Estimation of prevalence, incidence and sex ratio of transsexualism in Catalonia according to health care

Introduction. We estimate the epidemiology of transsexualism in the autonomous community of Catalonia according to data gathered at the Hospital Clinic of Barcelona, the single public hospital providing specialized psychiatric and endocrinological care for transsexual patients in this community. Patients and method. Prevalence was calculated on the basis of the total number of patients diagnosed of transsexualism (ICD-10, F64.0) at the Hospital Clinic and living in Catalonia, and the incidence by counting all new cases of transsexuals for the last 5 years, based on the population census between 15 and 65 years of age. Results. During the period from 1996 through 2004 a total of 201 subjects were referred to this hospital with complaints of gender dysphoria. Transsexualism was diagnosed in 182 patients, 161 of whom were living in Catalonia. This yields a prevalence rate in Catalonia of 1:21,031 males and 1:48,096 females. The sex ratio was 2.6. Annual incidence in the last five years was 0.73/100,000/year. Discussion. The low prevalence compared with recently published data from European Union countries may be due to the relatively few years of data collection and to the low clinical demand because surgical procedures costs are not covered by the public health insurance. In contrast, the high incidence may be due to the increasing demand since 2000, when a more benevolent and tolerant social climate in Spain started.