Prevalence of Gender Dysphoria by Gender and Age in Japan: A Population-Based Internet Survey Using the Utrecht Gender Dysphoria Scale

The Journal of Sexual Medicine - Tập 19 - Trang 1185-1195 - 2022
Yoshitaka Oshima1, Yosuke Matsumoto2, Seishi Terada1, Norihito Yamada1
1Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
2Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan

Tóm tắt

ABSTRACTBackgroundSeveral studies have attempted to estimate the prevalence of gender dysphoria (GD) from a general population sample. However, no previous studies used reliable questionnaires.AimTo estimate the prevalence of GD in Japan by gender and age using the Utrecht Gender Dysphoria Scale (UGDS).MethodsA cross-sectional observational study was conducted with 20,000 respondents between the ages of 20 and 69 who were registered with an internet research company. The study consisted of two phases. First, the participants were asked to self-identify their gender on two 5-point Likert scales. Second, the screened participants completed the UGDS.OutcomesSelf-identified gender and GD were defined as follows: ambivalent gender (equally feeling like the birth gender and another gender), incongruent gender (a stronger sense of the latter vs the former), narrow GD (incongruent gender + UGDS score ≥ 41), and broad GD (ambivalent or incongruent gender + UGDS score ≥ 41).ResultsAmong the eligible participants, the age-adjusted proportions of those classified as male (n = 7827) and female (n = 8903) at birth were 6.0% and 5.9%, respectively, for ambivalent gender, and 0.93% and 1.0%, respectively, for incongruent gender. The age-adjusted prevalence of GD was 0.27% (95% confidence interval, 0.18–0.42) and 0.35% (95% confidence interval, 0.25–0.50) for narrow GD and 0.87% (95% confidence interval, 0.69–1.1) and 1.1% (95% confidence interval, 0.86–1.3) for broad GD, respectively. No significant gender differences were found within the age groups, except for broad GD in respondents in their 50s (P = .016). However, for both genders, significant differences were found between age groups such that GD was more prevalent in younger vs older respondents, except for broad GD in respondents classified as female at birth (P = .063).Clinical ImplicationsClinicians should be aware that the prevalence of GD is not negligible and that it varies with age. GD should be assessed in detail from various perspectives in addition to self-identified gender.Strengths & LimitationsThis study used a reliable questionnaire to examine the prevalence of GD in a large population. However, the participants did not represent the general population because this was an internet survey.ConclusionThe prevalence of GD was much higher than previously estimated by clinic-based studies, and was more frequently associated with participant age vs gender.

