Objectives. To estimate the proportion of US adults who identify as transgender and to compare the demographics of the transgender and nontransgender populations. Methods. We conducted a secondary analysis of data from states and territories in the 2014 Behavioral Risk Factor Surveillance System that asked about transgender status. The proportion of adults identified as transgender was calculated from affirmative and negative responses (n?=?151?456). We analyzed data with a design-adjusted χ2 test. We also explored differences between male-to-female and nontransgender females and female-to-male and nontransgender males. Results. Transgender individuals made up 0.53% (95% confidence interval?=?0.46, 0.61) of the population and were more likely to be non-White (40.0% vs 27.3%) and below the poverty line (26.0% vs 15.5%); as likely to be married (50.5% vs 47.7%), living in a rural area (28.7% vs 22.6%), and employed (54.3% vs 57.7%); and less likely to attend college (35.6% vs 56.6%) compared with nontransgender individuals. Conclusions. Our findings suggest that the transgender population is a racially diverse population present across US communities. Inequalities in the education and socioeconomic status have negative implications for the health of the transgender population. In 2011, the Institute of Medicine described data on the proportion of people in the United States who identify as transgender as “sorely lacking” and called for research on transgender demographics. 1 Transgender is a term for individuals whose gender expression and gender identity do not align with cultural expectations and gender norms associated with their sex assignment at birth. 1 National surveys have not historically included questions about transgender identity. To date, estimates of the proportion of individuals who identify as transgender have been calculated from data such as disclosure of transgender status to a medical provider and single-state or nonprobability surveys. 2–7 Recently, the inclusion of a question about transgender status in the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) survey has provided a novel opportunity to learn more about the US adult transgender population. In a white paper published in June 2016, Flores et al. 8 used BRFSS data from 19 states to estimate that 0.5% of the respondents identified as transgender and imputed that 0.6% of adults identify as transgender nationwide. Beyond data on the portion of individuals identified as transgender, information about the demographics of the transgender population is needed to identify inequities; facilitate public health efforts to address health disparities, including disproportionately high rates of HIV, suicide, and violence against the transgender community 9 ; and lend data to policies focused on the transgender population. Our objective was to provide estimates of the demographic characteristics of the US adult transgender population compared with the nontransgender population.
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