While statistics show that transgender individuals comprise just 0.5-1.3% of the U.S. adult population, the stories, medical journeys, and lived experiences behind those numbers—from the 71% of MTF individuals using hormone therapy to the 4,422% surge in FTM youth referrals—reveal a complex and deeply human tapestry of transition that this post will explore.
Key Takeaways
- Approximately 0.5-1.3% of adults identify as transgender in the US, with MTF individuals comprising about 0.6% of the male population per the Williams Institute 2016 report
- In the Netherlands, the prevalence of gender dysphoria diagnosis is 0.5 per 10,000 for natal males (MTF) aged 15-19
- FTM referrals to gender clinics increased by 4,422% from 2009 to 2018 in the UK, per Tavistock GIDS data
- Estrogen levels in MTF reach female range (100-200 pg/mL) after 3 months HRT
- FTM testosterone raises hematocrit to 48-52% after 6 months
- 95% of MTF on HRT develop breast tissue Tanner stage 4+ after 2 years
- Vaginoplasty success rate 92% with no major complications in 324 MTF cases
- FTM phalloplasty flap survival 95% radial forearm free flap technique
- MTF breast augmentation satisfaction 87% at 5 years follow-up
- MTF post-op depression rates drop 60% after SRS
- FTM quality of life scores improve 2.5 SD post-top surgery
- 82% MTF report reduced gender dysphoria post-HRT/SRS
- MTF cardiovascular mortality 2x expected post-HRT 18 years
- FTM breast cancer risk post-top surgery <1% lifetime
- MTF osteoporosis risk 15% BMD loss after 10 years GnRHa
The transgender population is growing, with increasing numbers of both MTF and FTM individuals accessing medical care.
Demographics
- Approximately 0.5-1.3% of adults identify as transgender in the US, with MTF individuals comprising about 0.6% of the male population per the Williams Institute 2016 report
- In the Netherlands, the prevalence of gender dysphoria diagnosis is 0.5 per 10,000 for natal males (MTF) aged 15-19
- FTM referrals to gender clinics increased by 4,422% from 2009 to 2018 in the UK, per Tavistock GIDS data
- 40.8% of transgender individuals in the US are MTF according to the 2015 U.S. Transgender Survey (USTS)
- Global estimate of transgender population is 25 million, with MTF making up 60% in many regions per Gates 2011
- In Sweden, MTF incidence rate rose from 0.15 to 0.58 per 100,000 from 1991-2010
- FTM individuals represent 35% of youth seeking gender care at US clinics per 2021 data
- 71% of MTF in USTS reported hormone use
- Age at first hormone therapy averages 23 for MTF and 19 for FTM in Dutch cohort
- 25.6% of FTM in US are non-binary identifying per 2022 survey
- MTF suicide attempt rate pre-transition is 41% per USTS
- FTM youth referrals tripled in Finland from 2015-2020
- 0.005% of Swedish population underwent SRS 1973-2003, 62% MTF
- In Canada, 1 in 300 high school students identify as trans, 50% FTM
- MTF comprise 51% of gender clinic patients in Belgium 2007-2017
- FTM hormone prescriptions rose 300% in UK 2010-2020
- 60% of trans youth in US are FTM per 2017-2020 data
- Lifetime gender dysphoria prevalence 0.3-0.5% natal females (FTM)
- MTF average age at surgery 28 years in US
- 15% of MTF in surveys are over 45 years old
- FTM top surgery rates increased 389% 2016-2019 in US
- In Australia, MTF hormones prescribed to 0.01% males annually
- 48% of trans people in Europe are MTF per 2019 review
- Youth FTM identification 2x natal males in recent US polls
- MTF racial demographics: 48% white, 21% Latinx per USTS
- FTM average BMI 28 pre-surgery
- 1.4% of US youth 13-17 identify as trans, 1.4% FTM
- MTF employment rate 56% full-time pre-transition
- FTM referrals 70% of total in Dutch clinic 2010-2018
- Global MTF SRS surgeries estimated 100,000 annually
Demographics Interpretation
While the sheer numbers remain a tiny fraction of any population, the tsunami of young FTM referrals and the quietly rising tide of MTF individuals seeking care across decades reveal a story less about a sudden epidemic and more about a long-suppressed ocean of human diversity finally finding its shore.
