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Epidemiol Health > Volume 40; 2018 > Article |
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Current gender identity |
Legal sex at birth |
|
---|---|---|
Male | Female | |
Man | Cisgender2 | Transmasculine |
Woman | Transfeminine | Cisgender2 |
Do not identify as man or woman | Transfeminine | Transmasculine |
1 Modified from Reisner et al. Lancet 2016;388:412-436 [4].
All respondents (n=278) |
Gender identity spectrum1 |
p-value2 | ||
---|---|---|---|---|
Transfeminine (n=173) | Transmasculine (n=105) | |||
Age (yr) | <0.001 | |||
19-29 | 218 (78.4) | 124 (56.9) | 94 (43.1) | |
30-50 | 60 (21.6) | 49 (81.7) | 11 (18.3) | |
Sexual orientation | 0.001 | |||
Heterosexual | 129 (46.4) | 65 (50.4) | 64 (49.6) | |
Homosexual | 29 (10.4) | 24 (82.8) | 5 (17.2) | |
Bisexual | 96 (34.5) | 66 (68.8) | 30 (31.3) | |
Asexual | 24 (8.6) | 18 (75.0) | 6 (25.0) | |
Educational level3 | 0.87 | |||
≤High school graduate | 57 (22.4) | 34 (59.7) | 23 (40.4) | |
College graduate | 39 (15.4) | 25 (64.1) | 14 (35.9) | |
University graduate | 145 (57.1) | 86 (59.3) | 59 (40.7) | |
≥Graduate school graduate | 13 (5.1) | 9 (69.2) | 4 (30.8) | |
Annual household income (104 KRW) | 0.24 | |||
<1,000 | 69 (27.4) | 48 (69.6) | 21 (30.4) | |
1,000-1,999 | 53 (21.0) | 30 (56.6) | 23 (43.4) | |
2,000-2,999 | 45 (17.9) | 30 (66.7) | 15 (33.3) | |
3,000-4,999 | 43 (17.1) | 25 (58.1) | 18 (41.9) | |
≥5,000 | 42 (16.7) | 21 (50.0) | 21 (50.0) | |
Employment status3 | 0.42 | |||
Unemployed | 118 (46.6) | 69 (58.5) | 49 (41.5) | |
Non-precarious employment | 45 (17.8) | 28 (62.2) | 17 (37.8) | |
Precarious employment | 78 (30.8) | 48 (61.5) | 30 (38.5) | |
Self-employed | 11 (4.3) | 9 (81.8) | 2 (18.2) | |
Unpaid family worker | 1 (0.4) | 0 (0.0) | 1 (100.0) | |
Residential area3 | 0.95 | |||
Seoul metropolitan city | 104 (40.8) | 62 (59.6) | 42 (40.4) | |
Other metropolitan cities4 | 42 (16.5) | 26 (61.9) | 16 (38.1) | |
Other cities and counties | 109 (42.7) | 67 (61.5) | 42 (38.5) | |
Data collection | 0.33 | |||
Healthcare institutions | 130 (46.8) | 79 (60.8) | 51 (39.2) | |
Korea Queer Culture Festivals (Seoul, Daegu) | 22 (7.9) | 11 (50.0) | 11 (50.0) | |
Online/offline transgender communities | 126 (45.3) | 83 (65.9) | 43 (34.1) |
1 Gender identity spectrum included transfeminine (transwomen and non-binary men) and transmasculine (transmen and non-binary women).
2 p-value of the chi-square test comparing prevalence of gender identity spectrum across sociodemographic groups.
