People gather in support of transgender youth during a rally at the Utah State Capitol Tuesday, Jan. 24, 2023, in Salt Lake City. AP FILE PHOTO
New laws targeting LGBTQ+ people are proliferating in GOP-led states, but often absent from policy decisions is a clear understanding of how many people will be directly affected.
There has been relatively scant data collected on the number of LGBTQ+ residents in the U.S., particularly intersex people 鈥� those born with physical traits that don鈥檛 fit typical definitions for male or female categories. That means lawmakers are often writing laws without the same kind of baseline information they might have for other demographic groups.
鈥淲e can鈥檛 study the impact without knowing the population,鈥� said Christy Mallory, legal director of the Williams Institute at the UCLA School of Law. The Williams Institute is a think tank that researches sexual orientation and gender identity demographics to inform laws and public policy decisions.
Here鈥檚 a look at what we know and what we don鈥檛 know about the number of people in the U.S. who are LGBTQ+ or intersex.
Why does it matter?
Legislative decisions to ban transgender women and girls from playing school sports often fail to consider the impact on intersex students.
A new Kansas law defines a person鈥檚 sex as male or female, based on what it calls the 鈥渂iological reproductive system鈥� identified at birth, leaving no room for nonbinary or intersex people 鈥� and ignoring the existence of transgender Kansans.
Meanwhile, conversations about gender-affirming care bans, were at times clouded by a discredited 2018 study that claimed kids might experience gender dysphoria because of peer influence. This led to erroneous suggestions that the number of trans people was inflated.
Arguments based on the discredited study helped gender-affirming care bans pass in Georgia, Idaho and elsewhere.
鈥淪ocial media and social pressures that are put on our youth, and I do think that could play into this a little bit,鈥� said Idaho Republican Sen. Doug Ricks during a statehouse debate earlier this year. 鈥淚t鈥檚 difficult. And the conflicting testimony about the studies 鈥� there鈥檚 good arguments that validate those, and others that disvalidate that.鈥�
While most states鈥� bans on gender-affirming care have attempted to carve out exceptions for people who are born intersex, they could still make it harder for intersex people to receive medical care, said Erika Lorshbough, executive director of InterACT, an advocacy group that works to advance the rights of children born with intersex traits. Physicians and other medical practitioners who treat intersex people might be confused by the laws or unsure about their potential liability, especially if an intersex patient also identifies as LGBTQ+, Lorshbough said.
How many people are intersex?
Most advocacy groups estimate that 1.7% percent of people are born intersex 鈥� the equivalent of about 5.6 million U.S. residents. That estimate is based on a review published in the American Journal of Human Biology that looked at four decades of medical literature from 1955 to 1998. The estimate includes people with extra or missing sex-linked chromosomes, and those born with other physical variations that don鈥檛 fit into categories of 鈥渕ale鈥� or 鈥渇emale.鈥�
Intersex people are born with at least one of about 40 naturally occurring variations relating to their genitalia, internal reproductive organs, chromosome patterns or hormones.
Not all intersex people are identified at birth, and those who are may still be listed as either 鈥渕ale鈥� or 鈥渇emale鈥� on their birth certificate. That鈥檚 because only about 16 states currently allow a gender marker designation other than 鈥渕ale鈥� or 鈥渇emale鈥� on birth certificates, and not all hospitals have intersex-affirming policies.
Some intersex characteristics might not be evident until puberty or later 鈥� in fact, sometimes a person doesn鈥檛 know they are intersex until they seek treatment for infertility or undergo other unrelated medical procedures. Others might only find out if they run across medical records from their childhood, because many intersex infants and children are subjected to surgeries and treatments without their consent to make their bodies conform to categories of male or female, according to the American Academy of Family Physicians. Since 2018, the AAFP has opposed medically unnecessary genital surgeries performed on intersex children.
鈥淪ome people never know they鈥檙e intersex if they have what we think of as a milder variation,鈥� said Lorshbough. 鈥淎nd there are plenty of folks with variations in sex characteristics who don鈥檛 identify as intersex, and these issues impact them equally. It鈥檚 all about consent and autonomy.鈥�
Hospitals aren鈥檛 required to track information about how many babies are born with intersex characteristics, and there has never been a nationwide survey on intersex status done by the U.S. Census Bureau, National Institutes of Health or another government agency that normally collect demographic data, said Lorshbough.
That means there isn鈥檛 enough data to calculate a definitive population number.
How many people are LGBTQ+?
There are more than 13 million people who are lesbian, gay, bisexual or transgender in the U.S. ages 13 and older, including about 300,000 young people and 1.3 million adults who identify as transgender, according to the Williams Institute. Nearly half of them live in states without protections from discrimination at work, in school, in housing, public accommodations and credit.
Polling by KFF and The Washington Post shows that there are nearly 2 million people nationwide who identify as transgender or trans, representing less than 1% of all adults. The poll found that most trans adults are younger than 35 years old, and the vast majority 鈥� nearly 8 in 10 鈥� say that transitioning made them more satisfied with their life. Two-thirds of trans adults say they realized they were trans in childhood, and about one-third said they began to understand when they were 10 years old or younger.
The U.S. Census did not add questions about sexual orientation and gender identity until 2021, though it did begin collecting data about households led by same-sex couples in the 2010 census. The 2021 U.S. Census Household Pulse Survey found that 0.6% of responding adults described themselves as transgender and 1.7% described themselves as neither male, female nor trans.
The same Census survey found that 4.4% of adult respondents thought of themselves as bisexual, 3.3% said they were gay or lesbian, and 88.3% said they were straight. Around 2% said they were 鈥渟omething else鈥� or that they didn鈥檛 know.
Are more people identifying as LGBTQ+ now?
It鈥檚 difficult to tell. Efforts to quantify the number of LGBTQ+ people, including intersex people, in the U.S. were scarce until the last few decades, and stigma likely prevented some from disclosing their identities. There is some overlap between the groups; intersex people are included in the plus sign in the LGBTQ+ acronym, and some intersex people also identify as gay, lesbian, bisexual, transgender or queer.
From their demographic studies in 2017 and 2022, The Williams Institute noted a slight increase in the number of young people identifying as transgender, but Mallory said additional research will give a more accurate picture.
鈥淭his kind of data collection on transgender status is very new for youth,鈥� and some of the increase could be because more states are asking about transgender status during surveys of high school students, Mallory said. 鈥淏ut you know, some of it is probably youth feeling more comfortable identifying as trans.鈥�
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