Gender identity and transition trajectories in an online sample of gender diverse individuals

Objectives
Historically in research on gender diverse individuals (GDI), the focus has mostly been put on assigned sex at birth (ASAB) as variable. We wanted to study the possible transition trajectories (TT) of self-identified GDI and to investigate any statistically significant differences (SSD) that might be found, based on the self-defined gender identity (GId).
Methods
Our study was completed through an anonymous online survey based on an INSERM study (2011), which was developed internationally in six countries. The questionnaire comprises questions regarding the socio-demographic characteristics of the respondents and several other aspects of their lives, among which some concern possible gender affirming interventions, the person has undertaken or plans. Based on the answers to an open-ended question regarding self-definition of GId, our respondents (N=479) were divided into GId-categories: Man, Woman, Trans Man, Trans Woman, Nonbinary, Other GId.
Results
When comparing TT based on ASAB, we only found a SSD regarding previous or planned top surgery (p-value 0.0).
When analyzing TT based on GId, we found several SSDs regarding application for change of legal gender, previous assessment for Gender Incongruence, previous hormonal treatment, previous or planned top surgery, planned bottom surgery, including planned removal of the gonads (all p-values are 0.0).
Furthermore, we found a SSD regarding planned phalloplasty between the group of respondents identifying as Man and those identifying as Trans Man.We moreover found several SSDs regarding application for change of legal gender, previous and planned assessment for Gender Incongruence, previous and planned hormonal treatment (p-value ≤ 0.1) between the group of respondents identifying as Woman and those identifying as Trans Woman.
Conclusions
It is, based on our results, relevant to include the self-defined gender identity in the investigation of transition trajectories, and in general in transgender research, policy and healthcare, as it provides a fuller, more nuanced picture of the broad spectrum of gender diversity.