Estimate and needs of the transgender adult population: the SPoT study.
A D Fisher, M Marconi, G Castellini, J D Safer, S D'Arienzo, M Levi, L Brogonzoli, R Iardino, C Cocchetti, A Romani, F Mazzoli, P Matarrese, V Ricca, L Vignozzi, M Maggi, M Pierdominici, J Ristori
Author Information
A D Fisher: Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, University of Florence, Florence, Italy. fishera@aou-careggi.toscana.it.
M Marconi: Reference Centre for Gender Medicine, Italian National Institute of Health, Rome, Italy.
G Castellini: Psychiatric Unit, University of Florence, Florence, Italy.
J D Safer: Mount Sinai Center for Transgender Medicine and Surgery, New York City, NY, USA.
S D'Arienzo: Azienda USL Toscana Centro SOC Monitoraggio e Programmazione Performance Clinico-Assistenziale Pistoia, Prato ed Empoli e Relazioni con Agenzie Esterne, Florence, Italy.
M Levi: UFC Epidemiologia, Dipartimento di Prevenzione Azienda USL Toscana Centro, Florence, Italy.
L Brogonzoli: Fondazione The Bridge, Milan, Italy.
R Iardino: Fondazione The Bridge, Milan, Italy.
C Cocchetti: Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, University of Florence, Florence, Italy.
A Romani: Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, University of Florence, Florence, Italy.
F Mazzoli: Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, University of Florence, Florence, Italy.
P Matarrese: Reference Centre for Gender Medicine, Italian National Institute of Health, Rome, Italy.
V Ricca: Psychiatric Unit, University of Florence, Florence, Italy.
L Vignozzi: Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, University of Florence, Florence, Italy.
M Maggi: Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy.
M Pierdominici: Reference Centre for Gender Medicine, Italian National Institute of Health, Rome, Italy.
J Ristori: Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, University of Florence, Florence, Italy.
BACKGROUND: Despite the increasing interest in transgender health research, to date little is known about the size of the transgender and gender diverse (TGD) population. METHODS: A web-based questionnaire survey was developed, including a collection of socio-demographic characteristics and disseminated online through social media. Gender incongruence was evaluated by using a 2-item approach assessing gender recorded at birth and gender identity. The primary objective of the present population-based study was to estimate the proportion of TGD people across ages among a large sample of people who answered a web-based survey. The secondary endpoints were to identify gender-affirming needs and possible barriers to healthcare access. RESULTS: A total of 19,572 individuals participated in the survey, of whom 7.7% reported a gender identity different from the sex recorded at birth. A significantly higher proportion of TGD people was observed in the youngest group of participants compared with older ones. Among TGD people who participated in the study, 58.4% were nonbinary, and 49.1% experienced discrimination in accessing health care services. Nonbinary TGD participants reported both the need for legal name and gender change, along with hormonal and surgical interventions less frequently compared to binary persons. CONCLUSIONS: Being TGD is not a marginal condition In Italy. A large proportion of TGD persons may not need medical and surgical treatments. TGD people often experience barriers to healthcare access relating to gender identity.
