There are two distinct subtypes of male-to-female (MtF) transsexuals: homosexual and nonhomosexual. The relative prevalence of these two subtypes varies dramatically between countries, but no explanation of this variability has yet been proposed. This study examined the hypothesis that the prevalence of nonhomosexual MtF transsexualism, relative to homosexual MtF transsexualism, would be higher in individualistic countries than in collectivistic countries. I analyzed data from 22 studies of MtF transsexualism, conducted in 16 countries, examining the association between percentage of nonhomosexual participants and Hofstede’s (Culture’s consequences: Comparing values, behaviors, institutions, and organizations across nations, 2001) Individualism Index (IDV). IDV accounted for 77% of observed variance in the percentage of nonhomosexual MtF participants (r = 0.88, p < .0001). Controlling for differences in national wealth and in Hofstede’s other indices of societal values (Power Distance, Uncertainty Avoidance, and Masculinity) did not significantly change the ability of IDV to account for variance in the percentage of nonhomosexual participants. The factors that contribute to the observed association between societal individualism and the relative prevalence of nonhomosexual MtF transsexualism remain to be determined, but a greater tolerance within individualistic countries for socially disruptive gender transitions by nonhomosexual gender dysphoric men, and the availability within many collectivistic countries of socially approved transgender roles for pervasively feminine homosexual gender dysphoric men, are plausible contributors.
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In studies of MtF transsexuals conducted in Western countries, the percentage of participants who have been married to a woman is typically 10–35 percentage points lower than the percentage of participants who have a nonhomosexual orientation (e.g., De Cuypere et al., 1995: 45% married vs. 55% nonhomosexual; Lawrence, 2005: 67% vs. 91%; Muirhead-Allwood et al., 1999: 59% vs. 86%; Smith et al., 2005, reanalyzed by Lawrence, 2008: 33% vs. 67%; Verschoor & Poortinga, 1988: 28% vs. 63%).
A reviewer of an earlier version of this article proposed that I also examine two putative measures of societal gender polarization, the United Nations Development Programme’s (2005) Gender-related Development Index (GDI) and Gender Empowerment Measure (GEM), as supplemental predictors of %NHS, based on Lippa and Tan’s (2001) suggestion that societal differences in gender polarization might affect the likelihood that homosexual men will think of themselves as feminine (and therefore possibly consider gender transition). This note briefly summarizes the results of that analysis; further information is available from the author.
The GDI is a composite measure of male-female equality in life expectancy, literacy, education, and earned income; the GEM is a composite measure of male-female equality in political power, high-status professions, and earned income. GDI figures are available for all countries in the present study except Singapore; GEM figures are available for all except Brazil (United Nations Development Programme, 2005). For the countries in the present study, the most relevant bivariate correlations were: GDI and GEM, .77; GDI and IDV, .77; GDI and %NHS, .67; GEM and IDV, .84; GEM and %NHS, .57. In a multiple regression analysis, when GDI and GEM were added to IDV, PDI, UAI, MAS, and GNI/capita as predictors of %NHS, R 2 = .82, R 2 Adj = .72, and IDV remained the only statistically significant predictor of %NHS (cf. Table 4, first column).
The study by Kellogg et al. (2001) did not meet inclusion criteria for the present analysis, because the participants were not described as living full-time as women, having completed SRS, or having been diagnosed with gender identity disorder, transsexualism, or gender dysphoria. Moreover, MtF transgender persons who seek anonymous HIV testing may be unrepresentative of MtF transgender persons generally with respect to sexual orientation, in that exclusively gynephilic persons may be less likely to request such testing. Finally, ethnic minority groups appear to have been significantly overrepresented among the Kellogg et al. participants, relative to United States population norms. If the Kellogg et al. study had been included in the present analysis, the correlation between IDV and %NHS would have been .84.
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Lawrence, A.A. Societal Individualism Predicts Prevalence of Nonhomosexual Orientation in Male-to-Female Transsexualism. Arch Sex Behav 39, 573–583 (2010). https://doi.org/10.1007/s10508-008-9420-3