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Being trans in Korea: key milestones and stigmatization across life stages in a nationwide survey of 585 transgender and non-binary young adults
Sungsub Choo, Ranyeong Kim, Hyemin Lee, Horim Yi, Rockli Kim, Seung-Sup Kim
Epidemiol Health. 2025;47:e2025032.   Published online June 27, 2025
DOI: https://doi.org/10.4178/epih.e2025032
  • 11,861 View
  • 158 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Understanding the experiences of transgender and non-binary (TGNB) individuals from a life-course perspective is essential. This article aims to identify ages at key milestones related to transgender identity and assess experiences of stigmatization among TGNB individuals across different life stages.
METHODS
We analyzed data from a nationwide longitudinal survey of 585 TGNB adults in Korea collected in 2020 and 2021. Analysis of variance and chi-square test were used to compare mean ages at transgender identity developmental milestones and experiences of anti-transgender stigma across transgender identities.
RESULTS
On average, TGNB Koreans realized their transgender identity at age 13, accepted it at age 20, and came out to others at age 21. Regarding experiences of stigmatization across different life stages, 67.4% reported hearing homophobic and transphobic remarks from teachers in secondary school. Among TGNB individuals assigned male at birth (AMAB) who served mandatory military service, 29.0% were classified as maladjusted soldiers, and 12.1% experienced sexual harassment or violence. When asked about the job application process, 57.0% reported discontinuing their job search due to their transgender identity. Financial burden represented the primary barrier to psychiatric evaluations, hormone treatment, and gender-affirming surgery.
CONCLUSIONS
Our study identifies key milestone ages related to transgender identity and experiences of stigmatization across life stages among TGNB adults in Korea. With 97.6% of participants under 40 years old, these findings primarily reflect the experiences of TGNB young adults. Further research is necessary to better understand the experiences of middle-aged and elderly TGNB individuals in Korea.
Summary
Korean summary
한국에서 트랜스젠더 당사자들은 평균적으로 13살에 트랜스젠더 정체성을 자각하고, 20살에 트랜스젠더로서의 자신을 수용하며, 21살에 처음으로 트랜스젠더 정체성을 타인에게 알린다. 시스젠더 이성애자의 몸을 표준으로 구성된 한국 사회에서, 트랜스젠더는 청소년기와 성인기를 거치며 고등학교, 군 복무, 취업, 의료 이용 등에서 차별과 낙인을 경험한다.
Key Message
The average age of developmental milestones related to transgender identity include realizing their transgender identity at age 13, accepting it at age 20, and first coming out at age 21. TGNB individuals faced stigma and discrimination in key set- tings and situations such as secondary school, the military, and job applications from their adolescence and onwards.

