Chapter 1A History of Trans, a Canadian Perspective

by Micheline Johnson

Links to sources are contained in the superscripted references*.Superscripts W, X, Y, Z etc are reused in each paragraph.

To return to a link to a Bookmark after clicking that link, press Alt+Left-Arrow.* Seeing the source address (URL) and viewing the source article requires a computer.

Update: 2017-12-12Version: v4

This article was originally intended to be part of a history of transsexual and transgendered people in the Ottawa area. But knowledge about and services to T-people, before the days of the Internet, was only available from sources over a much wider area, so I have expanded the scope to include Canada in general. The words are mostly from Wikipedia. I just do the editing.

It was originally written anonymously, but as an octogenarian, what can they do to me now. It is time for me to be open about my own experience transitioning, and to summarize the change in the trans landscape in general, not just over the centuries, but over the last few decades.

It was originally written as a single article, but because of hardware/software limitations, it has had to be broken up into smaller chunks (chapters) that my computer can handle. Links between chapters and back again (Alt+Left-arrow) still work. It is still a work in progress.

ContentsChapter 1

WhyWhoTerminologyPrevalenceAcceptance

Chapter 2Trans People through History

Chapter 3Trans Achievers

Chapter 4Trans Characters in the Arts

Chapter 5Transition Options

Chapter 6Psychiatric Support

Chapter 7Surgical Support

Chapter 8 Peer-Support

Political and Legal Support – add to Chapter 1

Trans BibliographyAppendices

Appendix A, WPATH Standards of CareAppendix B, APA, DSMAppendix C, WHO, ICD

WhyToday most people who are trans, wish for the change because they are gender dysphoric. Historically, many women chose a male role, not because of gender identity, but because their chosen profession did not allow women, for example: pope, soldiers, doctors . . . Others were forced into a trans role by their superiors (eg Sporus for Nero), and for many other reasons. In many Islamic countries such as Afghanistan, Pakistan, Turkistan, women are not allowed to dance in public.In Turkestan in 1872 boys and youths were specially trained to take the place of the dancing-girls of other countries.In Afghanistan women are not allowed to dance in public, but boys can be made to dance in women's clothing.In Shakespeare’s day women could not appear on stage publicly, and it was only with the accession of Charles II in 1660 that the position changed. Professional theatre troupes in Renaissance England included male actors only, so that the roles of, for instance, Juliet, Rosalind, Lady Macbeth, and Cleopatra were first played by boys X, Y.Some (1% of births), for various reasons, are inter-sex, of which many receive surgery to “normalize” their genital appearance.

Who

I used to think that a large proportion of trans people were smarter, better educated, and/or of higher IQ than the average person. I now think that this bias was because of where I was meeting Trans people (educational support groups before the Internet), and what I was reading. Educated people publish more than uneducated people. That is why you find few working class people in the history books.Zagria indexes Trans people by profession. These lists suggest that Trans people come from all walks of life W. Havelock Ellis (1928) pointed out that eonists were often unusually gifted. Loers & Schultz (1963) pointed out that intellectual subnormality was not uncommon among transvestites. But most authors believe that transvestites/transsexuals show a normal variation in intellectual capacity.Jan Wålinder (1967) found that of 73 Trans women found in the literature where intellectual capacity was included:

13 (18%) had an IQ below 85,46 (63%) had an IQ between 85 and 115,14 (19%) had an IQ above 115,

thus they were distributed normally T. Gay/Trans and correlation to higher IQ, starting 04 Jan 2015, included U:

 nmi987….LA/SF/NY, which have major gay/trans communities, are the most expensive places to live in US. Does being Gay or Trans correlate with higher IQ and income?TurtleTapeI would say any correlation is due to the trend of educated people being more liberal and accepting of alternative lifestyles. A black rural gay man who dropped out of college is statistically much less likely to come out, even in a survey, than a white middle class gay man who completed grad school, for example.

The thread then got pretty heated, this part has been deleted, but the following seems worth quoting:soontobekate Well the theory that I have heard is that it takes a certain amount of intelligent introspection to realise that you are trans. The side theory to this is that people who aren't smart enough to figure it out sink into depression/alcoholism/drugs because they cant deal with the dysphoria.There is also a correlation between trans and autistic spectrum disorders.. . . . . . SoonToBeAlyssa sighI don't even know why I'm bothering... Explain in your own words what that study is saying. The results are interesting, sure. But irrelevant to your initial argument of intelligence between the sexes.Brain volume is irrelevant to intelligence or IQ as you assert. SURFACE AREA is what's important. It's called gyrification. That's why a brain looks wrinkly. A test carried out in 2008 bears this out. The results were that men had bigger brains, but females had wrinklier brains. They took a baseline of IQ, age, and surface area. The results were r=.51, P<.001. Of course, there are obvious problems with this test, too. For instance, when averaging curvature values from the brain scans, they used a geodesic distance of 3mm, then used a smoothing filter to interpolate. They should have used a smaller initial measurement, but I'm not sure of the effect that would have had on computation time. Maybe that was the limiting factor. But you end up with the Coastling Paradox as it applies to the brain surface. The authors acknowledge the limitations of their findings nevertheless, and even state in their conclusion:Thus, we believe that other micro-anatomical characteristics (possibly in addition to changes in neuronal numbers) need to be considered as the link between intelligence measures and cerebral macro-anatomy. For example, the regional degree and pattern of the convolution of the cortex has been suggested to reflect regional interconnectivity or neuronal circuitry.Another article (Citation 56) shows that females tend to have greater brain gyrification in some areas, and thus, similar surface areas to males. But as we saw in the earlier test, that might not mean all that much in the grand scheme of things.Unfortunately, there haven't been any studies I could find that indicated whether HRT affected gyrification. But it also might not matter. It seems that in the end, neuron count is a large factor. In fact, in direct contradiction to your linked article, Zhou, Hofman, Gooren, and Swaab chose to look at brains slices and neuronal counts from transgendered people, cis males, and cis females. Brain size DID vary as you noted. Crucially, this effect also does not appear to be due to HRT. First, several of the transsexual women had ceased HRT several years before death and their BSTc volumes were not different from those of the other transsexual women. Second, the subject pool included cissexual men and cissexual women whose adult hormones had changed (e.g., orchidectomy, menopause, adrenal tumors) and their BSTc volumes were in the cissexual male and cissexual female ranges, respectively. A second study 5 years later cited further in the article also found the same results. And even more interestingly, this second study also included the brain from a man who had gender dysphoria but never transitioned or had HRT. His SOM BSTc neuron numbers were in the same range as post-transition transsexual women and cissexual women.Recently, studies have shown that meditation increases gyrification. Interesting.This has been a very brief meta-analysis of several brain-based studies, but the conclusion appears to be that: Men and women have different brains, but no measurable difference in overall intelligence despite measurable differences in specific areas of

