Own Study

Prevalence

I used the census method in an attempt to estimate the prevalence of transsexualism, in Sweden. Thus I sent letters to all the psychiatrists (child psychiatrists excluded) in the country asking:

"Has a transvestite ever consulted you or been referred to you? If so, please let me know their names and addresses, birth dates and birth places, and whether they are still alive? By transvestites, I mean persons who feet as if they belong to the opposite sex, and who want others to look upon them as members of the opposite sex, whether they are content with only wearing the clothes of the opposite sex, or whether they also want to have their body changed to look like that of the opposite sex?"

I used the word "transvestite" because the word is much better known than "transsexual", and I defined "transvestite" to make it cover both transvestites and transsexuals.

I got the names of the psychiatrists, 474 in all, from the membership list of the Swedish Psychiatric Association and the list of doctors compiled by the Royal Medical Board for the year 1965. At the time the letters were sent, according to the Board altogether 453 psychiatrists were steadily employed in Sweden by the state or local authorities in mental hospitals or in psychiatric departments in general hospitals. As there are only a few psychiatrists with private practices in Sweden, 474 probably represented all the steadily employed psychiatrists in Sweden at the time (excluding child psychiatrists),

The letters were sent out in February of 1965 and the census date was fixed at December 31, 1965. For reckoning the prevalence I used the figures from the Official Statistics of Sweden; Population Changes 1964.

. Seventy-six per cent, or 361 out of the 474 psychiatrists answered the letter, and together reported 91 cases. Most of them gave detailed descriptions of their cases by letter or on the telephone. A few were unwilling to disclose any details about their patients, and these had to be excluded. Two of the patients were not known for sure to be alive on the census date, and these were also excluded. All patients under 15 were also excluded.

Sixty-seven of the remainder reported were transsexuals, judging by the safest criterion to use when one cannot interview the patient personally-they wanted a surgical change in sex. It was checked that none were registered more than once. Including my own 43 cases, this gave I 10 transsexuals in Sweden on December 31, 1965. Sweden having a population of ca. 5.96 million over 15 years of age, this meant a prevalence of ca. I per 54,000. Eighty-one of the 110 were men and 29 women, giving a male/female ratio of about 2.8:1, and a prevalence of ca. I per 37,000 for men and ca. I per 103,000 for women.

Transsexualism is naturally more common than indicated by these figures, which only stand for transsexuals under so much strain because of their anomaly that they had to consult a psychiatrist. Six of the I 10 were foreigners, but only 3 of them appear to have come to Sweden expressly for a "change in sex". As I know of some Swedish transsexuals who have gone to other countries to have plastic surgery done, the admixture of these 3 persons to the series should not distort the figures for prevalence.