1 L.M. Howden and J.A. Meyer, 2011, Age and Sex Composition: 2010, Washington, DC: U.S. Department of Commerce, U.S. Census Bureau, accessed Jan. 24, 2013.
2 G. Gates, 2011, How Many People Are Lesbian, Gay, Bisexual, and Transgender?, Los Angeles, CA: Williams Institute, accessed Jan. 24, 2013; L. Conway, 2002, "How Frequently Does Transsexualism Occur?" accessed Jan. 28, 2011.
3 Correspondence with Tri-Ess.
4 Intersex Society of North America, "How Common Is Intersex?" accessed Jan. 28, 2011.
8 See Conway's "How Frequently Does Transsexualism Occur?" for more information on the difference between the rates of those who transition publicly in some way (e.g., medically) and the rough rates of those who do not.
9 L. Cook-Daniels, 2002, "Transgender Elders and Significant Others, Friends, Family and Allies (SOFFAs): A Primer for Service Providers and Advocates," paper presented at the 110th Annual Convention of the American Psychological Association in Chicago, IL, accessed March 20, 2013.
10 J.M. Grant, L.A. Mottet, J. Tanis, J. Harrison, J.L. Herman, and M. Keisling, 2011, Injustice at Every Turn: A Report of the National Transgender Discrimination Survey, Washington, DC: National Center for Transgender Equality and National Gay and Lesbian Task Force, accessed Feb. 4, 2011.
12 L. Carson, 2009, Physical and Emotional Health Needs of Transgender Individuals Living in Philadelphia: Summary of Key Findings, Philadelphia, PA: Public Health Management Corporation; J. Xavier, J. Honnold, and J. Bradford, 2007, The Health, Health-Related Needs, and Lifecourse Experiences of Transgender Virginians, Richmond, VA: Virginia HIV Community Planning Committee and Virginia Department of Health, accessed March 20, 2013; R. Garofalo, J. Deleon, E. Osmer, M. Doll, and G.W. Harper, 2006, "Overlooked, Misunderstood and At-Risk: Exploring the Lives and HIV Risk of Ethnic Minority Male-to-Female Transgender Youth," Journal of Adolescent Health 38(3):230236.
13 G. Kenagy and W. Bostwick, 2005, "Health and Social Service Needs of Transgendered People in Chicago," International Journal of Transgenderism 8(2/3):5766; J. Xavier, M. Bobbin, B. Singer, and E. Budd, 2005, "A Needs Assessment of Transgendered People of Color Living in Washington, DC," International Journal of Transgenderism 8(2/3):3147; T. Nemoto, D. Operario, and J. Keatley, 2005, "Health and Social Services for Male-to-Female Transgender Persons of Color in San Francisco," International Journal of Transgenderism 8(2/3):519.
15 See the World Professional Association for Transgender Health's "Standards of Care."
16 The three largest LGBT health centers follow informed consent protocols. See Fenway Community Health Center's "Protocol for Hormone Therapy," Tom Waddell Health Center's "Protocols for Hormonal Reassignment of Gender," and Howard Brown Health Center's THInC program.
20 A heteroflexible person is primarily oriented to people of the "opposite sex" but may be open to relationships with individuals of any sex or gender. Pansexual differs from bisexual in that it does not imply there are only two genders. Polyamorous individuals are capable of loving more than one person at the same time. Polyamory is consensual non-monogamy, which may result in different types of relationships.
21 R. Savin-Williams, 1989, "Coming Out to Parents and Self-Esteem Among Gay and Lesbian Youths," Journal of Homosexuality 18:12; I. Meyer, 2003, "Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence," Psychological Bulletin 129:5; M. Eliason, 1996, "Identity Formation for Lesbian, Bisexual, and Gay Persons," Journal of Homosexuality 30:3.
22 For a state-by-state listing, see Lambda Legal's "Sources of Authority to Amend Sex Designation on Birth Certificates."
24 Ibid. FTMs who are or have used testosterone tend to have an overtly male appearance (e.g., facial hair, fat redistribution, deepened voices), whereas MTFs, even those who use estrogen, progesterone, or androgen-blockers, may not have any outward signs of a stereotypically female appearance.