reasoning. Despite physical differences in brain size and gyrification, there's little agreement that correlation implies causation. Some studies show the

exact opposite. Human thought patterns appear to have a distinct measurable effect on the brain. If a male identifies and thinks like a female, then his brain

tends to trend towards female proportions regardless of hormones.It's pretty interesting. I had never looked that deep into it before. It just goes to show what anecdotal evidence has pointed to all along: You like what you like, you know what you know, and the only thing that seems to change with HRT is how you feel about it.nmi987[S] summary: there is a correlation between being gay/trans and IQ. there is also a correlation between IQ and cross-gender hormones.there is no question that correlation exists. the question is the amount. could be significant, or could be insignificant.SoonToBeAlyssa At least take a few more minutes before you respond so people think you bothered to read any of the cited studies.I looked through everything you cited. Nothing there implies increased intelligence among the trans community. So I googled it. Nothing. There was ONE Wordpress (that's how you know it's very scientific and unbiased) article that attempted to show a correlation. Their conclusion was that socioeconomic factors played a larger role in that people who had more resources or confidence in their ability to obtain enough resources to transition with minimal social and economic hardship transitioned whereas those without the means or the confidence in obtaining the means tended to not transition and keep their feelings closeted.For that matter, one of the most-cited studies showing high correlation between homosexuality and intelligence was underwritten by the same "scientist" that suggested there's scientific proof that black women are less attractive. Perhaps their scientific method isn't the most... scrupulous. Other studies that purported to show that homosexuals tend to have more education and make more money (and thus must be smarter, right?) don't account for things like personal work ethic because of a predisposition to overcome challenges. One article notes:

Gays born into small towns—which tend toward homophobia—understand early on that they must escape in order to find acceptance. For LGBT youths, escape usually hinges on two all-important factors: good grades and money. When excelling in school and making money are the only escape hatch to happiness, hitting the books and working overtime have a lot more appeal.And while we're discussing homosexuality and intelligence, a study more recent than your 53-year old study suggests there is no difference in IQ dependent on sexual orientation.Don't get me wrong... if something motivates you to do better, then great. But I haven't seen any evidence that is the least bit credible to back up any of your claims despite my Google searching and report reading.

TurtleTape makes an interesting comment: “ I would say any correlation [between LBGT and with higher IQ and income] is due to the trend of educated people being more liberal and accepting of alternative lifestyles. A black rural gay man who dropped out of college is statistically much less likely to come out, even in a survey, than a white middle class gay man who completed grad school, for example.” However, the stats do not bear this out. Flores et al (Williams Institute, Oct 2016) V, found that:

66% of the general US population and 55% of its transgender community, are white, non-Hispanic, 12% of the general US population and 16% of its transgender community, are African-American or black, non-Hispanic, 15% of the general US population and 21% of its transgender community, are Hispanic or Latino,8% of the general US population and 8% of its transgender community, are of other race or ethnicity, non-Hispanic.

LGBT individuals are more likely to be non-white than white, and the majority of transgender people report transitioning before the age of 44. Transgender individuals are also four times more likely than the rest of America to make less than $10,000 per year, according to a 2012 report from two LGBT civil rights groups, The National Center for Transgender Equality and the National Gay and Lesbian Task Force W, X.

So, what is a Trans,A History of TerminologyTrans, in the context of this article, is a collective term encompassing anyone who wants to or went through a transition. It can encompass transsexual, transgender. Today it as used to describe someone who feels that they are not the same gender (= sex) as the physical body they were born with, or who does not fit easily into being either a male or a female, such as a trans woman or trans man X. It may refer or relate to people whose sense of personal identity and gender does not correspond with their birth sex Y. These terms have changed and evolved over the years.