Transition-related healthcare |
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---|---|---|---|---|---|---|---|---|---|
GID diagnosis (n=278) |
Hormone therapy (n=276) |
Sex reassignment surgery (n=271) |
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Respondents who were diagnosed with GID (n=253)1 | Respondents who were not diagnosed with GID (n=25) | p-value2 | Respondents who received hormone therapy (n=243)3 | Respondents who did not receive hormone therapy (n=33) | p-value4 | Respondents who underwent sex reassignment surgery (n=115)5 | Respondents who did not undergo sex reassignment surgery (n=156) | p-value6 | |
Gender identity spectrum7 | 0.005 | <0.001 | <0.001 | ||||||
Transfeminine | 164 (94.8) | 9 (5.2) | 160 (93.6) | 11 (6.4) | 57 (33.9) | 111 (66.1) | |||
Transmasculine | 89 (84.8) | 16 (15.2) | 83 (79.0) | 22 (21.0) | 58 (56.3) | 45 (43.7) | |||
Age (yr) | 0.02 | 0.006 | 0.71 | ||||||
19-29 | 194 (89.0) | 24 (11.0) | 185 (85.3) | 32 (14.7) | 90 (41.9) | 125 (58.1) | |||
30-50 | 59 (98.3) | 1 (1.7) | 58 (98.3) | 1 (1.7) | 25 (44.6) | 31 (55.4) | |||
Sexual orientation | 0.26 | 0.70 | 0.001 | ||||||
Heterosexual | 120 (93.0) | 9 (7.0) | 116 (89.9) | 13 (10.1) | 68 (54.4) | 57 (45.6) | |||
Homosexual | 24 (82.8) | 5 (17.2) | 23 (82.1) | 5 (17.9) | 11 (39.3) | 17 (60.7) | |||
Bisexual | 86 (89.6) | 10 (10.4) | 83 (87.4) | 12 (12.6) | 26 (27.7) | 68 (72.3) | |||
Asexual | 23 (95.8) | 1 (4.2) | 21 (87.5) | 3 (12.5) | 10 (41.7) | 14 (58.3) | |||
Educational level8 | 0.73 | 0.88 | 0.28 | ||||||
≤High school graduate | 53 (93.0) | 4 (7.0) | 52 (91.2) | 5 (8.8) | 19 (33.3) | 38 (66.7) | |||
College graduate | 35 (89.7) | 4 (10.3) | 34 (87.2) | 5 (12.8) | 17 (43.6) | 22 (56.4) | |||
University graduate | 134 (92.4) | 11 (7.6) | 128 (88.3) | 17 (11.7) | 68 (46.9) | 77 (53.1) | |||
≥Graduate school graduate | 11 (84.6) | 2 (15.4) | 11 (84.6) | 2 (15.4) | 4 (30.8) | 9 (69.2) | |||
Annual household income (104 KRW)8 | 0.38 | 0.21 | 0.10 | ||||||
<1,000 | 61 (88.4) | 8 (11.6) | 58 (84.1) | 11 (15.9) | 26 (37.7) | 43 (62.3) | |||
1,000-1,999 | 51 (96.2) | 2 (3.8) | 51 (96.2) | 2 (3.8) | 29 (54.7) | 24 (45.3) | |||
2,000-2,999 | 42 (93.3) | 3 (6.7) | 41 (91.1) | 4 (8.9) | 17 (37.8) | 28 (62.2) | |||
3,000-4,999 | 41 (95.3) | 2 (4.7) | 38 (88.4) | 5 (11.6) | 14 (32.6) | 29 (67.4) | |||
≥5,000 | 37 (88.1) | 5 (11.9) | 35 (83.3) | 7 (16.7) | 22 (52.4) | 20 (47.6) | |||
Employment status8 | 0.006 | 0.002 | 0.68 | ||||||
Unemployed | 105 (89.0) | 13 (11.0) | 98 (83.1) | 20 (16.9) | 54 (45.8) | 64 (54.2) | |||
Non-precarious employment | 42 (93.3) | 3 (6.7) | 42 (93.3) | 3 (6.7) | 19 (42.2) | 26 (57.8) | |||
Precarious employment | 74 (94.9) | 4 (5.1) | 74 (94.9) | 4 (5.1) | 29 (37.2) | 49 (62.8) | |||
Self-employed | 11 (100.0) | 0 (0.0) | 11 (100.0) | 0 (0.0) | 4 (36.4) | 7 (63.6) | |||
Unpaid family worker | 0 (0.0) | 1 (100.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | 1 (100.0) | |||
Residential area8 | 0.07 | 0.08 | 0.02 | ||||||
Seoul metropolitan city | 99 (95.2) | 5 (4.8) | 96 (92.3) | 8 (7.7) | 52 (50.0) | 52 (50.0) | |||
Other metropolitan cities9 | 40 (95.2) | 2 (4.8) | 39 (92.9) | 3 (7.1) | 21 (50.0) | 21 (50.0) | |||
Other cities and counties | 95 (87.2) | 14 (12.8) | 91 (83.5) | 18 (16.5) | 35 (32.1) | 74 (67.9) | |||
Data collection | 0.001 | 0.005 | 0.007 | ||||||
Healthcare institutions | 127 (97.7) | 3 (2.3) | 123 (94.6) | 7 (5.4) | 42 (32.6) | 87 (67.4) | |||
Korea Queer Culture Festivals (Seoul, Daegu) | 19 (86.4) | 3 (13.6) | 17 (77.3) | 5 (22.7) | 12 (54.5) | 10 (45.5) | |||
Online/offline transgender communities | 107 (84.9) | 19 (15.1) | 103 (83.1) | 21 (16.9) | 61 (50.8) | 59 (49.2) |
1 Not all study participants answered each question; Number of respondents diagnosed with GID who provided: educational level (n=233), annual household income and employment status (n=232), and residential area (n=234).
