Increases in Self-identifying as Transgender Among US Adults, 2014–2022

Introduction: Understanding changes in the number of people self-identifying as transgender is key to informing policy, legal, and healthcare practices. Examining demographic variation in changes is important to address socially and structurally determined health disparities. Methods: Analyses examined self-identification as transgender between 2014 and 2022 in the nationally representative Behavioral Risk Factor Surveillance Survey (n = 1.9 million), which collects cross-sectional data yearly. Results: An increasing number of US young adults self-identified as transgender between 2014 and 2022. Self-identifying as transgender nearly quintupled among 18- to 24-year-olds and quadrupled among 25- to 34-year-olds, but either declined or did not change significantly among those older than 35. By 2022, 2.78% of 18- to 24-year-old adults self-identified as transgender, up from 0.59% in 2014. The increase was driven by those identifying as transgender men or gender non-conforming; identification as a transgender woman did not change significantly among young adults and declined significantly among all adults. The increase in self-identifying as transgender was larger among White individuals than among Black or Hispanic individuals. Up to 2021, the increase was similar in states whose electoral college voted Democrat (“blue”) or Republican (“red”) in 2016, suggesting a nationwide shift. Conclusions: Results suggest that more people self-identify as transgender than in previous generations, with young people driving this change. Policy Implications: Results highlight the importance of accurate and inclusive measurement of gender. To support public and individual health, policy efforts should support access to gender-affirming care and aid individuals, families, professionals, and communities to support gender diversity.