The Truth About Transgenderism In America: Trans Population And Treatment By The Numbers

This is part 2 of a three-part series.

• Read Part 1: GOP Voters Share The Message, Not The Priority
• Read Part 3: Data Shows Mass Shooters Are Rarely Transgender

SITUATION:

Debate over transgender Americans often blurs several very different questions: how many people identify as transgender, how many actually receive medical treatment, and how many compete in sports as transgender athletes. Teens, adults, and athletes each get discussed as if the numbers were interchangeable.

Some commentators insist these populations are minimal across the board. Others describe surging numbers of transitioning minors, widespread medical treatment among adults, and a wave of transgender athletes dominating women’s sports.

Recent research makes it possible to separate these claims by age group and by category, using data on identification, medical treatment, and athletic participation rather than impressions drawn from headlines.

THE TRUTH:

The raw numbers, laid side by side, show how small each of these populations actually is relative to the group it is drawn from:

• Youth aged 13 to 17 who identify as transgender: about 724,000, or 3.3% of that age group
• Adults 18 and older who identify as transgender: about 2.1 million, or 0.8% of adults
• Minors nationally who received puberty blockers or hormones in a given year: fewer than 0.1% of insured adolescents aged 8 to 17
• Minors nationally who received dysphoria-linked chest surgery per year: roughly 260 to 280
• Minors aged 13-17 who received genital surgery per year: about 19 nationally
• Minors aged 12 or younger: none
• Adults who received gender-affirming surgery in 2019, per national claims data: 2,664 among 47.4 million insured adults, about 0.006% of the insured population
• Adult gender-affirming surgeries nationally per year, broader estimate: roughly 9,600 to 15,000
• Transgender athletes competing in NCAA sports, per December 2024 testimony: fewer than 10 among roughly 510,000 total NCAA student-athletes, less than 0.002%

No one of any age group, minors or adults, in the United States can receive gender-affirming care without an extensive clinical screening process first. Endocrine Society and WPATH guidelines require a full evaluation and confirmation the patient can give informed consent, and for minors specifically, treatment of co-occurring mental health conditions before care begins. A 17-year-old cannot simply request treatment and receive it that same day, even with a parent’s signature.

WHY IT MATTERS:

These numbers are easier to understand next to a comparison point. ASPS member surgeons alone performed more than 365,000 voluntary breast augmentation procedures in the United States in 2024, or roughly 1,000 per day, among American women who needed no diagnosis at all to qualify. That works out to about 0.28% of adult women choosing the procedure in a single year, nearly 50 times the rate at which transgender adults receive gender-affirming surgery.

The athlete numbers tell a similar story. Since fewer than 10 of roughly 510,000 NCAA athletes are transgender, that means the “wave of trans athletes” claim in conservative media is false and in direct contradiction with the NCAA’s own testimony to Congress.

Readers should know the numbers back neither the loudest fear nor the loudest dismissal, for teens, adults, or athletes.

SOURCES:

• Williams Institute, UCLA School of Law, “New estimate: 2.8 million people aged 13 and older identify as transgender in the US,” August 2025
• Hughes et al., “Gender-Affirming Hormone Prescribing Among Youth,” JAMA Pediatrics, January 2025 (Harvard T.H. Chan School of Public Health)
• Das et al., “Gender-Affirming Chest Reconstruction Among Transgender and Gender-Diverse Adolescents in the US from 2016 to 2019,” JAMA Pediatrics, 2023
• Reuters analysis of gender-affirming surgeries among minors, 2019-2021
• Dai et al., “Gender-Affirming Surgery Among Transgender and Gender-Diverse Adults,” JAMA Network Open, 2024
• Endocrine Society, “Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons,” Clinical Practice Guideline
• World Professional Association for Transgender Health, Standards of Care, Version 8, 2022
• NCAA President Charlie Baker, testimony before U.S. Senate panel, December 2024
• Outsports, “These 47 trans athletes have competed openly in college sports,” 2025
• American Society of Plastic Surgeons, 2024 Procedural Statistics Report