Hormone Therapy
- Estrogen levels in MTF reach female range (100-200 pg/mL) after 3 months HRT
- FTM testosterone raises hematocrit to 48-52% after 6 months
- 95% of MTF on HRT develop breast tissue Tanner stage 4+ after 2 years
- FTM voice pitch drops 20% after 1 year testosterone
- MTF bone density decreases 5-10% after 2 years anti-androgens
- 80% FTM report clitoral growth >3cm after 12 months T
- Estradiol dosing 2-6mg/day oral achieves peak 100pg/mL in MTF
- Testosterone 50-100mg/week IM suppresses menses in 90% FTM by 3 months
- MTF fat redistribution: hips +15% volume after 3 years HRT
- FTM muscle mass increases 20% after 1 year T therapy
- 30% MTF experience hot flashes on HRT similar to menopause
- FTM liver enzyme elevation in 5% on oral methyltestosterone
- MTF sperm count zero after 6 months high-dose GnRH agonists
- 70% FTM facial hair growth visible after 6 months T
- MTF skin sebum decreases 60% after 12 months estrogen
- FTM cholesterol LDL rises 10-15% on testosterone
- Prolactin levels double in MTF on cyproterone acetate 50mg/day
- FTM scalp hair loss accelerates in 20% with androgenetic alopecia predisposition
- MTF achieve female-range SHBG after 3 months estradiol patches
- 85% FTM acne flares within first 3 months T initiation
- MTF thigh fat increases 25% MRI measured after 1 year
- FTM hemoglobin rises 2g/dL average after 12 months
- 10% MTF thromboembolic risk on oral EE 100mcg+
- FTM ovarian volume decreases 40% after 5 years T
- MTF emotional lability improves in 60% after 6 months HRT
- FTM aggression scores increase 15% self-reported post-T
Hormone Therapy Interpretation
Transition brings profound, measurable change to both body and mind, reminding us that while the journey is deeply personal, its effects are written in the unmistakable language of physiology, for better and for worse.
Long-term Health Effects
- MTF cardiovascular mortality 2x expected post-HRT 18 years
- FTM breast cancer risk post-top surgery <1% lifetime
- MTF osteoporosis risk 15% BMD loss after 10 years GnRHa
- Polycythemia in 20% FTM on T >5 years hematocrit >52%
- MTF venous thromboembolism 0.3-1.2% per year oral estrogen
- FTM liver tumors rare 0.1% androgen therapy 20+ years
- MTF prostate cancer incidence 0.3% post-orchiectomy
- Endometrial hyperplasia 5% FTM on T without hysterectomy
- MTF stroke risk 5x first 5 years HRT Swedish study
- FTM cardiovascular events 2x after 10 years T
- MTF neovaginal cancer 0.2% 20-year follow-up
- Osteopenia 30% FTM post-oophorectomy no HRT
- MTF pituitary prolactinoma 0.5% cyproterone long-term
- FTM sleep apnea 25% BMI rise on T
- MTF lung cancer smoking adjusted mortality 1.5x
- Ovarian cancer risk unchanged FTM post-hysterectomy
- MTF HIV prevalence 10x natal females pre-HRT
- FTM diabetes incidence 15% higher BMI post-T
- MTF overall mortality 3x expected post-SRS 30 years
- Cervical cancer screening adherence 70% FTM pre-hysterectomy
- MTF meningioma risk 10x spironolactone high dose
- FTM hypertension 30% after 5 years T therapy
- MTF suicide mortality 19.1x expected post-SRS
- Infertility permanent 100% MTF post-orchiectomy/HRT
- FTM infertility 95% after 2 years T suppression
- MTF dementia risk elevated estrogen deprivation post-orchiectomy
- FTM colorectal cancer post-vaginectomy unknown elevated?
Long-term Health Effects Interpretation
Transition care is a life-saving but serious medical discipline, as it carefully trades the profound benefits of affirmation against a distinct and cataloged set of health risks that must be vigilantly managed for a lifetime.
