Vasterman: U.S. Transgender Survey Shows Young, Non-Binary, Assigned Female at Birth
Peter Vasterman analyzes the preliminary results of the 2022 U.S. Transgender Survey. The figures show a radically different population from the classic transgender patient of twenty years ago — and blow the innate-explanation theory out of the water.
92,329 respondents — the largest survey ever
The 2022 U.S. Transgender Survey, conducted by the National Center for Transgender Equality, is the largest survey of people who identify as transgender or non-binary. The report includes 92,329 respondents aged 16 and older. Vasterman uses this as his starting point: a sample of this size demands that the findings be taken seriously, and the findings in turn demand a thorough revision of the prevailing narratives about who is transgender.
55 percent assigned female at birth
The first figure that stands out is the sex ratio. Vasterman: "transgender people who were assigned female at birth are in the majority, namely 55 to 45 percent." Twenty years ago, when the Amsterdam gender clinic developed the Dutch Protocol, the ratio was reversed: boys and men dominated the clinical population. This shift from male-dominated to female-dominated is not limited to the United States — it is happening everywhere self-identification becomes measurable. Which innate neurological condition shifts from predominantly male to predominantly female within two decades? None.
38 percent identify as non-binary
Even more revealing is the breakdown by identity. "The non-binary identity category already accounts for 38 percent of the total group." Among people assigned female at birth, non-binary is the modal identity: 30 percent of the total fall into the category "assigned female at birth, identifies as non-binary." Among those assigned male at birth, the figure is 8 percent. Four times as many people assigned female at birth choose non-binary as those assigned male at birth. Vasterman points to the implication: non-binary is empirically not a midpoint between male and female, but a strongly gendered label — chosen predominantly by young women.
43 percent are aged 18–24
The age distribution is the third hard figure. 43 percent of respondents are between 18 and 24 years old. This cohort is approximately three and a half times as large as the cohorts between 25 and 44. The 45-to-54 age group accounts for only 9 percent — nearly five times less than the youngest group. If transgender identity were an innate, evenly distributed characteristic, you would expect a flat age distribution with a slight decline due to mortality. What we see is a sharp peak among young adults and a chasm among older cohorts. That is not a biological profile; it is a generational effect.
Young adult women, non-binary: who are they?
Combine the three variables — assigned female at birth, aged 18 to 24, and a non-binary identity — and you get the modal respondent of the U.S. Transgender Survey. This is precisely the demographic group in which sociologists have measured an explosion of eating disorders, autism diagnoses, depression and anxiety symptoms over the past fifteen years. This is the group that grew up with identity content on TikTok and Tumblr. Vasterman does not draw this connection explicitly in this blog post, but the figures invite it unavoidably. What is supposed to be explained by innate neurology turns out empirically to be a cohort phenomenon among young women in a specific digital environment.
Satisfaction and what that figure does and does not say
Supporters of the self-identification model readily point to another figure from the survey: "almost all respondents who underwent a transition report that their lives have improved." Vasterman is cautious here. A survey that only questions people who still identify as transgender by definition misses the detransitioners — the group who stop identifying that way or regret their transition. Self-reporting at a stage when a person still actively identifies as trans does not measure the outcome, but the current mood of the self-selecting respondent. It is an important figure, but not evidence of long-term effectiveness.
Why this matters for the Netherlands
Vasterman explicitly links the American figures to the Dutch debate. Dutch referrals to gender clinics follow exactly the same pattern: explosive growth since 2013, dominated by teenage girls, with a strikingly large non-binary and questioning subgroup. The Dutch Protocol was designed for the old population — male children with dysphoria present since early childhood. Current referrals do not fit that protocol. Continuing to treat them along the same pathway despite that mismatch — while the UK, Sweden and Finland have already reversed course — is precisely what Vasterman has been writing against for years.
What the survey does not measure
The U.S. Transgender Survey measures who currently says they are transgender or non-binary. It does not measure how many of these respondents will still think of themselves that way in five or ten years. It does not measure the comorbidities — autism, eating disorders, depression, trauma — that are overrepresented in clinical populations. It does not measure what percentages have medically transitioned or how many of those later detransitioned. Longitudinal research is lacking for all these questions. What the survey does establish clearly is that the 2022 population identifying as trans is younger, more female and more non-binary than any previous transgender population. Anyone who calls that a natural biological given is not reading the figures.