Demographic trends in gender identity among adults in the United States, 2014–2021

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Background Overall increases in the population reporting a transgender or nonbinary (TNB) identity in the United States are well-documented. Although previous analyses have considered trends in TNB identification across time period, age and birth cohort, no study has rigorously disentangled these three dimensions of demographic change, despite the existence of relevant methods. The Behavioral Risk Factor Surveillance System (BRFSS) has collected consistent information on TNB identity since 2014.Methods We add to what is known about TNB population changes in the US by disentangling age, period, and cohort (APC) effects using the 2014–2021 BRFSS surveys. We explore four specific research questions regarding changes in TNB identity trends along various APC dimensions, including whether those changes are slowing down.Results We found that the growth in the proportion of American adults reporting TNB identities is primarily driven by cohort effects, not age effects, despite previous descriptions to the contrary. Increases extended back to birth cohorts from the 1970s and showed no signs of consistent deceleration. We also observed less uncertainty about gender identity (“don’t know/not sure” responses) and less reticence in expressing that identity (“decline to answer” responses) among more recent birth cohorts.Conclusion: The patterns of increase in the proportion of American adults reporting TNB identities suggests that these increases are widespread, persistent and likely to continue. This signals the need for continued inclusion of TNB populations in health research, and the continued development, maintenance and expansion of TNB-supportive and inclusive health and social services.

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