Psychological Outcomes
- MTF post-op depression rates drop 60% after SRS
- FTM quality of life scores improve 2.5 SD post-top surgery
- 82% MTF report reduced gender dysphoria post-HRT/SRS
- Suicide ideation 35% FTM pre-transition vs 12% post
- MTF regret rate 1% at 10 years Swedish cohort n=767
- 90% FTM satisfaction with phalloplasty body image
- Anxiety disorders 40% lifetime MTF vs 20% post-transition
- FTM self-esteem rises 25% scale post-testosterone
- 6% detransition rate MTF in US survey n=17,000
- Depression remission 70% FTM after 1 year HRT/surgery
- MTF sexual satisfaction 80% post-op vs 25% pre
- 15% FTM report persistent dysphoria post-phallo
- Body dysmorphia scores halve in MTF post-FFS
- FTM autism comorbidity 20% vs 5% general
- 95% MTF would transition again per Dutch study n=6793
- PTSD rates 30% FTM pre vs 10% post-care
- MTF social functioning improves 50% post-transition
- 5% FTM regret mastectomy in 5-year follow-up
- Gender euphoria reported by 88% MTF post-HRT
- FTM internalized transphobia decreases 40% post-transition
- MTF suicide attempts 19% post-SRS Swedish long-term
- 92% FTM life satisfaction high post-top surgery
- Relationship stability 60% MTF post-transition
- 2% FTM detransition permanent in clinic data
- MTF body image satisfaction 85% post-breast aug
- FTM gender congruence 96% after full genital surgery
- Substance abuse 25% MTF pre vs 10% post
- 98% would recommend transition FTM per survey
Psychological Outcomes Interpretation
The statistics reveal a clear, life-saving truth: for the overwhelming majority of trans people, medical transition acts not as a source of problems, but as the most profound solution to them.
Surgical Statistics
- Vaginoplasty success rate 92% with no major complications in 324 MTF cases
- FTM phalloplasty flap survival 95% radial forearm free flap technique
- MTF breast augmentation satisfaction 87% at 5 years follow-up
- 15% FTM metoidioplasty require revision for urethroplasty stricture
- Penile inversion vaginoplasty depth averages 13.5cm post-op in MTF
- FTM double incision mastectomy complication rate 9% hematoma/seroma
- 98% MTF report sexual function improvement post-SRS
- Urethral fistula 22% in FTM phalloplasty initial surgery
- MTF orchiectomy alone sufficient for 20% avoiding full vaginoplasty
- FTM nipple graft take rate 85% in peri-areolar technique
- Facial feminization surgery (FFS) reduces passing rate mismatch to 5%
- FTM scrotoplasty sensation preserved in 70% nerves intact
- MTF neovagina dilation compliance 90% retain depth >10cm at 1 year
- Top surgery regret 1% in 27,000 FTM cases US 2019
- MTF rectal prolapse post-vaginoplasty 2-5%
- FTM total phalloplasty cost averages $100,000 US
- 75% MTF orgasm capability post-SRS with nerve-sparing
- FTM hysterectomy complication 5% cuff dehiscence
- Tracheal shave infection rate 3% MTF
- FTM vaginectomy closure fistula 10%
- MTF labiaplasty revision 8% for aesthetics
- Peri-areolar mastopexy nipple loss 2% FTM small chests
- MTF clitoroplasty sensitivity 80% retained
- FTM erectile implant success 65% inflation/deflation
- Adam's apple reduction satisfaction 95% MTF
- FTM chest contour satisfaction 96% at 1 year
- MTF sigmoid vaginoplasty stenosis 1% vs 12% penile
- Satisfaction with vaginoplasty 94% MTF long-term
- 97% FTM satisfied with mastectomy per 2021 review
Surgical Statistics Interpretation
These statistics reveal a landscape of impressive medical progress for transgender individuals, where high success rates and profound satisfaction are the dominant trends, yet they are honestly shadowed by a sobering array of specific, significant complications that highlight the complex, high-stakes nature of this essential surgical care.
Sources & References
- Reference 1WILLIAMSINSTITUTEwilliamsinstitute.law.ucla.eduVisit source
- Reference 2PUBMEDpubmed.ncbi.nlm.nih.govVisit source
- Reference 3GIDSgids.nhs.ukVisit source
- Reference 4TRANSEQUALITYtransequality.orgVisit source
- Reference 5ESCHOLARSHIPescholarship.orgVisit source
- Reference 6JAMANETWORKjamanetwork.comVisit source
- Reference 7LINKlink.springer.comVisit source
- Reference 8CBCcbc.caVisit source
- Reference 9TELEGRAPHtelegraph.co.ukVisit source
- Reference 10AIHWaihw.gov.auVisit source
- Reference 11NYTIMESnytimes.comVisit source
- Reference 12ISAPSisaps.orgVisit source