Tài liệu tham khảo

Arcelus, 2015, Systematic review and meta-analysis of prevalence studies in transsexualism, Eur Psychiatry, 30, 807, 10.1016/j.eurpsy.2015.04.005 Collin, 2016, Prevalence of transgender depends on the “case” definition: A systematic review, J Sex Med, 13, 613, 10.1016/j.jsxm.2016.02.001 Zucker, 2009, Epidemiology of gender identity disorder: recommendations for the Standards of Care of the World Professional Association for Transgender Health, Int J Transgend, 11, 8, 10.1080/15532730902799946 Kuyper, 2014, Gender identities and gender dysphoria in the Netherlands, Arch Sex Behav, 43, 377, 10.1007/s10508-013-0140-y Van Caenegem, 2015, Prevalence of gender nonconformity in Flanders, Belgium, Arch Sex Behav, 44, 1281, 10.1007/s10508-014-0452-6 Crissman, 2017, Transgender demographics: a household probability sample of US adults, Am J Public Health, 107, 213, 10.2105/AJPH.2016.303571 Åhs, 2018, Proportion of adults in the general population of Stockholm County who want gender-affirming medical treatment, PLoS One, 13, 10.1371/journal.pone.0204606 Zucker, 2017, Epidemiology of gender dysphoria and transgender identity, Sex Health, 14, 404, 10.1071/SH17067 Cohen-Kettenis, 1997, Sex reassignment of adolescent transsexuals: a follow-up study, J Am Acad Child Adolescent Psychiatry, 36, 263, 10.1097/00004583-199702000-00017 Schneider, 2016, Measuring gender dysphoria: a multicenter examination and comparison of the Utrecht gender dysphoria scale and the gender identity/gender dysphoria questionnaire for adolescents and adults, Arch Sex Behav, 45, 551, 10.1007/s10508-016-0702-x Bockting, 2009, Gay and bisexual identity development among female-to-male transsexuals in North America: emergence of a transgender sexuality, Arch Sex Behav, 38, 688, 10.1007/s10508-009-9489-3 Ishimaru, 2011, Reliability, validity, and cut-off value of the Japanese version of the self-administered questionnaire scale (UGDS) for assessing the intensity of gender dysphoria, J Jap Soc Gender Identity Disorder, 4, 162 Steensma, 2013, The Utrecht Gender Dysphoria Scale: a validation study Kreukels, 2012, A European network for the investigation of gender incongruence: the ENIGI initiative, Eur Psychiatry, 27, 445, 10.1016/j.eurpsy.2010.04.009 Cohen-Kettenis, 2010, The DSM diagnostic criteria for gender identity disorder in adolescents and adults, Arch Sex Behav, 39, 499, 10.1007/s10508-009-9562-y Statistics Bureau of Japan Altman, 2000, Statistics with confidence: confidence intervals and statistical guidelines, 2nd edition R Core Team, 2021, R: a language and environment for statistical computing Miner, 2012, Conducting internet research with the transgender population: reaching broad samples and collecting valid data, Soc Sci Comput Rev, 30, 202, 10.1177/0894439311404795.20 Okabe, 2008, Clinical characteristics of patients with gender identity disorder at a Japanese gender identity disorder clinic, Psych Res, 157, 315, 10.1016/j.psychres.2007.07.022 Baba, 2011, Distinctive features of female-to-male transsexualism and prevalence of gender identity disorder in Japan, J Sexual Med, 8, 1686, 10.1111/j.1743-6109.2011.02252.x Flores, 2016, How many adults identify as transgender in the United States?, Williams Inst, 13 Herman, 2017, Age of individuals who identify as transgender in the United States Gómez-Gil, 2009, Sociodemographic, clinical, and psychiatric characteristics of transsexuals from Spain, Arch Sex Behav, 38, 378, 10.1007/s10508-007-9307-8 Fisher, 2013, Sociodemographic and clinical features of gender identity disorder: an Italian multicentric evaluation, J Sex Med, 10, 408, 10.1111/j.1743-6109.2012.03006.x Dhejne, 2014, An analysis of all applications for sex reassignment surgery in Sweden, 1960–2010: Prevalence, incidence, and regrets, Arch Sex Behav, 43, 1535, 10.1007/s10508-014-0300-8 Simonsen, 2015, Sociodemographic study of Danish individuals diagnosed with transsexualism, Sex Med, 3, 109, 10.1002/sm2.48 Becerra-Fernández, 2017, Prevalence, incidence, and sex ratio of transsexualism in the autonomous region of Madrid (Spain) according to healthcare demand, Arch Sex Behav, 46, 1307, 10.1007/s10508-017-0955-z Wiepjes, 2018, The Amsterdam cohort of gender dysphoria study (1972–2015): trends in prevalence, treatment, and regrets, J Sex Med, 15, 582, 10.1016/j.jsxm.2018.01.016 Meyer, 2020, Increasing normality–persisting barriers: current socio-demographic characteristics of 350 individuals diagnosed with gender dysphoria, Clin Endocrinol, 92, 241, 10.1111/cen.14140 Kraut, 2004, Psychological research online: report of Board of Scientific Affairs’ Advisory Group on the Conduct of Research on the Internet, Am Psychol, 59, 105, 10.1037/0003-066X.59.2.105 Tsuboi, 2015, Selection bias of Internet panel surveys: a comparison with a paper-based survey and national governmental statistics in Japan, Asia–Pacific J Pub Health, 27, 10.1177/1010539512450610 McGuire, 2020, Utrecht Gender Dysphoria Scale-Gender Spectrum (UGDS-GS): construct validity among transgender, nonbinary, and LGBQ samples, Int J Transgend Health, 21, 194, 10.1080/26895269.2020.1723460