If your statistical data depends on that degree of precision then it should include medical records, not just death certificates.
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I generally assume 0% transgender in my models knowing that it is not perfect. Maybe someone else has addressed the issue, but probably not if the data hadn’t been recorded that way until recently.
It generally includes data from the CDC and CMS.
And who cares what their health risks are is an acceptable position in your profession?
“ More recent studies released in 2016 estimate the proportion of Americans who identify as transgender at 0.5 to 0.6 %. This would put the total number of transgender Americans at approximately 1.4 million adults (as of 2016).”
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People who are not clued in have this distressing tendency to talk about “biological sex” when they mean assigned gender, because they don’t understand that aside from certain obvious things, after a while on hormones our bodies have changed in some surprising fundamental ways. My skin has softened and gotten less hairy. My body stores fat in female places. I have breasts that I grew myself. I don’t even smell like a man any more. Because in all of these ways, my body is biologically female.
So yeah, there’s gonna be an asterisk because clearly my body is not a 100% match for a cis woman’s, but as long as we insist on sorting people into two buckets and as long as we’re not talking about my reproductive system, a competent doctor is going to treat my body as that of a woman rather than a man.
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I think the point is that without accurate data that reflects the detail (i.e. do trans women need to be their own separate category than cis women etc… are the risks the same? Are frequencies of certain diseases? etc…), anything that depends on actuarial data is going to inherently be inaccurate or non-representational for trans folks.
You could look at this like “for what nefarious purposes are they trying to single out trans people?”, or it could be looked at as “if there’s no info on trans people, assumptions (very likely incorrect ones) are being made, and that’s a kind of marginalization as well…”. Disease surveys and insurance pricing are just two things what come to mind as being very dependent on this kind of info.
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OTOH - to a trans person- transphobia and institutional transphobia get experienced in much the same fashion.
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Yeah, that’s the unfortunate aside of shitty humans running institutions.
The actuaries I know are all really impartial numbers oriented people. “The truth comes from the data” sort of folks. The problem is that data/information is power, and that can be abused/misapplied. The problem beyond that is that as long as things like gender and biological sex remain relevant bits of data, then true integration into society is going to involve that information not being hidden away.
To raise a point: as there are a lot of hormonal related cancers, I’d think that studies involving massive numbers (gleaned from death certificate info) on say cancer rates in transgender individuals and their cis counterparts could be very medically important.
But, the devil’s in the details, and I do agree that as long as there are shitty humans involved, it would serve to be extremely cautious approaching things like this.
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Because there is a long history of transgender people dying, and then their unsupportive family wiping away their gender in death. It’s like the ultimate insult. I’ve seen it happen to transgender women,
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Actuaries don’t know what to do with transgender people. When I got life insurance, they had to literally call the main office, and make a decision on where to put me. I ended up with mad good rates because they decided to go by my birth identification, which was female. They weren’t even sure if that was right, or if the risks would be more male or female, now that I was on testosterone.
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Let’s say i want to look at life expectancy from birth for females. I need to know what age previous females died at, regardless of whether they identified as male in order to make an accurate estimate.
We don’t have enough data to know, though. My risks changed to masculine when I transitioned female to male, yet my life insurance insists on placing me in the lady category. Far be it from me to point out the latests studies show I have increased risks, just like cisgendered men.
The truth of the matter is that if you placed us in the gender we were assigned at birth, you are getting really skewed data. We do not have the same risks as cis gendered people. Hell, just the risk for assault and murder alone are through the roof for us. Then add in long term HRT for those medically transitioning, and that’s going to put us more in line, but not exactly, with cis gender people of the same gender.
So the argument that demographic information needs to be accurate, isn’t going to work because we do not have the same life expectancy, or risks, as the gender were assigned at birth, nor our actual gender.
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anything that depends on actuarial data is going to inherently be inaccurate or non-representational for trans folks.
