How many people are trans and how many regret their medical transitions
Executive summary
Roughly 1.3 million adults in the United States—about 0.5% of the population—self-identify as transgender or gender‑diverse, though prevalence has risen with greater visibility and changing survey methods [1]. Estimates of regret after medical transition are consistently low in surgical series and systematic reviews—typically around 1% for gender‑affirming surgery with some studies reporting pooled regret between ~0.8% and 1.9%—but broader measures of “detransition” or stopping treatment show much wider and methodologically heterogeneous ranges [2] [3] [1].
1. How many people are trans: the best available counts and their limits
Population estimates come from survey-based work and clinic case series; a recent synthesis reported about 1.3 million U.S. adults identify as transgender or gender nonconforming, representing just over 0.5% of the U.S. population, and researchers note those numbers have increased over time with changing acceptance and access to care [1]. These figures are bounded by sampling decisions, question wording, and who participates in surveys, so they describe self‑identification in studied populations rather than an immutable biologic count; global and age‑specific estimates are not uniformly available in the provided reporting [1].
2. Regret after gender‑affirming surgery: what surgical studies show
Systematic reviews and meta‑analyses of patients who underwent gender‑affirming surgery (GAS) find regret rates that are rare: a pooled prevalence commonly cited is about 1% (95% CI <1%–2%) and some analyses separate transfeminine and transmasculine outcomes with rates often below 1% for many procedures, though one pooled analysis reported pooled regret of 1.94% and heterogeneity across studies [2] [3] [4]. Clinical reviews and surgical surveys similarly characterize regret as uncommon and emphasize that improved patient selection and standards of care likely contributed to low historic and contemporary rates [5] [1].
3. Detransition and “regret” beyond surgical series: wider, more varied signals
When the lens widens to include stopping hormones, social detransition, or self‑reported detransition in community surveys, prevalence estimates diverge: large non‑probability surveys have found higher lifetime reports of detransition—one national U.S. survey reported 13.1% ever having detransitioned—while clinic cohorts and administrative studies often report much lower rates, and a Danish cohort measured regret at 0.06% per person‑year in some contexts [6] [7] [8]. These discrepancies reflect differences in definitions—detransition is not the same as regret—and substantial methodological problems such as loss to follow‑up, convenience sampling, and varying questions about identity versus medical reversal [9] [8].
4. Why numbers vary and what the evidence cannot yet settle
Scholars and clinicians warn that frequently cited “low” regret rates rest on studies with long follow‑up but also on chart reviews, high loss to follow‑up, and inconsistent measurement of regret; conversely, higher detransition figures often come from convenience samples or broad definitions that include temporary changes in gender expression or stopping hormones for external reasons [9] [8] [4]. The literature also distinguishes types of regret—true gender‑related regret, social regret, and medical regret from complications—which complicates any single headline statistic and means that the “how many regret” question depends on which outcome is counted [5].
5. Takeaway: a qualified, evidence‑based answer
Best peer‑reviewed surgical evidence indicates regret after gender‑affirming surgery is uncommon, generally near 1% or less in many pooled analyses, while broader measures of detransition or stopping medical care show a wider and less certain range from under 1% in some cohorts to double‑digit lifetime self‑reports in some surveys; underlying methodological heterogeneity prevents a single global percentage and warrants cautious interpretation and better standardized measurement going forward [2] [3] [6] [9]. The provided reporting does not offer a definitive global headcount of transgender people beyond the cited U.S. estimate or a single, universally agreed regret rate across all medical interventions and populations, so conclusions must remain calibrated to those evidentiary limits [1] [9].