Citations

Citations to this article as recorded by  
  • Transphobic bullying in adolescence: a systematic review of psychological outcomes for victims and predisposing factors for perpetrators
    Alessandro Taurino, Francesca Nicois, Morena Bottalico, Cristina Semeraro, Veronica Verri
    International Journal of Adolescence and Youth.2026;[Epub]     CrossRef
  • Victimization and mental health among transgender and gender-diverse young adults in South Korea: the moderating role of family support
    Gwanghyeon Kim, Seojune Yoon, Sun Young Lee, Ssirai Kim, Hye Ryeon Jang, Kuylhee Kim, Na-Hyun Hwang, Hyein Chu, Jung-won Yoon, Eun Sil Lee, Yehoon Choi
    International Journal of Transgender Health.2026; : 1.     CrossRef
Experiences of and barriers to transition-related healthcare among Korean transgender adults: focus on gender identity disorder diagnosis, hormone therapy, and sex reassignment surgery
Hyemin Lee, Jooyoung Park, Bokyoung Choi, Horim Yi, Seung-Sup Kim
Epidemiol Health. 2018;40:e2018005.   Published online February 27, 2018
DOI: https://doi.org/10.4178/epih.e2018005
  • 55,131 View
  • 495 Download
  • 48 Web of Science
  • 49 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Transgender people may encounter barriers to transition-related healthcare services. This study aimed to investigate the experiences of transition-related healthcare and barriers to those procedures among transgender adults in Korea.
METHODS
In 2017, we conducted a nationwide cross-sectional survey of 278 transgender adults, which named Rainbow Connection Project II, in Korea. We assessed the prevalence of transition-related healthcare, including gender identity disorder (GID) diagnosis, hormone therapy, and sex reassignment surgery. To understand the barriers to those procedures, we also asked participants for their reasons for not receiving each procedure. Further, this study examined their experiences of and the reasons for using non-prescribed hormone medications.
RESULTS
Of transgender people participated in the survey, 91.0% (n=253/278) were diagnosed with GID, 88.0% (n=243/276) received hormone therapy, and 42.4% (n=115/271) have had any kind of sex reassignment surgery. Cost was the most common barrier to transition-related healthcare among Korean transgender adults. Other common barriers were identified as follows: negative experiences in healthcare settings, lack of specialized healthcare professionals and facilities, and social stigma against transgender people. Among those who had taken hormone medications, 25.1% (n=61/243) reported that they had ever purchased them without a prescription.
CONCLUSIONS
Our findings suggest that barriers to transition-related healthcare exist in Korea and constrain transgender individuals’ safe access to the needed healthcare. Institutional interventions are strongly recommended to improve access to transition-related healthcare. These interventions include provision of programs to train Korean healthcare professionals and expansion of national health insurance to include these procedures.
Summary
Korean summary
- 본 연구는 한국 성인 트랜스젠더의 정신과진단, 호르몬요법, 성전환수술의 경험과 그 과정에서 마주하는 장벽에 대해 파악하고자 했다. 전체 트랜스젠더 중 성주체성장애 진단을 받은 참여자는 91.0%(N=253/278), 호르몬요법을 현재 받고 있거나 과거에 받은 경험이 있는 참여자는 88.0%(N=243/276), 한 가지 종류 이상 성전환수술을 받은 참여자는 42.4%(N=115/271)였다. 트랜스젠더가 의료적 트랜지션 과정에서 경험하는 가장 큰 장벽으로는 의료적 조치에 소요되는 비용인 것으로 밝혀졌다.

Citations

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    Eun Sil Lee, Sun Young Lee, Ssirai Kim, Kuylhee Kim, Na-Hyun Hwang, Yehoon Choi, Hyein Chu, Jung-won Yoon
    International Journal of Transgender Health.2026; 27(5): 2740.     CrossRef
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    The Journal of LGBTQ+ Mental Health.2026; : 1.     CrossRef
  • Transgender Identity Dimensions and Unmet Dental Care Needs Among Korean Transgender Adults
    Min-Joo Shin, Yongsun Choi, Yuyi Park, Hyun-Jae Cho, Dong-Hun Han
    International Dental Journal.2026; 76(5): 109741.     CrossRef
  • Prevalence of and Factors Associated with Unmet Need for Gender-Affirming Surgery Among Transgender Women and Nonbinary Adults Assigned Male at Birth Receiving Hormone Therapy in South Korea
    Kuylhee Kim, Ssirai Kim, Sun Young Lee, Na-Hyun Hwang, Yehoon Choi, Hyein Chu, Jung-won Yoon, Eun Sil, Lee
    LGBT Health.2026;[Epub]     CrossRef
  • Experiences of Transformation: The Challenges of Gender Transition for Transgender Women in Pakistan
    Arooj Fatima, Humaira Jami
    Archives of Sexual Behavior.2025; 54(4): 1375.     CrossRef
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    Patience A. Muwanguzi, Racheal Nabunya, Moses Sabila
    BMC Health Services Research.2025;[Epub]     CrossRef
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    Chelle Jones
    Gender & Society.2025; 39(3): 458.     CrossRef
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    Sara Fernandes, Jenny Pitts, Christophe Lançon, Delphine Drai, Bach Tran, Laurent Boyer, Guillaume Fond
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