My spouse and I are finding, as we are both trans, going in opposite directions, that nobody really knows. The current data shows were are trading to the other genders risk factors, but insurance, life insurance, and anything else that uses actuary data just aren’t sure. Every time I have to deal with the cross section of medical and gender, it’s a coin toss. Not a lot of studies have been done on us, and certainly nothing in depth.
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Understanding causes of death of transsexuals is critical to advancing transgender public health. For example, understanding the actual risks of death by homicide—with an eye on creating preventive policies—is hampered by an inability to account for specifically transgender deaths (emphases added):
[There are] at least 3 reasons homicides of transgender individuals may be invisible as specifically transgender homicides, and thus the numbers I have presented are likely to be undercounted.
First, “Our institutions of recording death—coroners, death certificates, police reports, hospital records, obituaries—are unprepared to represent transgender. . . . Boxes labeled ‘Was transgender’ do not exist to be checked off or not.” Newspapers and other media outlets running obituaries are just recently coming to terms with noting surviving children with 2 parents of the same sex; editorial social conservatism censors and erases transgender deaths.
Second, the fact that a homicide victim was transgender, whether surgically or hormonally transitioned or not, is not necessarily apparent to those who record deaths. Even were the checkbox “Was transgender at time of death” present, how would someone recording a death for institutional reasons— almost certainly a stranger to the deceased— know to mark it?
Finally, the family of origin, because of transphobia—well documented in the United States—can seek to efface transgender identity and experience when contributing information about deceased transgender relatives.
Dinno, A. (2017). Homicide rates of transgender individuals in the United States: 2010–2014. American Journal of Public Health, 107(9):1441–1447.
“Causing difficulties for researchers” is, ahem, an anti-transgender researcher position. Researchers can and should do better.
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Pretty sure you don’t have those data. (Or if you do, please cite!) Transgender and epidemiologist here, and want.
This is conflating sex and gender somewhat. For example, trans women generally have prostate glands as a male sex characteristic. However, trans women often have histories with longer estrogen-mediated physiologies, and much shorter testosterone mediated physiologies, so the risk of prostate cancer—itself mediated by estrogen—is likely different than for cis men.
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No sources to cite, unfortunately. Pretty much quoting my endo on that. IIRC, the example he gave was decreased risk of prostate cancer (or maybe testicular cancer?) and increased risk of breast cancer.
At this point, I feel like I’m a helluva lot less likely to die of suicide than when I was running on T so there’s that.
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My endo said pretty much the same. Higher heart risks in line with cis men because of my testosterone levels.
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There is zero epidemiological evidence of increased risk of breast cancer in MtFs (in the U.S.). From what several trans-specializing MDs with patient loads in above 1000 have told me, there is surprisingly little risk in their patient groups.
The point is we do not know what trans folks as a population get sick and die of, which is a tragedy, precisely because the data are not collected. That must change. (Aside: MDs also need to get comfortable saying “I don’t know” and “We don’t know,” instead of spouting of things that sound good at the time. Trans folks deserve better.)
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Well, the data tells us that trans women are women and trans men are men. Psychology, biology, medical science, sociology, all these fields of study have been recognizing people as this. So, in turn, your data as an actuary should reflect this as well.
Um, I personally want to be remembered (YES, including in any documentation pretaining to me) as the woman I am, not a man. I live my life as a woman, I exist in spaces as a woman. I am not a man and to have that reflected in my death is a horrible thing to me. Do you want to have the documentation of your entire existence to reflect a gross inaccuracy like that? I highly doubt it.
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So far, and I’ll have to get the data from my doctor but we talk about things like this in depth, as far as we’ve been able to tell trans people do have disease curves that shift away from birth assigned risks towards my gender’s risks (for me I move away from things like testicular and prostate cancers and towards breast cancer). The thing to note, though, is my current risk of breast cancer is far from my age bracket’s risk. I’m in the 35-40 age bracket, but due to transitioning late in life I probably have somewhere near a 20-year-old’s risk, and I’ll pretty much remain in a lower aged risk group for my entire life. But my risk does significantly increase over a male’s risk; it’s the nature of having actual breast tissue.
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New Zealand drivers licenses don’t have gender designations.
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