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Introduction: The number of individuals seeking sex hormone therapy for gender dysphoria has been increasing. The prevalence gender dysphoria has recently been estimated as high as 390 to 460 per 100,000 with a consistently greater prevalence of trans women (MTF) than trans men (FTM). We report here the changing demographics encountered in our experience over the past 2 decades. Methods: We collected data on individuals receiving hormonal therapy in the transgender clinic at Albany Medical Center in upstate New York from 1990 to 2017. We analyzed temporal changes in the number, age, and gender identity of transgender individuals. Results: Through June 2017, a total of 421 transgender individuals were seen who initiated hormonal therapy after 1990. Over the past 25 years, there has been a significant increase in the number of individuals seen. The mean age at initiation has remained higher in MTF than in FTM but has decreased steadily in both groups with the overall average dropping <30 years since 2015 (27.5±10.6). Since 1990, there has been a steady increase in the percentage of FTM such that it is now equivalent to MTF. Conclusion: Consistent with many reports, we are seeing an increasing number of gender dysphoric individuals seeking hormonal therapy. The age at initiation has been dropping over the past 25 years, and we have seen a steady increase in the number of FTM such that the incidence now equals that of MTF. Possible reasons for these changes are discussed.
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