Uranian is a 19th-century term that referred to a person of a third sex—originally, someone with "a female psyche in a male body" who is sexually attracted to men, and later extended to cover homosexual gender variant females, and a number of other sexual types. It is believed to be an English adaptation of the German word Urning, which was first published by activist Karl Heinrich Ulrichs (1825–95) in a series of five booklets (1864–65) which were collected under the title Forschungen über das Räthsel der mannmännlichen Liebe ("Research into the Riddle of Man-Male Love"). Ulrichs developed his terminology before the first public use of the term "homosexual", which appeared in 1869 in a pamphlet published anonymously by Karl-Maria Kertbeny (1824–82). The word Uranian (Urning) was derived by Ulrichs from the Greek goddess Aphrodite Urania, who was created out of the god Uranus' testicles. Therefore, it stands for homosexual gender, while Aphrodite Dionea (Dioning) represents the heterosexual gender.The term "Uranian" was quickly adopted by English-language advocates of homosexual emancipation in the Victorian era, such as Edward Carpenter and John Addington Symonds, who used it to describe a comradely love that would bring about true democracy, uniting the "estranged ranks of society" and breaking down class and gender barriers. Oscar Wilde wrote to Robert Ross in an undated letter (?18 February 1898): "To have altered my life would have been to have admitted that Uranian love is ignoble. I hold it to be noble - more noble than other forms" X.

In the early 20th century, Havelock Ellis (1859 –1939), an English physician, writer, progressive intellectual and social reformer, studied human sexuality. Ellis studied what today are called transgender phenomena. Together with Magnus Hirschfeld, Havelock Ellis is considered a major figure in the history of sexology to establish a new category that was separate and distinct from homosexuality. Aware of Hirschfeld's studies of transvestism, but disagreeing with his terminology, in 1913 Ellis proposed the term sexo-aesthetic inversion to describe the phenomenon. In 1920 he coined the term eonism, which he derived from the name of a historical figure, Chevalier d'Eon.

'Transvestite' originated in 1910 from the German sexologist Magnus Hirschfeld, who would later develop the Berlin Institute where the very first 'sex change' operations took place. 'Transsexual' was not coined until 1949 [1923 by Hirschfeld, see below], 'transgender' not until 1971, and 'trans' (a very British term) not until 1996. According to the Oxford English Dictionary, the first use of 'androgyne' was recorded in 1552, but it has only been in the last 10 years that people have claimed it for themselves to describe a state of being in-between, or having both genders. 'Polygender' is a late 1990s Californian invention used to describe a state of being multiple genders X. The sexual physician Dr. Levy-Lenz, who joined Hirschfeld's Institute for Sexual Research in 1925, used the term “transvestite” for a trans person at that time.

In 1923, recognizing some of the differences from transvestites, Magnus Hirschfeld introduces the term "transsexual" X.

Transgender people are people who have a gender identity or gender expression that differs from their assigned sex. Transgender people are sometimes called transsexual if they desire medical assistance to transition from one sex to another.

The term transsexual was introduced to English in 1949 by David Oliver Cauldwell. Benjamin first used the term transsexualism in a December 1953 symposium held by the Association for Advancement of Psychotherapy X. He later popularized the term in 1966 around the same time transgender was coined and began to be popularized. Since the 1990s, transsexual has generally been used to describe the subset of transgender people who desire to transition permanently to the gender with which they identify and who seek medical assistance (for example, sex reassignment surgery) with this. However, the concerns of the two groups are sometimes different; for example, transsexual men and women who can pay for medical treatments (or who have institutional coverage for their treatment) are likely to be concerned with medical privacy and establishing a durable legal status as their gender later in life Y.

In 1965, psychiatrist John F. Oliven of Columbia University coined the term transgender in his reference work Sexual Hygiene and Pathology, where he uses it is to mean transsexualism, writing that the term which had previously been used, transsexualism, "is misleading; actually, 'transgenderism' is meant, because sexuality is not a major factor in primary transvestism."

The term transgender was then popularized with varying definitions by various transgender, transsexual, and transvestite people, including Virginia Prince, who used it in the December 1969 issue of Transvestia, a national magazine for cross dressers she founded. By the mid-1970s both trans-gender and trans people were in use as umbrella terms, and 'transgenderist' was used to describe people who wanted to live cross-gender without sex reassignment surgery (SRS).

In 1966, in Baltimore, USA, the term 'gender identity' is first used in a press release, 21st November 1966, to publicize a new clinic for transsexuals at The Johns Hopkins Hospital in Baltimore, Maryland. The concept is picked up by the media, and quickly becomes common currency around the world X.

Distinctions between the terms transgender and transsexual are commonly based on distinctions between gender (psychological, social) and sex (physical). Hence, transsexuality may be said to deal more with physical aspects of one's sex, while transgender considerations deal more with one's psychological gender disposition or predisposition, as well as the related social expectations that may accompany a given gender role. Many transgender people prefer the designation transgender and reject transsexual. For example, Christine Jorgensen publicly rejected transsexual in 1979, and instead identified herself in newsprint as trans-gender, saying, "gender doesn't have to do with bed partners, it has to do with identity." This refers to the concern that transsexual implies something to do with sexuality, when it is actually about gender identity. Some transsexual people, however, object to being included in the transgender umbrella. The definitions of both terms have historically been variable X.

In 2005, I was asked (I think by the Police Liaison Committee) to define some of the terms used in the Trans Community. In reply, I wrote the following, which is now rather dated, but which indicates the terms used at that time:

SexYour Biological sex is determined by your chromosomes. A person with Female biological sex has XX chromosomes. A person with Male biological sex has XY chromosomes. Those with other combinations of chromosomes are termed of Inter-sex. Typically, these have XXY chromosomes (Klinefelter syndrome) or variations thereof. Such persons often have characteristics of both sexes, and may be hermaphroditic.

In practice, your Legal sex is the sex you are Assigned at birth, based on the appearance of the child’s genitalia (not on its chromosomes) which is then recorded on a birth certificate. If the genitalia are ambiguous, many doctors will surgically modify the genitalia, with the intention of simplifying the child’s later life. Often, they arbitrarily choose to feminize the child because the surgery is simpler, without waiting for the child to grow and develop its own gender identity.

