Cross-dressing and surgical alteration of primary sex characteristics both have deep historical roots. Understanding that history matters because it shapes how a family member's disclosure today is received and understood.

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Ancient and biblical references — The Bible suggests this was an issue as early as Old Testament times (Deuteronomy 22:5), and it references eunuchs — people who underwent surgical alteration of sexual characteristics (Acts 8:27). In Metamorphoses, the Roman poet Ovid retold the Greek myth of Caenis, a woman transformed into a man (Caeneus) after being granted her wish following an assault by Poseidon.

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Renaissance through the 18th century — From ancient Greece through Shakespeare's era, male performers played all female roles on stage (a boy, for instance, would have played Juliet in a 17th-century Romeo and Juliet). From the 16th–18th centuries, castrati — male singers surgically altered before puberty to preserve a higher vocal range — performed sacred music in churches; Handel's Messiah (1741) was later rewritten to accommodate a castrato voice.[¹,²]

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Colonial and 19th-century America — Jemima Wilkinson led a Christian commune in 1790s New York as a self-styled prophet who preferred male pronouns.[³] Women are reported to have disguised themselves as men to fight in the Revolutionary War.[⁴] Charlotte Brontë published Jane Eyre (1847) under the male pen name Currer Bell.[⁵] That same year, Elizabeth Newcomb enlisted as "Bill Newcomb" in the Missouri Mounted Volunteers, later discharged when discovered.[⁵] In 1849, Elvira Field cross-dressed as "Charles Douglass," secretary to a Mormon sect leader in Michigan.[⁵] The Oneida Community (founded 1848, NY) held gender norms considered radical for the era, including clothing for women viewed as masculine.[⁵] More than 400 women are reported to have disguised themselves as men to serve as Civil War soldiers.[⁶] Female impersonation was also common in minstrel shows and Vaudeville acts, including performer Julian Eltinge (1904).[⁷]

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20th century — Christine Jorgensen became the first widely known person to undergo sex reassignment surgery, in 1952.[⁸] From the 1950s–80s, major film and TV actors — Milton Berle, Tony Curtis, Jack Lemmon, Flip Wilson, Tom Hanks, Dustin Hoffman, Julie Andrews — played cross-dressing roles played largely for comedy. From the 1990s onward, portrayals shifted toward depicting transgender identity itself, rather than cross-dressing as comedy — The Birdcage, Diary of a Mad Black Woman, and Hairspray on the comedic side; Ugly Betty and Transparent depicting transgender characters more directly.

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21st century politics — In March 2021, Dr. Rachel Levine was confirmed as U.S. Assistant Secretary for Health, becoming the highest-ranking transgender official in U.S. government history. Days after her nomination, President Biden reversed the 2017 ban on transgender military service. That order was itself revoked four years later, in January 2025, by a new executive order banning transgender service members — enforcement of which the Supreme Court later upheld.

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History of clinical treatment

For the history of clinical treatment of transgender-related behavior from the 19th century to today, see Clinical History.

 

How many people have a transgender identity?

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This history, combined with a sense of scale, can help families place a loved one's identity in context:

• An estimated 1.8% of students in grades 9–12 (about 273,000 youth) report a transgender identity.[⁹] Among adults, estimates range from 0.5–1.3% (about 1.4 million people).[¹⁰]

• A Gallup survey found this has risen across generations: 0.2% of Gen X, 1.2% of Millennials, 1.8% of Gen Z.

• Parents have increasingly reported their children identifying as transgender and seeking treatment.[¹¹,¹²] Even so, a recent study found only 0.1% of privately insured youth ages 13–17 (fewer than 18,000) had a gender dysphoria diagnosis between 2018–2022, and fewer still received medical treatment (under 2,000 on puberty blockers; under 1,000 on hormones).

• About one-fifth of transgender adults over 45 have not told anyone about their gender identity — even as rates of gender-affirming surgery among transgender adults overall have risen in recent years.[¹³]

• A 2025 Centre for Heterodox Social Science report found the share of U.S. college students identifying outside male/female had declined to 3.6%, down from 5.2% (2024) and 6.8% the year before. Around the same time, the Society for Evidence Based Gender Medicine's analysis of separate survey data found transgender/nonbinary identification among college students at an all-time high of 4.7–6.7%, though showing signs of plateauing — with rates among college-aged females (8.1%) notably higher than males (4.7%). (These two 2025 findings differ somewhat, likely reflecting different underlying survey data — worth noting both rather than treating either as the final word.)

 

The science on what causes a transgender identity remains under development, with a range of perspectives that aren't all equally supported by evidence — see Etiology, Treatment, & Outcomes for more (written for clinicians, but accessible to general readers too), or Yarhouse (2015) and Zucker (1995, chs. 6–7) for book-length treatments.

 

Everyone in the family is affected

• 25–50% of transgender people report being parents.[¹⁴]

• About 70% of transgender parents maintain contact with their children.[¹⁵]

 

When a family member comes out, others often experience confusion about their own identity in relation to that person, along with grief and stigmatization.[¹⁶]

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And the church, too

Although only about 2% of transgender people identify with a religious denomination[¹⁷] — and roughly half of those who identify as Christian describe themselves as "evangelical" or "born again" — churches have significantly raised this topic's visibility, whether through public position statements or a fuller institutional welcome. This raises real theological questions clergy and congregants may feel unprepared to address. More in I'm Clergy or a Church Member.

 

*The citations on this page come from the research literature and other publications and are available upon request.

1. Riding, 2006; Wheadon, 2009; Bauman & Feldman, 1994

2. Riding, 2006

3. Morris, 2019

4. Colonial Williamsburg Foundation, 2019; Cashier, Albert D. J., 1913; Terris, 2013

5. Harvey, 2020

6. Fischer, 2001

7. DeCaro, 2019

8. McQuiston, 1989

9. Johns et al 2019

10. Zucker 2017; Flores et al 2016

11. Singal 2018

12. Chen, Fuqua, & Eugster 2016

13. Canner et al 2018

14. Stotzer, Herman & Hasenbush 2014

15. Grant et al 2011

16. Whitley, 2013; Veldorale-Griffin & Darling 2016; Canfield-Lenfest, 2008; Norwood, 2012, 2013b

17. Djupe 2017