US Transgender Survey: mostly young, non-binary and born female
Peter Vasterman dissects the preliminary results of the 2022 U.S. Transgender Survey. The figures show a radically different population than the classical transgender patient of twenty years ago — and blow the innate-condition explanation out of the water.
92,329 respondents — the largest survey ever
The US Transgender Survey 2022, carried out by the National Center for Transgender Equality, is the largest survey among people who call themselves transgender or non-binary. The report counts 92,329 respondents aged 16 and over. Vasterman uses this as a starting point: a sample of this size forces one to take the outcomes seriously, and the outcomes in turn force one to thoroughly revise the standard stories about who is transgender.
55 percent born female
The first striking figure is the sex ratio. Vasterman: "transgender people born female are in the majority, namely 55 to 45 percent." Twenty years ago, when the Amsterdam gender clinic was developing the Dutch Protocol, the ratio was reversed: boys and men dominated the clinical population. This tipping from male-dominant to female-dominant is not only happening in the US — it is happening wherever self-identification becomes measurable. Which innate neurological condition switches from predominantly male to predominantly female within two decades? None.
38 percent call themselves non-binary
Even more revealing is the identity breakdown. "The category of non-binary identity already makes up 38 percent of the total group." Among people born female, non-binary is the modal identity: 30 percent of the total fall into the category "born female, identifies non-binary". Among those born male this is 8 percent. Four times as many people born female choose non-binary as those born male. Vasterman points to the implication: non-binary is empirically not a mid-position between man and woman, but a strongly gendered label — predominantly chosen by young women.
43 percent are 18-24 years old
The age distribution is the third hard figure. 43 percent of respondents are between 18 and 24 years old. This cohort is about three and a half times as large as the cohorts between 25 and 44 years. The group from 45 to 54 years still makes up only 9 percent — almost five times less than the youngest group. If transgender identity were an innate, evenly distributed trait, you would expect a flat age distribution with a slight decline due to mortality. What we see is a steep peak in young adults and a cliff in older cohorts. That is not a biological profile, that is a generation effect.
Young women, non-binary: who are they?
Combine the three variables — female-born, 18 to 24 years old, non-binary identity — and you get the modal respondent of the US Transgender Survey. This is exactly the demographic in which sociologists for fifteen years have been measuring an explosion of eating disorders, autism diagnoses, depression and anxiety complaints. This is the group that grew up on TikTok and Tumblr with identity content. Vasterman does not draw this line explicitly in this blog post, but the figures invite it inescapably. What ought to be explained as innate neurology turns out empirically to be a cohort phenomenon among young women in a specific digital milieu.
Satisfaction and what that figure does and doesn't say
Proponents of the self-identification model like to point to another figure from the survey: "almost all respondents who went through a transition report that their life improved." Vasterman is cautious here. A survey that only asks people who still call themselves transgender misses by definition the detransitioners — the group that after transition drops out or has regrets. Self-reporting at a still-active-trans-identity stage does not measure the outcome, but the current mood of the self-selecting respondent. It is an important figure, but not long-term effectiveness evidence.
Why this is relevant 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 striking high non-binary and doubting sub-category. The Dutch Protocol was designed for the old population — male children with since-toddler-age persistent dysphoria. The current referrals do not fit that protocol. Continuing to treat them along the same route despite that mismatch — while the UK, Sweden and Finland have already pulled back — is exactly what Vasterman has been writing against for years.
What the survey does not measure
The US Transgender Survey measures who currently says they are transgender or non-binary. It does not measure how many of these respondents will still think this way about themselves in five or ten years. It does not measure the comorbidities — autism, eating disorders, depression, trauma — that are over-represented in clinical populations. It does not measure what percentages have medically transitioned and how many of those later detransitioned. For all these questions, longitudinal research is lacking. What the survey does make hard: the 2022 population that calls itself trans is younger, more female and more non-binary than any earlier transgender population. Whoever calls that a natural biological given is not reading the figures.