Your Medical sex is usually determined by your genital ability (not your desire) to penetrate or be penetrated. If your genitalia are surgically modified to reverse this ability, then the state (with a doctor’s certification to this effect) will usually, in most western societies, change your legal sexual status, and modify documents such as a birth certificate, a citizenship card, a passport, and/or a driving license.

Those who choose not to have sex are termed Asexuals, but they still have a biological, legal and a medical sex.

GenderGender Identity is a person's concept of him/herself as being masculine or feminine, or ambivalent, usually based on physical characteristics, parental attitudes and expectations, and psychological and social pressures [www.mercksource.com]. However, in the case of a transsexual, the internal concept contradicts the external indicators. It is the private experience of gender role. Note that male and female are terms denoting sex, whereas masculine and feminine are terms denoting gender and gender identity.

Gender Role refers to your public behaviour, and whether it fits the more typical behaviour of a man or a woman. It includes things such as decorum, as well as modes of dress.

Transgender people are individuals whose gender expression and/or gender identity differs from conventional expectations based on the physical sex they were born into, and who do not believe that they should be bound by the traditional concepts of masculinity or femininity. The word transgender is an umbrella term which is often used to describe a wide range of identities and experiences, including: FTMs, MTFs, cross-dressers, drag queens, drag kings, gender queers, and many more X .

Gender Expression is everything we do that communicates our gender role. Gender expression comes in many forms and for many reasons.

A Cross Dresser is a person who dresses occasionally in clothing appropriate to people of the opposite sex. Unlike a transsexual, a cross-dresser has no desire to live full-time in this mode.

A Transvestite is one who acts and dresses in the clothes of the opposite sex for reasons of sexual gratification.

A Drag Queen or Drag King is one who wears clothes and makeup, usually exaggerated, to represent characters of the opposite sex, for the purposes of entertainment.

A Female or Male Impersonator is usually a stage or film entertainer who acts, usually in a more realistic manner than in drag, a person or series of persons of the opposite sex.

In the Sex Trade, a male prostitute will sometimes cross-dress or female-impersonate, in order to make the client (the john) feel more comfortable and able to convince themselves that they are not acting in a homosexual way.

In Gender Fuck, a person cross-dresses without trying to be convincing, for example a bearded man in a dress, usually in order to shock the public. Gender Fuck is a gender performance which "fucks with" or plays with traditional gender identities, gender roles, and gender presentation [Wikipedia].

Androgyny is the state of indeterminate gender. It was once used to denote the state of having both male and female traits. Its current usage is to

denote a form of gender expression presenting both masculine and feminine attributes representing a mixed gender identity. It is usually hard to tell whether an androgyne is male or female.

Some Genderqueer people believe they are a little of both of the traditional genders or think they have no gender at all. Others view gender, not as binary system, but as a continuum, with the two traditional genders at the two poles and their place as somewhere within the continuum, while others believe there are as many genders as there are people. Still others believe that gender is a social construct, and choose not to adhere to that construct [Wikipedia].

Two-Spirit is a term that in most Native American and Canadian First Nations peoples implies a masculine spirit and a feminine spirit living in the same body. It is also used by gay, lesbian, bisexual, transgender, and intersex Native Americans to describe themselves. Their dress is usually a mixture of traditionally male and traditionally female articles. The old term "berdache" is a generic term used primarily by anthropologists and is frequently rejected as inappropriate and offensive by Native Americans. It has widely been replaced with two-spirit. Two-spirited individuals perform specific social functions in their communities. Some are counselors while others are medicine persons or spiritual functionaries. They study skills including storytelling, theater, magic, hypnotism, healing, herbal medicine, ventriloquism, singing, music and dance [Wikipedia].

OrientationSexual Orientation refers to the sex to which you are most frequently sexually attracted, regardless of gender role or gender expression. Heterosexual Orientation refers to couples of the opposite sex being attracted to one another. Homosexual Orientation (gays and lesbians) refers to a person who is primarily attracted to persons of the same sex. A Bisexual person is someone who can be attracted to persons of either sex. GLBT (gay, lesbian, bisexual, transgender) is an umbrella abbreviation covering all types of sexual and genderal orientations. Some lesbian couples adopt Butch and Femme gender roles. This phenomenon is less common amongst gay men. Defining orientation is more complicated when applied to transsexual couples or when one partner is transsexual. Transsexuals themselves tend to define their orientation in terms of their gender identity rather in terms of their present or former legal sex.

TransitionTranssexuals are people (about 1% of the population) in whom their gender identity does not match their assigned sex, and they are more comfortable in the opposite gender role. Psychological methods to reverse gender identity usually do not work. Religion is sometimes used to convince the person of the error of their ways. But the most effective method of treating people with Gender Dysphoria, that pioneered by Harry Benjamin, is not to try and reverse the gender identity to correspond with the sex, but to reverse the medical sex by surgery thus allowing a legal sex change to correspond with the gender identity.

There is debate as to whether a transsexual is only one who is undergoing the transition, and whether one who has undergone such a transition, and has changed legal status, is still a transsexual.

To distinguish between those who start one way, and those that come from the opposite direction, the terms Male to Female (abbreviated MTF or MtF) and Female to Male (abbreviated FTM or FtM) are commonly used to indicate the direction of transition. Hospitals commonly use the terminology Born Female or Born Male.

FTMs seek to not only appear to be men, but to be accepted as and treated as men. Likewise, MTFs seek not only to appear to be women, but to be accepted as and treated as women. Looking like a convincing man or woman is not always possible, since there are some things, like depth of voice, height (too tall or too short), and bone structure (hips, shoulders, hands), that cannot easily be changed by surgery. But for most transsexuals, being accepted in the society of your choice is the most important thing for your happiness. For some, being able to function sexually in your chosen role, is important. For others, cosmetic sexual appearance is sufficient, allowing one, for example, to shower in the swimming pool change room corresponding to your gender identity.

