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History and Epidemiology

History 1

Evidence of TGNC people have been documented throughout history and across cultures throughout the world. The following presents a snapshot of this history:

19th Century

In 1864, Karl Ulrichs, a German writer and philosopher, ) first described the idea of a “female psyche caught in a male body.”

Early writings suggested that transgender identities were a form of homosexuality, confusing the difference between sexual orientation and gender identity.

1950s and 60s

The notion of gender confirming surgery was brought to public attention in 1952 by Christine Jorgensen, whom the New York Daily News referred to as “Ex-GI Becomes Blonde Bombshell.”

In the 1950s, John Money, Ph.D. at Johns Hopkins University described the difference between gender identity and gender role.

In the 1950s and 1960s, gender-confirming surgery was performed by a select group of surgeons, although the practice was discouraged.

Endocrinologist Harry Benjamin, M.D., published several papers throughout the 1950s and 1960s describing “transsexualism.” He was a pioneer in providing treatment and laid the foundation for what is today the World Professional Association for Transgender Health (WPATH).


Transsexualism first appeared as a psychosexual disorder in DSM-III (1980).


In the 1990s, the dichotomy of male/female was challenged, giving way to an understanding of gender spectrum. Genderqueer came into use as an identity label.

21st Century

The past 20 years have brought a greater understanding of gender as a whole. Gender-affirming therapy came into being, though the area is still in its infancy as a field of study.

In 2013, DSM-5 was published; changing the diagnosis to gender dysphoria.

  • Being TGNC is not pathological. Gender variance is a human variant just as sexual orientation. The diagnosis of gender dysphoria gives patients access to care.
  • Dysphoric symptoms include the reaction to one’s body not matching the mind.

Epidemiology 2

It is difficult to obtain accurate information on the number of TGNC people residing in the United States. This is similar to the difficulty faced in estimating the number of LGB people within the U.S. Attempts to obtain such population estimates are hampered by variation in the ways researchers categorize TGNC individuals, the variety of ways in which TGNC individuals identify themselves, the sampling methods used, and the discomfort that that many TGNC may feel about openly identifying as such on a survey.

Despite these limitations, it is estimated that 0.6% of the U.S population aged 18 and up identifies as transgender (Flores et al, 2017).


  1. Group for the Advancement of Psychiatry
  2. WPATH Standards of Care, Version 7

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