There are certain difficulties in the diagnosis of thyroid disorders. US Census **data** suggest that approximately 15 million adults (almost half of the total) have unrecognized thyroid disease, including subclinical hypothyroidism. 49 The same is true for the European population that a large proportion unknowingly has laboratory evidence of thyroid dysfunction. 50 It has only been within the last couple of decades that common thyroid antibody tests became widely available, which are crucial for the diagnosis of autoimmune thyroid dysfunction. Thus, the more we learn about the thyroid gland and its disorders, the more we will understand the precise mechanisms affecting sexual orientation. A comprehensive consideration of all thyroid issues is needed in the study of gender nonconformity and same-sex attraction.