report as much distress. Prevalence here has ranged from 1 in 215 to 1 in 300. This means that transgender people are much more common than those formally diagnosed with gender dysphoria, but not nearly as common as those who identity as gay or lesbian, which is 2 to 4 percent of the US population. While on the topic of homosexuality, let me clarify that gender dysphoria and transgender issues are not about having sex or attraction to the same sex; they are about an experiential mismatch between