Abstract
Gender nonconformity refers to the extent to which a person’s gender identity, gender role and/or gender expression differs from the cultural norms prescribed for people of a particular sex, within a certain society and era. Most data on gender nonconformity focus on the prevalence of gender dysphoria (which also includes a distress factor) or on the number of legal sex changes. However, not every gender nonconforming individual experiences distress or applies for treatment. Population-based research on the broad spectrum of gender nonconformity is scarce and more information on the variance outside the gender binary is needed. This study aimed to examine the prevalence of gender incongruence (identifying stronger with the other sex than with the sex assigned at birth) and gender ambivalence (identifying equally with the other sex as with the sex assigned at birth) based on two population-based surveys, one of 1,832 Flemish persons and one of 2,472 sexual minority individuals in Flanders. In the general population, gender ambivalence was present in 2.2 % of male and 1.9 % of female participants, whereas gender incongruence was found in 0.7 % of men and 0.6 % of women. In sexual minority individuals, the prevalence of gender ambivalence and gender incongruence was 1.8 and 0.9 % in men and 4.1 and 2.1 % in women, respectively. With a current Flemish population of about 6 million, our results indicate a total of between 17,150 and 17,665 gender incongruent men and between 14,473 and 15,221 gender incongruent women in Flanders.
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Baba, T., Endo, T., Ikeda, K., Shimizu, A., Honnma, H., Ikeda, H., … Saito, T. (2011). Distinctive features of female-to-male transsexualism and prevalence of gender identity disorder in Japan. Journal of Sexual Medicine, 8, 1686–1693.
Bakker, A., van Kesteren, P. J., Gooren, L. J., & Bezemer, P. D. (1993). The prevalence of transsexualism in The Netherlands. Acta Psychiatrica Scandinavica, 87, 237–238.
Bockting, W., Benner, A., & Coleman, E. (2009). Gay and bisexual identity development among female-to-male transsexuals in North America: Emergence of a transgender sexuality. Archives of Sexual Behavior, 38, 688–701.
Buysse, A., Caen, M., Dewaele, A., Enzlin, P., Lievens, J., T’Sjoen, G., … Vermeersch, H. (2013). SEXPERT. Seksuele gezondheid in Vlaanderen (Sexual Health in Flanders). Ghent: Academia Press.
Coleman, E., Bockting, W., Botzer, M., Cohen-Kettenis, P. T., De Cuypere, G., Feldman, J., … Zucker, K. (2011). Standards of Care for the Health of Transsexual, Transgender and Gender Nonconforming People. 7th edition. International Journal of Transgenderism, 13, 165–232.
Conron, K. J., Scott, G., Stowell, G. S., & Landers, S. J. (2012). Transgender health in Massachusetts: Results from a household probability sample of adults. American Journal of Public Health, 102, 118–122.
De Cuypere, G., Jannes, C., & Rubens, R. (1995). Psychosocial functioning of transsexuals in Belgium. Acta Psychiatrica Scandinavica, 91, 180–184.
De Cuypere, G., Van Hemelrijck, M., Michel, A., Carael, B., Heylens, G., Rubens, R., … Monstrey, S. (2007). Prevalence and demography of transsexualism in Belgium. European Psychiatry, 22, 137–141.
Dewaele, A., Caen, M., & Buysse, A. (2014). Comparing survey and sampling methods for reaching sexual minority individuals in Flanders. Journal of Official Statistics, 30, 251–275.
Dillman, D. A. (1978). Mail and telephone surveys: The total design method. New York: Wiley.
Dillman, D. A. (2000). Mail and internet surveys: The tailored design method. London: Wiley.
Eklund, P. L., Gooren, L. J., & Bezemer, P. D. (1988). Prevalence of transsexualism in The Netherlands. British Journal of Psychiatry, 152, 638–640.
Gronow, J., Haavio-Mannila, E., Kivinen, M., Lonkila, M., & Rotkirch, A. (1997). Cultural inertia and social change in Russia. Helsinki: Department of Sociology, University of Helskiki.
Haavio-Mannila, E., & Kontula, O. (2001). Seksin Trendit Meillä ja Naapureissa. Helsinki: WSOY.
Kuyper, L., & Wijsen, C. (2014). Gender identities and gender dysphoria in the Netherlands. Archives of Sexual Behavior, 43, 377–385.
Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels, S. (1994). The social organization of sexuality: Sexual practices in the United States. Chicago: University of Chicago Press.
Mercer, C. H., Bailey, J. V., Johnson, A. M., Erens, B., Wellings, K., Fenton, K. A., & Copas, A. J. (2007). Women who report having sex with women: British national probability data on prevalence, sexual behaviors, and health outcomes. American Journal of Public Health, 97, 1126–1133.
Olsson, S. E., & Moller, A. R. (2003). On the incidence and sex ratio of transsexualism in Sweden, 1972–2002. Archives of Sexual Behavior, 32, 381–386.
Schoonacker, M., Dumon, E., & Louckx, F. (2009). WELEBI. Onderzoek naar het mentaal en sociaal welbevinden van lesbische en biseksuele meisjes [Study on the mental and social well-being of lesbian and bisexual girls]. Brussels: Vrije Universiteit Brussel.
Van Kesteren, P. J., Gooren, L. J., & Megens, J. A. (1996). An epidemiological and demographic study of transsexuals in The Netherlands. Archives of Sexual Behavior, 25, 589–600.
Van Kesteren, N. M. C., Hospers, H., & Kok, G. (2007). Sexual risk behavior among HIV positive men who have sex with men: A literature review. Patient Education and Counseling, 65, 5–20.
Veale, J. F. (2008). Prevalence of transsexualism among New Zealand passport holders. Australian and New Zealand Journal of Psychiatry, 42, 887–889.
Wilson, P., Sharp, C., & Carr, S. (1999). The prevalence of gender dysphoria in Scotland: A primary care study. British Journal of General Practice, 49, 991–992.
Zucker, K. J., & Lawrence, A. A. (2009). Epidemiology of gender identity disorder: Recommendations for the Standards of Care of the World Professional Association for Transgender Health. International Journal of Transgenderism, 11, 8–18.
Acknowledgments
The first two authors contributed equally to this article. The Sexpert study group consists of Ann Buysse (Ghent University: Department of Experimental Clinical and Health Psychology), Paul Enzlin (KU Leuven, Department of Development and Regeneration, Institute for Family and Sexuality Studies and UPC KU Leuven, Context-Center for Couple, Family and Sex therapy), Guy T’Sjoen (Ghent University Hospital: Department of Endocrinology and Center for Sexology and Gender Problems), John Lievens, Mieke Van Houtte, and Hans Vermeersch (Ghent University: Department of Sociology, Research Team Cultural Diversity: Opportunities and Socialisation). The Sexpert study was funded by the Strategic Basic Research program of the Flemish Agency for Innovation by Science and Technology.
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Van Caenegem, E., Wierckx, K., Elaut, E. et al. Prevalence of Gender Nonconformity in Flanders, Belgium. Arch Sex Behav 44, 1281–1287 (2015). https://doi.org/10.1007/s10508-014-0452-6
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DOI: https://doi.org/10.1007/s10508-014-0452-6