2 p-value of the chi-square test comparing the prevalence of being or not being diagnosed with GID across different sociodemographic groups.
3 Not all study participants answered each question; Number of respondents who received hormone therapy who provided: educational level (n=225), annual household income (n=223), employment status (n=225), and residential area (n=226).
4 p-value of the chi-square test comparing the prevalence of receiving or not receiving hormone therapy across different sociodemographic groups.
5 Not all study participants answered each question; Number of respondents who had at least one sex reassignment surgery who provided: educational level and annual household income (n=108), employment status (n=106), and residential area (n=108).
6 p-value of the chi-square test comparing the prevalence of having or not having sex reassignment surgery across different sociodemographic groups.
7 Gender identity spectrum included transfeminine (transwomen and non-binary men) and transmasculine (transmen and non-binary women).
GID diagnosis | Distribution (n=278) |
Gender identity spectrum1 |
|
---|---|---|---|
Transfeminine (n=173) | Transmasculine (n=105) | ||
Yes | 253 (91.0) | 164 (94.8) | 89 (84.8) |
No | 25 (9.0) | 9 (5.2) | 16 (15.2) |
Reason for not pursing GID diagnosis (n=25)2 | |||
I was having financial difficulties | 12 (48.0) | 4 (44.4) | 8 (50.0) |
I was debating whether I should see a doctor for a diagnosis | 11 (44.0) | 2 (22.2) | 9 (56.3) |
I am currently not in need of a diagnosis of gender identity disorder | 11 (44.0) | 3 (33.0) | 8 (50.0) |
I was worried about possible discrimination associated with a psychiatric diagnosis on my medical history | 9 (36.0) | 3 (33.0) | 6 (37.5) |
I could not find a psychiatrist who would provide an adequate diagnosis | 7 (28.0) | 2 (22.2) | 5 (31.3) |
I am currently seeing a counsellor/psychiatrist for counselling services | 7 (28.0) | 3 (33.3) | 4 (25.0) |
I was concerned with the stigma associated with having a mental disorder | 4 (16.0) | 3 (33.3) | 1 (6.3) |
My family and/or friends advised against it | 1 (4.0) | 0 (0.0) | 1 (6.3) |
I was refused a diagnosis of gender identity disorder | 0 (0.0) | 0 (0.0) | 0 (0.0) |
Other reasons | 3 (12.0) | 1 (11.1) | 2 (12.5) |
Currently receiving hormone therapy | Distribution (n=276) |
Gender identity spectrum1 |
|
---|---|---|---|
Transfeminine (n=171) | Transmasculine (n=105) | ||
Yes | 225 (81.5) | 150 (87.7) | 75 (71.4) |
No | 51 (18.5) | 21 (12.3) | 30 (28.6) |
Reason for not currently receiving hormone therapy (n=51)2 | |||
I was having financial difficulties | 28 (54.9) | 10 (47.6) | 18 (60.0) |
I believed it would raise difficulties in my economic activities such as finding employment and working | 24 (47.1) | 8 (38.1) | 16 (53.3) |
It raised health issues | 23 (45.1) | 9 (42.9) | 14 (46.7) |
I did not have a medical certificate from a psychiatrist | 17 (33.3) | 4 (19.0) | 13 (43.3) |
I was debating whether I should receive hormone therapy | 15 (29.4) | 2 (9.5) | 13 (43.3) |
I was worried about potential stigma from other people around me | 13 (25.5) | 5 (23.8) | 8 (26.7) |
My family and/or friends advised against it | 8 (15.7) | 1 (4.8) | 7 (23.3) |
I did not have access to healthcare facilities that provided hormone therapy | 8 (15.7) | 3 (14.3) | 5 (16.7) |
I did not think hormone therapy was necessary | 7 (13.7) | 3 (14.3) | 4 (13.3) |
