temporal changes in the number and demographic composition of transgender/gender non-binary (TGNB) population using data from integrated health care systems. METHODS Electronic health records from Kaiser Permanente health plans in Georgia and Northern and Southern California were used to identify TGNB individuals, who sought care from January 2006 to December 2014, and the data were analyzed by year, site, age, and sex assigned at birth. RESULTS In 2006, the number of TGNB people (and corresponding 95% CI) per 100 000 population were 3.5 (1.9, 6.3) in Georgia, 5.5 (4.8, 6.4) in Southern California, and 17 (16, 19) in Northern California. In 2014, these frequencies increased to 38 (32, 45), 44 (42, 46), and 75 (72, 78) per 100 000 population, respectively. When analyzed by age, the most rapid increase was observed among persons 18 to 25 years old, and this increase accelerated after 2010. The ratio of transmasculine to transfeminine persons also changed from 1:1.7 in 2006 to 1:1 in 2014 overall and from 1:1 in 2006 to 1.8:1 in 2014 among persons <18 years of age. CONCLUSION This analysis confirms previous observations that the proportion of TGNB people is growing, especially among young adults. The composition of the TGNB population is also changing from predominantly transfeminine to roughly 1:1 overall and to predominantly transmasculine in children and adolescents.
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Affiliation(s)
- Qi Zhang
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Willi Rechler
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Emory University, School of Medicine, Atlanta, Georgia
| | - Andrew Bradlyn
- Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, Georgia
| | - W Dana Flanders
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Darios Getahun
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Courtney McCracken
- Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, Georgia
| | - Rebecca Nash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Douglas Roblin
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland
| | - David E Sandberg
- Susan B. Meister Child Health and Evaluation Research Center, University of Michigan Medical School, Ann Arbor, Michigan
| | - Michael J Silverberg
- Division of Research, Kaiser Permanente, Northern California, Oakland, California
| | - Vin Tangpricha
- Emory University, School of Medicine, Atlanta, Georgia; The Atlanta VA Medical Center, Atlanta, Georgia
| | - Suma Vupputuri
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland
| | - Michael Goodman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
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