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As of November 9, 2022, a total of 28,730 cases of monkeypox (mpox) had been reported in the United States,* primarily among adult cisgender men reporting recent male-to-male sexual contact (1). Transgender and gender-diverse persons, who constitute an estimated 0.5% of the U.S. adult population, † face unique health disparities and barriers to care (2-4). However, data on the epidemiologic and clinical features of Monkeypox virus infections in this population are limited (5). CDC analyzed U.S. case surveillance data on mpox cases in transgender and gender-diverse adults reported during May 17-November 4, 2022. During this period, 466 mpox cases in transgender and gender-diverse adults were reported, accounting for 1.7% of reported cases among adults. Most were in transgender women (43.1%) or gender-diverse persons (42.1%); 14.8% were in transgender men. Among 374 (80.3%) mpox cases in transgender and gender-diverse adults with information available on sexual or close intimate contact, 276 (73.8%) reported sexual or close intimate contact with a cisgender male partner during the 3 weeks preceding symptom onset. During the ongoing outbreak, transgender and genderdiverse persons have been disproportionately affected by mpox. Members of this population frequently reported recent sexual or close intimate contact with cisgender men, who might be in sexual networks experiencing the highest incidence of mpox. These findings highlight the importance of tailoring public health prevention * https://www.cdc.gov/poxvirus/monkeypox/response/2022/index.html (Accessed November 9, 2022). † Transgender and gender-diverse persons are those whose gender identity might differ from their assigned sex at birth. This description includes transgender women, transgender men, and gender-diverse persons identifying as another gender (i.e., not transgender or cisgender), such as nonbinary, genderqueer, and gender nonconforming. Using data from CDC's 2017-2020 Behavior Risk Factor Surveillance System and 2017 and 2019 Youth Risk Behavior Survey, which rely on self-reporting of gender identity, the Williams Institute estimates that 1.3 million transgender and gender-diverse adults live in the United States; however, this percentage might be an underestimate because some persons might have been reluctant to disclose their gender identity because of fear of stigma or other reasons. and outreach efforts to transgender and gender-diverse communities and could guide strategies to reduce mpox transmission. Data on confirmed and probable cases of mpox are electronically reported by jurisdictional health departments to CDC using a standardized case report form § or the National Notifiable Diseases Surveillance System. ¶ CDC analyzed case report form § https://www.cdc.gov/poxvirus/monkeypox/pdf/sCRF-Short-Form.pdf ¶ https://www.cdc.gov/nndss/index.html INSIDE

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