Compared with their cisgender peers, the 1.8 percent of transgender high school students who say they are transgender report higher risks of numerous serious threats to their health and well-being. A recent Centers for Disease Control and Prevention (CDC) survey found that trans teens reported consistently higher rates of numerous subcategories of violence victimization, substance use and suicide risk as well as sexual behaviors that are associated with an elevated risk of contracting HIV.

Publishing their findings in the CDC’s Morbidity and Mortality Weekly Report, researchers analyzed data from the 2017 Youth Risk Behavior Survey, a survey conducted every other year that for the first time gave school districts the option to ask about transgender identity. Ten states and nine large urban school districts included this question, yielding a pool of 131,901 high school students in grades nine through 12. The data were weighted to be representative of each district.

A total of 94.4 percent of these students responded “No, I am not transgender”; 1.8 percent (1.0 percent to 3.3 percent across all the sites) responded “Yes, I am transgender”; 1.6 percent responded “I am not sure if I am transgender”; and 2.1 percent responded “I do not know what this question is asking.”

The researchers compared the responses to various questions of those who said they were trans versus those who said they were not trans. To follow are the various questions asked of the students, followed by statistics pertaining to transgender students and the degree (adjusted to account for various factors) to which their responses were more common (except in one instance noted with an asterisk when the response was less common) than among their cisgender peers.

Violence victimization:

Felt unsafe at or traveling to or from school (26.9 percent of trans students reported experiencing this, a rate that was a statistically adjusted 5.44-fold greater than reported by cisgender students); threatened or injured with a weapon at school (23.8 percent, 3.39-fold); ever forced to have sexual intercourse (23.8 percent, 5.45-fold); experienced sexual dating violence (22.9 percent, 6.42-fold); experienced physical dating violence (26.4 percent, 4.15-fold). Bullied at school (34.6 percent, 2.33-fold); electronically bullied (29.6 percent, 2.9-fold).

Lifetime substance use:

Smoking (32.9 percent, 1.34-fold); alcohol (70 percent, 1.31-fold); marijuana (43.8 percent, 1.26-fold); cocaine (27.2 percent, 5.99-fold); heroin (26.1 percent, 10.23-fold); meth (24.9 percent, 9.75-fold); ecstasy (31.6 percent, 7.87-fold); inhalants (31.1 percent, 4.7-fold); and prescription opioid misuse (35.9 percent, 2.95-fold).

Suicide risk in previous 12 months:

Felt sad or hopeless (53.1 percent, 2.58-fold); considered attempting suicide (43.9 percent, 3.95-fold); made a suicide plan (39.3 percent, 3.72-fold); attempted suicide (34.6 percent, 6.3-fold); and had a suicide attempt treated by a doctor or nurse (16.5 percent, 7.55-fold).

Sexual behaviors:

Had first sexual intercourse before 13 years old (14.9 percent, 3.17-fold); had at least four sexual partners during lifetime (16.4 percent, 1.64-fold); did not use a condom for the last act of sexual intercourse (63.8 percent, 1.69-fold); did not use any method to prevent pregnancy during last sexual intercourse (29.7 percent, 2.2-fold); and never been tested for HIV (70 percent, 18 percent less likely)*. In other words, 30 percent of trans students had ever been tested for HIV and they were 1.22-fold more likely to have ever been tested for the virus than their cisgender peers.

“Transgender youths in high school appear to face serious risk for violence victimization, substance use, and suicide, as well as some sexual risk behaviors, indicating a need for programmatic efforts to better support the overall health of transgender youths,” the study authors concluded. “Taking steps to create safe learning environments and provide access to culturally competent physical and mental health care might be important first steps to improving the health of transgender youths. Continued research into the health of transgender youths and development of effective intervention strategies are warranted.”

To read the CDC report, click here.