Real Life Test (RLT) is a period of time in which a transsexual person is required to live full time in the role of the sex they identify with before the medical community will begin the medical gender reassignment process (hormones, surgery). The RLT is required under the Harry Benjamin Standards of Care, but other Standards of Care do not require a RLT or may use discretion in determining the length of a RLT.

Today (2017), terminology has evolved.The term Trans encompasses both transsexuals and transgenderists.The terms Trans Men and Trans Women have replaced FtM and MtF transsexuals.Genital surgery has gone through a number of different names:

Sex Reassignment Surgery (SRS)Gender Reassignment Surgery (GRS)Genital Reconstruction Surgery (GRS)

and is now called Gender Confirming Surgery (GCS).

How Many Trans Persons are there?CanadaThe article Sex and Gender Diversity among Transgender Persons in Ontario, Canada, results from a respondent-driven sampling survey, April 24, 2014 5 , says “Recent estimates suggest that as many as 1 in 200 adults may be trans (transgender, transsexual, or transitioned),” ie 0.5%. This is close to the 0.6% found in the US by Flores et al below. As of Aug 2017, the population of Canada is said to be 36,663,415 6, so there are currently some 183,000 adult TG persons across Canada.

The Trans PULSE community- based research project surveyed trans Ontarians (n=433) in 2009–2010 using respondent- driven sampling. Frequencies were weighted by recruitment probability to produce estimates for the networked Ontario trans population. An estimated 30% of trans Ontarians were living their day-to-day lives in their birth gender, and 23% were living in their felt gender with no medical intervention. In all, 42% were using hormones, while 15% of male-to-female spectrum persons had undergone vaginoplasty and 0.4% of female-to-male spectrum persons had had phalloplasty. Of those living in their felt gender, 59% had begun to do so within the past four years. A minority of trans Ontarians reported a linear transition from one sex to another, yet such a trajectory is often assumed to be the norm.

USAIn How Frequently Does Transsexualism Occur? by Lynn Conway, original article posted on January 30, 2001, updated version posted on December 17, 2002 X, Conway found (Abstract):

In this investigative report we calculate an approximate value of the lower bound of the prevalence of male-to-female (MtF) transsexualism in the United States, based on estimates of the numbers of sex reassignment surgeries performed on U.S. residents during the past four decades. We find that the prevalence of SRS is at least on the order of 1:2500, and may be twice that value. We thus find that the intrinsic prevalence of MtF transsexualism must be on the order of ~1:500 and may be even larger than that. We show that these results are consistent with studies of TS prevalence emerging in recent studies in other countries. Our results stand is sharp contrast to the value of prevalence (1:30,000) so oft-quoted by "expert authorities" in the U.S. psychiatric community to whom the media turns for such information. We ponder why that community might persist in quoting values of prevalence that are roughly two full orders-of-magnitude (a factor of ~100) too small. Finally, we discuss the challenge that our much larger and more realistic numbers present to the medical community, public health community, social welfare community and government bureaucracies.

In the US as a whole, a recent estimate found in How Many Adults Identify as Transgender in The United States? by Andrew R. Flores, Jody L Herman, Gary J. Gates, and Taylor N. T. Brown, Williams Institute, June 2016 7

In 2011, Gary J. Gates utilized two state-level population-based surveys that collected data from 2003 in California and from 2007 and 2009 in Massachusetts to estimate that 0.3% of the U.S. adult population, roughly 700,000 adults, identified as transgender.2 Since then, more state-level data sources have emerged that allow us to utilize an estimation procedure that would not have been possible with the limited data available in 2011. Compared to the data used in Gates' study, these new data sources provide more recent data (2014), larger sample sizes, and more detailed information about respondents. This allows for the development of more recent, detailed, and statistically robust estimates of the percentage and number of adults in the United States who identify as transgender.This report utilizes data from the CDC's Behavioral Risk Factor Surveillance System (BRFSS) to estimate the percentage and number of adults who identify as transgender nationally and in all 50 states.3 We find that 0.6% of U.S. adults identify as transgender. This figure is double the estimate that utilized data from roughly a decade ago and implies that an estimated 1.4 million adults in the U.S. identify as transgender.4 State-level estimates of adults who identify as transgender range from 0.3% in North Dakota to 0.8% in Hawaii.5 In addition, due to current state-level policy debates that specifically target and affect transgender students, we provide estimates of the number of adults who identify as transgender by age. The youngest age group, 18 to 24 year olds, is more likely than older age groups to identify as transgender.

In the US Military alone, a 2016 Rand Corp. study8, “Assessing the Implications of Allowing Transgender Personnel to Serve Openly”,commissioned by the Defense Department concluded that letting transgender people serve openly would have a "minimal impact" on readiness and health care costs, largely because there are so few in the military's 1.3 million-member force.The study put the number of transgender people in the military between 1,320 and 6,630. Gender-change surgery is rare in the general population, and the RAND study estimated the possibility of 30 to 140 new hormone treatments a year in the military, with 25 to 130 gender transition-related surgeries among active service members. The cost could range from $2.4 million and $8.4 million, an amount that would represent an "exceedingly small proportion" of total health care expenditures, the study found.

