Clearly not “born that way” since it is both a regional and generational phenomena. Places that have never heard of it or been exposed to it don’t have it. “What is a Woman?” documentary demonstrated that clearly.
Urbanized areas (something that Cal, Fl, NY, and Colorado are famous for) are the magnets to attract higher populations of LGBTQ folks. Highly ruralized areas...such as Montana or Oklahoma...will have next to nothing.