I was preparing for a sex reassignment surgery | 4 (7.8) | 3 (14.3) | 1(3.3) |
The sex reassignment surgery has successfully altered my physical appearance | 3 (5.9) | 2 (9.5) | 1 (3.3) |
I believed it would reduce my reproductive capacity | 2 (3.9) | 1 (4.8) | 1 (3.3) |
Other reasons | 10 (19.6) | 3 (14.3) | 7 (23.3) |
Ever purchased hormone medications without a prescription | Distribution (n=243) |
Gender identity spectrum1 |
|
---|---|---|---|
Transfeminine (n=160) | Transmasculine (n=83) | ||
No | 182 (74.9) | 109 (68.1) | 73 (88.0) |
Yes | 61 (25.1) | 51 (31.9) | 10 (12.0) |
Ever purchased hormone medications without a prescription (yes; n=61)2 | |||
Over-the-counter medicines | 28 (45.9) | 26 (51.0) | 2 (20.0) |
Online foreign vendors/suppliers | 19 (31.1) | 18 (35.3) | 1 (10.0) |
Acquaintances/friends | 15 (24.6) | 8 (15.7) | 7 (70.0) |
Online domestic vendors/suppliers | 10 (16.4) | 9 (17.6) | 1 (10.0) |
Offline vendors/suppliers | 5 (8.2) | 4 (7.8) | 1 (10.0) |
Reason for ever purchasing hormone medications without a prescription (n=61)2 | |||
I did not have a diagnosis from a psychiatrist | 34 (55.7) | 28 (54.9) | 6 (60.0) |
I did not know healthcare facilities where I could acquire prescription for hormone medications | 15 (24.6) | 11 (21.6) | 4 (40.0) |
I did not want to have a record of medical treatment on my medical history | 10 (16.4) | 8 (15.7) | 2 (20.0) |
Purchase hormone medications without a prescription was a cheaper choice | 10 (16.4) | 6 (11.8) | 4 (40.0) |
I did not want to go to a hospital | 10 (16.4) | 6 (11.8) | 4 (40.0) |
Other reasons | 17 (27.9) | 14 (27.5) | 3 (30.0) |
Sex reassignment surgery | Distribution (n=271) |
Gender identity spectrum1 |
|
---|---|---|---|
Transfeminine (n=168) | Transmasculine (n=103) | ||
Yes | 115 (42.4) | 57 (33.9) | 58 (56.3) |
No | 156 (57.6) | 111 (66.1) | 45 (43.7) |
Reason for not having sex reassignment surgery (n=156)2 | |||
The surgery was too costly | 122 (78.2) | 85 (76.6) | 37 (82.2) |
I wish to receive the surgery eventually, but I am not ready for it right now | 100 (64.1) | 68 (61.3) | 32 (71.1) |
I believed it would raise difficulties in my economic activities such as finding employment and working | 57 (36.5) | 37 (33.3) | 20 (44.4) |
My family and/or friends advised against it | 39 (25.0) | 30 (27.0) | 9 (20.0) |
The dangers of the surgery were too high | 36 (23.1) | 27 (24.3) | 9 (20.0) |
I was worried about potential stigma from other people around me | 32 (20.5) | 22 (19.8) | 10 (22.2) |
I have not met the medical requirements for the surgery | 27 (17.3) | 19 (17.1) | 8 (17.8) |
The surgery would not guarantee satisfactory sexual function | 19 (12.2) | 9 (8.1) | 10 (22.2) |
I did not have access to healthcare facilities that provided sex reassignment surgery | 11 (7.1) | 6 (5.4) | 5 (11.1) |
I did not think sex reassignment surgery was necessary | 10 (6.4) | 5 (4.5) | 5 (11.1) |
It raised issues regarding family planning and reproduction such as pregnancy and childbirth | 7 (4.5) | 3 (2.7) | 4 (8.9) |
I was refused a sex reassignment surgery | 1 (0.6) | 1 (0.9) | 0 (0.0) |
Other reasons | 13 (8.3) | 10 (9.0) | 3 (6.7) |
Cost of GID diagnosis (n=251) | Distribution |
Gender identity spectrum2 |
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Transfeminine (n=162) |
Transmasculine(n=89) |