Intersex1% of people are born with bodies that differ from standard male or female. 1-2% of these receive surgery to “normalize” their genital appearance X . There are a number of reasons that babies are born intersex. The Intersex Society of North America X says:

“If you ask experts at medical centers how often a child is born so noticeably atypical in terms of genitalia that a specialist in sex differentiation is called in, the number comes out to about 1 in 1500 to 1 in 2000 births. But a lot more people than that are born with subtler forms of sex anatomy variations, some of which won’t show up until later in life.

Below we provide a summary of statistics drawn from an article by Brown University researcher Anne Fausto-Sterling.9 The basis for that article was an extensive review of the medical literature from 1955 to 1998 aimed at producing numeric estimates for the frequency of sex variations. Note that the frequency of some of these conditions, such as congenital adrenal hyperplasia, differs for different populations. These statistics are approximations.”

Not XX and not XY one in 1,666 birthsKlinefelter (XXY) one in 1,000 birthsAndrogen insensitivity syndrome one in 13,000 birthsPartial androgen insensitivity syndrome one in 130,000 birthsClassical congenital adrenal hyperplasia one in 13,000 birthsLate onset adrenal hyperplasia one in 66 individualsVaginal agenesis one in 6,000 birthsOvotestes one in 83,000 birthsIdiopathic (no discernable medical cause) one in 110,000 birthsIatrogenic (caused by medical treatment, for instance progestin administered to pregnant mother) no estimate5 alpha reductase deficiency no estimateMixed gonadal dysgenesis no estimateComplete gonadal dysgenesis one in 150,000 birthsHypospadias (urethral opening in perineum or along penile shaft) one in 2,000 birthsHypospadias (urethral opening between corona and tip of glans penis) one in 770 birthsTotal number of people whose bodies differ from standard male or female one in 100 birthsTotal number of people receiving surgery to “normalize” genital appearance one or two in 1,000 births

Public AcceptanceMany trans people would like to “pass” in public, i.e. be accepted as the gender they present. Lynn Conway calls this “stealth-mode". Most do not, and it is apparent to most observers that they are trans. Whether this matters or not depends on the level of acceptance of trans people in the society in which they live.

One measure of the degree of public acceptance is whether or not that country has laws for or against trans people.

An extremely detailed list of LGBT-related laws by country or territory, including laws concerning gender identity/expression, may be found in Wikipedia 10, 11

In North Africa: Algeria, Egypt, Libya, Morocco, Western Sahara, Sudan, South Sudan, and Tunisia are not good countries to live in if you are a T-person. Neither are all the countries in Western Africa, Central Africa, South-East Africa (Burundi, Kenya, Rwanda, Uganda, Tanzania), Horn of Africa (Djibouti, Eritrea, Ethiopia, Somalia, Somaliland), the Indian Ocean States of Africa (Madagascar, Mauritius, Seychelles), and

all of Southern Africa (Angola, Botswana, Lesotho, Malawi, Mozambique, Namibia, Swaziland, Zambia, Zimbabwe) except South Africa which is more liberal.

In North America: Canada, the US and Mexico are OK to live in; not so Bermuda and Greenland. Central America is generally OK, but mixed. In the Caribbean: Cuba (and Guantanamo Bay), Guadeloupe, Martinique, Puerto Rico, Saint Barthélemy, Saint Martin, US Virgin Islands, are OK to

live in, the rest are not.In South America: all countries support TG-people except the Falkland Islands, Guyana, Paraguay, Suriname and Venezuela. However, your

chances of being murdered if you are trans is the highest in the world if you live in Brazil, see https://tdor.info/ . According to Rede Trans, a Brazilian website that monitors attacks on transgender people, a record 144 transgender people were murdered in Brazil in 2016.

In Central Asia: Kazakhstan, Kyrgyzstan and Tajikistan support TGs, while Turkmenistan and Uzbekistan do not.In Eurasia: the laws concerning TGs are unknown in Abkhazia, Akrotiri and Dhekelia, Nagorno-Karabakh, Northern Cyprus, and South Ossetia; are

anti-TG in Armenia; and are pro-TG in Azerbaijan, Cyprus, Georgia, Russia and Turkey – though Azerbaijan, Georgia, Russia and Turkey require sterilization for [a sex] change.

In Western Asia: Israel is strongly pro-TG, while Iran, Jordan, Lebanon, Syria and United Arab Emirates are somewhat supportive. Bahrain, Iraq, Kuwait, Oman, Palestinian Territories (Gaza Strip), Qatar, Saudi Arabia and Yemen are anti-TG. The penalty for same-sex sexual activity in these countries is severe, ranging from up to 100 whip lashes, imprisonment, and death by stoning etc. In Iran under the Shah transsexuals and crossdressers were classed with gays and lesbians and faced punishment of lashing or even death. The new religious government that came to be established under the Ayatollah treated them initially the same way. Beginning in the mid-1980s, however, transsexuals were officially recognized by the government and allowed to undergo sex reassignment surgery. Sex changes have been legal since the late Ayatollah Ruhollah Khomeini, spiritual leader of the 1979 Islamic revolution, passed a fatwa authorising them nearly 25 years ago. The government provides up to half the cost for those needing financial assistance, and a sex change is recognized on the birth certificate 5. Iran has between 15,000 and 20,000 transsexuals, according to official statistics, although unofficial estimates put the figure at up to 150,000. As of 2008, Iran carries out more gender change operations than any country in the world except Thailand. Whereas homosexuality is considered a sin, transsexuality is categorised as an illness subject to cure. The government provides up to half the cost for those needing financial assistance, and a sex change is recognized on the birth certificate X , Y.

