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About 3.3 percent of high school students identify as transgender and another 2.2 percent are questioning their gender identity, according to the first nationally representative survey on these groups, published by the Centers for Disease Control and Prevention on Tuesday.
Transgender and gender-questioning teenagers reported alarmingly higher rates of bullying at school, persistent sadness and suicidal thoughts and behaviors, according to the survey, which was carried out in 2023. About one in four transgender students said they had attempted suicide in the past year, compared with 11 percent of cisgender girls and 5 percent of cisgender boys.
“We have 5 percent of young people in the country who, because of the way they identify around their gender, are stigmatized, bullied, made to feel unsafe, feel disconnected at school and consequently have poorer mental health and higher risk for suicide than their cisgender peers,” said Kathleen Ethier, the director of C.D.C.’s adolescent and school health division. “That’s just heartbreaking.”
The data come from the agency’s Youth Risk Behavior Surveillance System, a survey of more than 20,000 high school students conducted in public and private schools across the country every two years. The 2023 survey was the first to ask teenagers in all schools whether they identified as transgender.
This small group of young people has drawn outsize and often harsh political attention across the country. The survey data were collected during a record year of legislation related to transgender issues. Around two dozen states have passed laws limiting bathroom use, sports participation or access to medical treatments for transgender children under 18.
In the C.D.C.’s survey, transgender and gender-questioning students reported feeling worse than even cisgender girls, who have drawn national attention to a crisis in mental health among young people.
Roughly 70 percent of transgender and questioning students reported feeling persistent sadness or hopelessness for a period of more than two weeks in the past year, compared with half of cisgender girls and 26 percent of cisgender boys. Ten percent of transgender students reported receiving medical treatment from a doctor or nurse for a suicide attempt in the past year, compared with 2.6 percent of cisgender girls and 1 percent of cisgender boys.
Transgender students were also much more likely to experience bullying and isolation at school. Just 37 percent of these students reported feeling close to others at school, versus 62 percent of boys and about half of girls. And they were five times as likely to report having unstable housing in the past month.
Previous estimates of the number of transgender teenagers in the United States were considerably lower than 3.3 percent. It is unclear how much those differences are because of past gaps in data or because of continuing increases in the population of young people identifying as transgender.
A 2022 report by the Williams Institute, an L.G.B.T.Q. public-policy research center at the University of California, Los Angeles, estimated that 1.4 percent of teenagers identified as transgender. But that figure was based on C.D.C. data collected from just 15 states in 2017 and 2019; researchers used statistical modeling to then extrapolate a national number.
“Data like this is exceedingly rare,” said Jody Herman, senior scholar of public policy at the Williams Institute and an author of the 2022 report. “It certainly fills in significant gaps in our knowledge about trans youth.”
Dr. Herman said the data seemed to align with trends the institute had seen in its own data: More young people identified as transgender than adults did, and that number grew over time. But she cautioned against drawing direct comparisons with her group’s prior estimates.
“If the age trend holds, we would imagine as time goes on, that younger age group might have more youth identifying as trans,” she said. But that idea cannot be confirmed until the next batch of data from the C.D.C.’s survey, she said: “That is the gold standard for looking at something like that.”
The timing of the survey was notable because of the many state laws enacted since 2021 that affect transgender students, especially in schools, researchers said.
A peer-reviewed study published in September by the Trevor Project, an L.G.B.T.Q. suicide-prevention nonprofit, found that transgender and nonbinary teenagers in states that passed such laws reported more suicide attempts than those in states that didn’t, according to online surveys by the group.
“What we’re finding is that when you don’t create safe and supportive school environments for the most vulnerable youth,” Dr. Ethier of the C.D.C. said, “it has an impact on their mental health and their suicidal thoughts and behaviors.”
If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources. Go here for resources outside the United States.
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