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n (%) | n (%) | n (%) | |||
<25 | 42 (16.7) | 26 (16.0) | 16 (18.0) | ||
25-49 | 170 (67.7) | 110 (67.9) | 60 (67.4) | ||
50-74 | 22 (8.8) | 11 (6.8) | 11 (12.4) | ||
>74 | 17 (6.8) | 15 (9.3) | 2 (2.2) | ||
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Sex reassignment surgery (n=115) |
Distribution |
Transfeminine (n=57) |
Transmasculine(n=58) |
||
n | n | Average cost (SD) | n | Average cost (SD) | |
|
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Breast/chest | 71 | 17 | 532.4 (443.3) | 54 | 368.5 (146.4) |
Orchiectomy, hysterectomy/salpingo-oophorectomy | 63 | 21 | 297.1 (523.8) | 42 | 397.6 (290.1) |
Genital reconstruction | 34 | 27 | 1,514.8 (657.3) | 7 | 2,057.1 (1,135.6) |
Face | 30 | 27 | 1,159.6 (1,048.5) | 3 | 366.7 (57.7) |
Voice | 9 | 9 | 655.6 (545.7) | - | - |
Others | 9 | 7 | 132.9 (118.1) | 2 | 100 (0.0) |
Distribution (n=262) |
Delaying or avoiding hospital visits (n=112) |
Being denied healthcare services (n=14) |
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p-value1 | p-value2 | ||||
Gender identity spectrum3 | 0.02 | 0.17 | |||
Transfeminine | 160 (61.1) | 59 (36.9) | 11 (6.9) | ||
Transmasculine | 102 (38.9) | 53 (52.0) | 3 (2.9) | ||
Age (yr) | 0.04 | 0.91 | |||
19-29 | 209 (79.8) | 96 (45.9) | 11 (5.3) | ||
30-50 | 53 (20.2) | 16 (30.2) | 3 (5.7) | ||
Sexual orientation | 0.27 | 0.003 | |||
Heterosexual | 123 (46.9) | 52 (42.3) | 4 (3.3) | ||
Homosexual | 26 (9.9) | 9 (34.6) | 2 (7.7) | ||
Bisexual | 90 (34.4) | 37 (41.1) | 3 (3.3) | ||
Asexual | 23 (8.8) | 14 (60.9) | 5 (21.7) | ||
Educational level4 | 0.24 | 0.62 | |||
≤High school graduate | 57 (22.5) | 25 (43.9) | 2 (3.5) | ||
College graduate | 39 (15.4) | 12 (30.8) | 2 (5.1) | ||
University graduate | 144 (56.9) | 68 (47.2) | 10 (6.9) | ||
≥Graduate school graduate | 13 (5.1) | 4 (30.8) | 0 (0.0) | ||
Household income4 (104 KRW) | 0.38 | 0.67 | |||
<1,000 | 69 (27.5) | 30 (43.5) | 6 (8.7) | ||
1,000-1,999 | 52 (20.7) | 28 (53.8) | 3 (5.8) | ||
2,000-2,999 | 45 (17.9) | 16 (35.6) | 1 (2.2) | ||
3,000-4,999 | 43 (17.1) | 16 (37.2) | 2 (4.7) | ||
≥5,000 | 42 (16.7) | 17 (40.5) | 2 (4.8) | ||
Employment status4 | 0.67 | 0.93 | |||
Unemployed | 117 (46.4) | 53 (45.3) | 7 (6.0) | ||
Non-precarious employment | 45 (17.9) | 21 (46.7) | 2 (4.4) | ||
Precarious employment | 78 (31.0) | 29 (37.2) | 3 (3.8) | ||
Self-employed | 11 (4.4) | 5 (45.5) | 1 (9.1) | ||
Unpaid family worker | 1 (0.4) | 0 (0.0) | 0 (0.0) | ||
Residential area4 | 0.43 | 0.22 | |||
Seoul metropolitan city | 104 (40.9) | 49 (47.1) | 4 (3.8) | ||
Other metropolitan cities5 | 42 (16.5) | 15 (35.7) | 1 (2.4) | ||
Other cities and counties | 108 (42.5) | 45 (41.7) | 9 (8.3) | ||
Data collection | 0.07 | 0.15 | |||
Healthcare institutions | 127 (48.5) | 48 (37.8) | 7 (5.5) | ||
The Korean Queer Culture Festivals (Seoul, Daegu) | 22 (8.4) | 14 (63.6) | 3 (13.6) | ||
Online/offline transgender communities | 113 (43.1) | 50 (44.2) | 4 (3.5) |
1 p-value of chi-square test comparing prevalence of delaying or avoiding hospital visits across sociodemographic groups.
2 p-value of chi-square test comparing prevalence of being denied healthcare services across sociodemographic groups.
3 Gender identity spectrum included transfeminine (transwomen and non-binary men) and transmasculine (transmen and non-binary women).
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