There are more of us than you think

Next time you find yourself in a crowd of 5,000 people, consider this: In the crowd there will be on average one person living with muscular dystrophy. There will also be on average two people who have already undergone male-to-female sex-reassignment surgery. And there may as many as 75 in that crowd who fall under the transgender umbrella. Are you surprised?

For years, the only statistics available on transgender prevalence were those first developed in the 1960s and 1970s. These statistics, as still cited in the American Psychiatric Association’s most recent Diagnostic and Statistics Manual, DSM-IV, “suggest that roughly one per 30,000 adult males and one per 100,000 adult females seek [sex-reassignment surgery].”

Thank goodness Lynn Conway could not believe these low numbers. Lynn is a noted computer scientist and distinguished professor emerita of engineering who transitioned from male to female in the 1960s and then lived “stealth,” or closeted about her transgender status, before coming out in 2000 (more about “stealth,” and Lynn, in upcoming columns). Shortly after her coming-out, Lynn turned her highly analytical brain toward understanding the statistics.

Her skepticism was based on simple reasoning. If the psychiatrists were right, there would be only three or four thousand MTFs in the United States who had ever sought surgery. Under the optimistic assumption that only 20% or so would have been able to afford or attain surgery, there would be fewer than 800 postoperative women in the country today. Impossible, she cried, given that the top sex-reassignment surgery surgeons in the United States alone perform that many MTF SRS operations every single year.

Lynn then extended her logic to come up with much more realistic and believable numbers for transsexuals and then the entire transgender population, revealing large errors in the psychiatrists’ old claims. All of Lynn’s reasoning and estimates are detailed on her tremendously valuable Web site, www.lynnconway.com.

Why don’t we have better “official numbers?” Lynn postulates that (1) psychiatrists don’t question the numbers because they don’t see the significant number of transsexuals who manage to transition without their “help,” and (2) because more accurate numbers showing a much larger prevalence would be bad for the psychiatry business—and its bias toward marginalizing transsexualism as an extremely rare “mental illness.”

So what about statistics for female-to-male trans people? The old official stats imply that there are less than a third as many FTMs as MTFs. I used to believe that. After all, when I first started attending transgender conferences, the attendees were overwhelmingly individuals presenting as females. And then one day, wanting to know more about the seemingly elusive FTMs, I read Jamison Green’s fabulous book, Becoming a Visible Man.

James is a charismatic (and handsome, even to this lesbian) writer and activist who transitioned FTM in the late 1980s. In his book, James states the obvious: FTMs were simply not interested in the feminine grooming tips and female hormones being discussed in conferences and support groups that largely catered to MTF trans people. But gender counseling providers assumed the groups had broader appeal and that the men actually stayed away to be self-sufficient like “other” men. This became self-perpetuating when the professionals actively told patients that men “like to go it alone.”

James showed how this thinking deprived FTMs of role models, and more importantly of an awareness of just how many others were out there. Fortunately the treatment of FTMs is much less monolithic these days, and FTMs have learned that “communication among men does not threaten their independence.” There are now FTM-centric conferences like True Spirit and Gender Odyssey, and FTMs are now quite visible in the LGBT community and on college campuses across the country. Current thinking is that the prevalence of FTMs is much closer to the prevalence of MTFs.

But my fellow trustees at the Point Foundation are convinced that there are considerably more FTMs. We award scholarships to undergraduate and graduate students whom we feel will be the LGBT leaders of tomorrow. Our evaluation process is rigorous. That process has resulted in seven of the 77 scholarships to date going to transgender students, and all seven of them were FTMs. This year I personally reviewed the applications from all of the transgender students, and I was stunned to see that well over 80% were from FTMs. Where are all the MTFs?

I asked Lynn Conway, who as a professor emerita spends a fair amount of time on college campuses, for her take on this. Lynn points out that while accepting of girls who present as “tomboys,” our society still has incredibly deep hang-ups about boys presenting in a feminine way. This stigmatization results in an alarming number of young MTF kids being thrown away or disowned by their parents, even before they reach college age.

Of the MTFs who do manage to enter college, the vast majority remain totally closeted so as to avoid ostracism. Lynn also notes that some campus LGBT offices remain dominated by second-wave feminist thinking, which tends to look askance at anyone who appears to them to preserve feminine stereotypes. Although such offices may honor the FTM in transition, they often aren’t places where young MTFs feel welcome, leading to a big asymmetry in visible numbers on campuses.

It is situations like this that limit awareness of the size of the transgender population. There actually are a lot of us, and only when the transgender stigma finally crumbles will everyone finally see all of us.