In South Asia: Bangladesh, India, Nepal and Pakistan are pro-TG, while Afghanistan, Bhutan, Maldives and Sri Lanka are anti-TG.In Eastern Asia: China, Hong Kong, Taiwan, Japan, Mongolia, South Korea are pro-TG, while the laws concerning TGs are unknown in Macau and

North Korea. Public transgenderism in Japan began during the Edo period. Women actors were banned from kabuki theatre performances and, in turn, effeminate male performers took on the roles of women. Such actors maintained their dress both inside and outside of the theater. It was widely believed, at the time, that only men could really know what beauty in a woman looked like. Moreover, if a man acted like a woman, dressed like a woman and took on the social roles of a woman, he was simply socialized as one. The latter is a result of how Japan conceptualized gender and sexuality in terms of adopted social roles X.

In Southeast Asia: Malaysia, Singapore, Thailand, and Vietnam are pro-TG, while in Brunei, Myanmar (Burma), Indonesia, Philippines they are anti-TG. The laws in Cambodia, East Timor and Laos are unknown. Kathoey is a Thai term, often translated as "ladyboy" in modern English, which has undergone an evolution. It used to refer to intersex individuals, then in the 20th century to cross-dressing males or gay men who display varying degrees of femininity which may or may not include hormonal or surgical intervention. Toms and Dees are two kinds of female gender identity in Thailand. A "Tom" is a female who dresses, acts, and possibly speaks in a masculine fashion. A "dee" is a homosexual (or bisexual) female who follows typical Thai female gender expression. The only difference between dees and traditional Thai females is that dees engage in relationships with toms. A kathoey refers to a male who dresses as and adopts the mannerisms and identity of a woman. Thailand’s first sex change surgery was performed in 1972 and the country now hosts more of these procedures per year than any other country in the world. Estimates on the current number of Thai transsexuals range from 10,000 to 100,000, including a number of pop singers and television and movie stars X, Y.

In Western Europe: all 28 states in the European Union are pro-TG, as they are in Austria, Croatia, Czech Republic, Germany, Poland, Romania, Slovakia, Slovenia and Switzerland. Only in Hungary and Liechtenstein are they anti-TG.

In Northern Europe: Denmark, Estonia, Finland (includes Åland Islands), Iceland, Latvia, Lithuania, Norway and Sweden are all pro-TG. Only the Faroe Islands (Constituent country of the Kingdom of Denmark) are anti-TG. In 2017 Denmark became the first country in the world to officially delete transgender identities from its list of disorders of mental health X.

In Southern Europe: Akrotiri and Dhekelia (Overseas territory of the United Kingdom), Albania, Andorra, Bosnia and Herzegovina, Bulgaria, Cyprus, Greece, Italy, Malta, Montenegro, Northern Cyprus, Portugal, Serbia, and Spain are pro-TG, while Gibraltar (Overseas territory of the United Kingdom), Kosovo, Macedonia and San Marino are not.

In Western Europe: all the countries (Belgium, France, Guernsey (Crown dependency of the United Kingdom), Ireland, Isle of Man (Crown dependency of the United Kingdom), Jersey (Crown dependency of the United Kingdom), Luxembourg, Netherlands and the United Kingdom) are pro-TG with the exception of Monaco, where the law is unknown. In 2017 Denmark became the first country in the world to officially delete transgender identities from its list of disorders of mental health.

Australia and New Zealand are pro-TG. The islands of Melanesia, Micronesia and Polynesia are not included here.

The “Legal and Social Mapping” at http://transrespect.org was conducted by Transgender Europe’s Transrespect versus Transphobia Worldwide (TvT) research project X in close cooperation with activists and experts from all world regions. A comprehensive 30-page expert questionnaire developed by the TvT project’s research team and reviewed by more than 15 researchers and activists from all six worlds regions was distributed to over 100 international activists and experts, who provided detailed information including comments and explanations on the specific situation in the respective country. The focus was on collaboration with trans activists who were able to draw on their expertise regarding current political processes and actual legal and social practices, rather than with scholars or lawyers as such. The TvT Legal and Social Mapping consist of several different categories:

1) legal gender recognition (legal change of name and gender)2) anti-discrimination, hate-crime and asylum legislation3) criminalisation, prosecution and state-sponsored discrimination4) trans-specific health care (hormones and hormone therapy, gender reassignment treatment and body modifications)5.) community and movement (existence of visible trans community, trans organizations, trans publications, networks, funding etc.)6.) good practices (by governments/states, the trans movement and its organizations, or allies)7.) reports of transphobic incidents (murder, rape, physical assault, hate speech etc.)

A key characteristic of the TvT mapping is its attempt to map not only existing laws, but also actual legal practices and proposals for legislation, thereby seeking to increase its relevance to activists and human-rights actors. The TvT tables are also designed to clearly show the important differences between legal criminalisation and actual prosecution of gender-diverse/trans people. We made this distinction because there are countries where there are legal measures that specifically target gender-diverse/trans people, e.g. laws that criminalise ‘so-called cross-dressing’, which are no longer enforced. In contrast, there are also cases where prosecution occurs without a legal basis or based on laws not created to target gender-diverse/trans people such as anti-prostitution, loitering or nuisance

laws. The tables thus aim to provide a comprehensive understanding of the legal situation beyond the existence of legal measures as such. The tables furthermore list the existence of alternative practices to medically supervised hormone therapy and gender reassignment treatments, such as acquiring hormones on the black market without medical supervision or applying industrial silicone without medical supervision. These ‘alternatives’ exist in countries where trans-specific health-care is not provided, in cases where gender-diverse/trans people do not meet the requirements for medically supervised treatment or when funding for hormone therapy is not provided and it is easier to access hormones in pharmacies without prescription. These ‘alternative’ practices can lead to serious health problems and even death. At present (September 2015) the TvT Legal and Social Mapping encompasses 119 countries. This data builds the basis for the maps and the comparative country data in the TvT databank X.The data is very detailed. The index is in map form, and includes 126 countries in the world, but not Canada:

