Abstract

Abstract Background Prejudice against transgender & gender-diverse people persists & is associated with physical & mental health harm. This study describes & characterizes comparative data between countries on gender self-definition/expression & its relationship to gender incongruence diagnosis. Methods We used snowball sampling for a face-to-face survey in France (N = 379; 2010), Italy (N = 167; 2015-2016), Brazil (N = 391; 2016), & Chile (N = 377, 2018). Participants were 18+ years & identified as transgender. An open-ended item was used to capture the self-designation of gender: “How would you describe your gender identity in your own words?” We conducted chi-square bivariate analyses and multivariate regression models to examine variation in gender self-definition across countries & its relationship to obtain a change of legal sex/gender markers between countries & incongruence diagnoses. Results The preliminary results indicate that self-definitions vary across countries. In France, categories were man, trans man, woman, trans woman, & trans. In Brazil & Chile, a traditional cultural category not in European countries was expressed: travesti. Results showed that a “non-binary” had to be included too. Results showed that lower percentages of trans persons in Chile (22% of trans men & 15% of trans women, Brazil (25% & 12%, respectively) & Italy (10% and 21%, respectively) changed their legal gender markers, as compared to France (34% and 35%, respectively) (p < 0.000). The results showed differences between countries considering the self-definition made by each participant regarding obtaining gender incongruence diagnosis with higher rates of diagnosis in Italy and France (p < 0.001). Conclusions These findings show that transgender identity varies between countries & over time. The results indicate the importance of self-identification in trans-health studies, which have implications for global policy and research on the health of trans-identifying persons.

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