Gender Characteristics and Population Size Estimation of Transgender People: A Field-Based Study from Iran

Purpose: We determined the size of the transgender population in Shiraz, Iran.Methods: In this cross-sectional study, the respondent-driven sampling technique was used by choosing eight seeds, three waves, and six coupons for each participant. The estimated population size was calculated by wisdom of the crowds, multiplier, and successive sampling-population size estimation (SS-PSE) methods. Pooling of results was done by an Anchored Multiplier calculator.Results: The mean age of participants (n=200) was 22.7 +/- 4 years, 197 (98.5%) were single, 86 (43%) were educated <12 years, 25 (12.5%) were not living with their families, and 52 (26%) were not financially supported by their parents. The transgender population was estimated by the wisdom of the crowds, multiplier, and SS-PSE methods to be 300 (95% confidence interval [CI]: 200-400), 677 (95% CI: 655-696), and 665 (95% CI: 624- 677), respectively. Their prevalence was found to be 0.017% (95% CI: 0.011-0.022%), 0.038% (95% CI: 0.036-0.039%), and 0.037% (95% CI: 0.034-0.038) using the same methods, respectively. Pooled results revealed that 22-37 per 100,000 general population were transgender individuals. Weighted estimation showed that trans men (56.6%) are more prevalent than trans women (43.4%), and only 17% of transgender people succeeded in gender reassignment.Conclusion: Transgender people should not be considered as marginalized groups of the community; they should be respected, heard, and valued. Establishing a standard and routine procedure for the collection of data on the status of transgender people and gender identity is necessary for policymaking and intervention programs.