Albania, American Samoa, Andorra, Angola, Antigua and Barbuda, Argentina, Armenia, Australia, Austria, Azerbaijan, Bahamas, Barbados, Belarus, Belgium, Belize, Bonaire, Saint Eustachius and Saba, Bosnia and Herzegovina, Botswana, Brazil, Brunei, Darussalam, Bulgaria, Chile, China, Colombia, Croatia, Cuba, Cyprus, Czech Republic, Denmark, Ecuador, Egypt, El Salvador, Estonia, Finland, France, French Polynesia, Georgia, Germany, Greece, Guam, Haiti, Hong Kong, Hungary, Iceland, India, Indonesia, Ireland, Israel, Italy, Jamaica, Japan, Kazakhstan, Kenya, Kiribati, Kosovo, Kyrgyzstan, Latvia, Liechtenstein, Lithuania, Luxembourg, Macedonia, Malawi, Malaysia, Malta, Mexico, Moldova, Monaco, Mongolia, Montenegro, Namibia, Nauru, Nepal, Netherlands, New Caledonia, New Zealand, Nicaragua, Nigeria, Niue, Norway, Pakistan, Papua New Guinea, Peru, Philippines, Poland, Portugal, Puerto Rico, Romania, Russia, Saint Kitts and Nevis, Saint Lucia, Saint Martin, Saint Vincent and the Grenadines, Samoa, San Marino, Serbia, Singapore, Slovakia, Slovenia, Solomon Islands, South Africa, South Korea, Spain, Suriname, Svalbard and Jan Mayen, Sweden, Switzerland, Taiwan, Tajikistan, Tanzania, Thailand, Timor-Leste, Tokelau, Tonga, Trinidad and Tobago, Turkey, Tuvalu, Uganda, Ukraine, United Kingdom, United States, US Virgin Islands, Uzbekistan, Venezuela, Vietnam, Zambia, Zimbabwe.

The TvT project is TGEU’s longest ongoing research project, and includes three sub-projects; Trans Murder Monitoring, Legal and Social Mapping, and a survey on the Social Experiences of Trans and Gender-Diverse people X.

Another measure of the degree of public acceptance or transphobia in a country is the murder rate for trans people in that country. The worst countries for a trans person to live in are Brazil and the USA. The numbers reported vary with the source because of under-reporting.

According to Trans Murder Monitoring (TMM) from 2008 to June 2016 worldwide, the absolute number of trans murders per country were P:

The web site is interactive, and gives the actual total for each country with mouse-over. You can also zoom into one particular country from the menu bar. The menu bar allows you to select world maps for absolute numbers for each year since 2008, and perhaps more useful as an indicator of danger, the relative number for each country in terms of trans murders per million of population Q :

The TMM IDAHOT (International Day Against Homophobia, Transphobia & Biphobia) 2016 update shows the absolute number of trans murders per continent, and the absolute and relative numbers for the worst 6 countries, for the period 2008-01-01 to 2016-04-30 R:

The TMM map for 2015, shows the absolute numbers by country for that single year S:

Of which I have selected the following by regionCanada: 1US: 22Mexico: 35Columbia: 20

Brazil: 113UK: 2Italy: 2Turkey: 4

Pakistan: 6India: 7

The TMM IDAHOT (International Day Against Homophobia, Transphobia & Biphobia) Update for 2015 T, also provides the following data up to 2014:

Highest absolute numbers occur in countries with strong trans movements and monitoring, according to senior TGEU researcher, Carla Lagata. Countries with highest relative numbers per million inhabitants (2008-2014) are shown below U.

Where the profession of the victim was known, 65 % of them were sex trade workers. Of those reported victims where the cause of death is known, 628 were shot to death, 330 were stabbed to death and 183 were beaten to death, 67 were strangled, 46 were stoned, and 34 were dismembered V.

According to TMM, section 4:From 2008-2014: there were a total of 868 trans murders world wide. In 2015 there were113, in 2014 there were 132, in 2013 there were 104, in 2012 there were 126, in 2011 there were 103, in 2010 there were 99, in 2009 there were 68, and in 2008 there were 0.

The Transgender Day of Remembrance (TDoR), lists hundreds of trans people that had been murdered by year and country 2016, 2015, 2014,

2013. TDoR may be underestimating the numbers for Brazil. According to Rede Trans (National Trans Personnel Network of Brazil), a Brazilian website that monitors attacks on transgender people, a record 144 transgender people were murdered in 2016, compared with 57 in 2008, when the site began recording cases W. List of unlawfully killed transgender people X covers 1980 to 2017 world-wide. Violence Against Trans People in Canada: A Primer Y, (last updated: February 14, 2017).

TDoR lists 59 trans murders in Brazil in 2014, 63 in 2015, 65 in 2016Wikipedia lists only 10 trans murders in Brazil in 2017 and 7 in 2016

TDoR data:Country/year 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007

1. Argentina 32. Belize 13. Brazil 65 63 594. Canada 15. Columbia 26. Cuba 17. El

Salvador1

8. Georgia 19. Guyana 110. Honduras 111. India 2 112. Italy 113. Japan 114. Mexico 115. Pakistan 1 216. Philippine

s 2

17. Russia 118. Spain 1 119. Thailand 120. Turkey 1 121. UK 122. USA 15 14 11

Brazilhttp://transrespect.org/en/map/trans-murder-monitoring/