This dataset is a retrospective study of de-identified electronic-medical record data of transgender and gender-diverse (TGD; i.e. those whose gender identity does not align with their sex assigned at birth) adults 18 years and older who receive gender-affirming care within the University of Utah healthcare system. Gender-affirming care includes gender-affirming hormone therapy (i.e. estrogen- or testosterone-based medications) and gender-affirming surgeries. The goal of creating this dataset is to contribute to the growing literature needed about the TGD population in order to facilitate public health efforts to address health disparities as well as answer clinically-impactful questions.