MSM   Agreed  Every single source I have and Puellanivis has referred to has said that TGTS women are considered MSM or along side MSM The much vaunted CDC source made it sound even less ambigous Her very own source backed me That TGTS women are for the CDCs and any other medical purpose biologically male that the MSM category does not take into account any aspec of identity Which would include gender identity Case closed  The rest of this has just been about Puella and her personal feelings     No my source states that gender identity is not tracked at all so the assumption on their part is that everyone is reported as they biological sex  However again if a TSTG were reported as female since no gender identity information would be collected there would be no indication of which were which  Literally TSTG information is entirely intermingled in some indeterminable amount  The ambiguity of not collecting TSTG information means that there is simply a blanket assumption about how the information is received from the CDC the true answer is because of the ambiguity no one knows how theyre split up the data is intermingled and there is no way to separate the information  Again the answer from the CDC and from your sources is that the assumption is that MTF TSTG are reported as MSM and FTM are just pretty much ignored NB assumption since gender identity information isnt collected no one can say what it is  Again being that my medical records indicate me as female and I continue to be asked are you pregnant when getting xrays indicates that I would not be reported as a male to the CDC  Without collecting gender identity information no one can with certainty that all TSTG are recorded as MSM  The answer is its inconsistent and no one knows not haha Im right youre wrong TSTG are always MSM