Roughly 3.3 percent of high school students identify as transgender, and 2.2 percent are questioning their gender identity, new data reveal—and they face high rates of bullying and symptoms of depression amid a national landscape that has become especially charged surrounding their identity.
The data, collected in 2023 and released this week by the Centers for Disease Control and Prevention, are the first to capture a nationally representative picture of transgender and gender-questioning high school students. It comes as transgender adolescents have seen increased scrutiny and hostility toward their identity nationally—with statewide legislation targeting what sports teams they can play on, which bathrooms they can use, whether their gender identity can be talked about in class, and whether parents have to be notified about changes to a student’s name or pronouns.
In that challenging environment, transgender high school students are facing disparate health outcomes and challenges in school—including violence toward them and discrimination—the CDC report found. Researchers and advocates say schools are a vital piece of the puzzle for improving those outcomes and supporting students.
“A big finding from my research is just that: You can do this, that it’s not an impossible task,” said Melinda Mangin, professor and chairwoman for the department of educational theory, policy, and administration at Rutgers University. “There are ways that we can be proactive about creating environments where students can feel accepted and feel like they’re part of a community and that gender doesn’t have to be a destructive factor for them.”
The new CDC data shows an increase from estimates the Williams Institute published in 2022, which used federal health surveys from 2017 to 2020 to determine that roughly 1.4 percent of youth ages 13 to 17 identified as transgender.
“I think it’s really important to remember this increase is due largely to access to vocabulary that people can use to describe their experience,” Mangin said.
Transgender and questioning students struggle with mental health, school connectedness
Approximately a quarter of transgender and gender-questioning students have skipped school because they felt unsafe, compared to just 8.5 percent of cisgender boys, and around 15 percent of cisgender girls, according to the data collected through the Youth Risk Behavior Surveillance System, a set of surveys that track high school students’ behaviors, experiences, and conditions that can lead to poor health.
Though bullying was prevalent across all gender categories, there was a higher rate reported by transgender and questioning students compared to cisgender boys and girls.
At the same time, roughly 65 percent of transgender students reported poor mental health in the past month, with about 72 percent saying they had experienced “persistent sadness or hopelessness” in the past year. Those metrics were similarly high for students who reported questioning their gender identity—about 53 percent and 69 percent, respectively.
Approximately half of transgender students and about 45 percent of questioning students seriously considered attempting suicide in the past year, according to the data. One-fourth of transgender and questioning students attempted suicide.
Cisgender girls had the next highest prevalence of sadness and hopelessness (50 percent) and suicide ideation (24 percent), while cisgender boys had the lowest in all areas.
Transgender students also felt more isolated in school, reporting the lowest feeling of connectedness to others at school compared to their peers. School connectedness has declined in the last few years, especially for LGBTQ+ youth and girls. Research shows that when students have strong connections to their school and teachers, they have better mental health, better attendance and grades, better behavior, and lower dropout rates.
Transgender students (10.7 percent) and questioning students (10 percent) also had higher rates of unstable housing than their cisgender peers. Previous research showed that transgender and questioning students, who are more likely to face stigma at home, were three times more likely to be living on the streets—a car, park, campground, or other public place, according to the report.
For those researchers and advocates supporting trans youth, the data aren’t surprising. It confirms what has long been known to be true, said Ronita Nath, vice president of research at the Trevor Project, an organization focused on suicide prevention for LGBTQ+ youth.
“It is crucial to clarify that these young people are not inherently prone to these negative mental health outcomes, but rather, placed at higher risk because of how they are mistreated and stigmatized by others,” Nath continued. “The figures reported by the CDC are harrowing, and indicate that much remains to be done to support transgender young people’s health and safety in the U.S.”
Schools are an avenue for support
At least 26 states have passed bans on gender-affirming care for adolescents under the age of 18, according to the Human Rights Campaign, a LGBTQ+ civil rights organization. At least eight states entirely censor discussions of LGBTQ+ people or issues in school curricula, according to the Movement Advancement Project, a nonprofit focused on equality and opportunity.
Often, teachers want to support their students, said Bethy Leonardi, a professor of educational foundations, policy, and practice at the University of Colorado Boulder, and the co-founder of A Queer Endeavor, a center for gender and sexual diversity in education that provides training for educators.
The complexity of doing that work is entirely dependent on educators’ environment, she said. State policies vary—“but there’s always, always, always something to do,” Leonardi said.
LGBTQ+ people are a minority group who don’t necessarily share their identity with their family, and school becomes a place where supportive adults exist for students who don’t always have one at home, she said.
Mangin, who researched how 20 elementary school principals made safe environments for transgender students and wrote a book about trans elementary school students, said she saw two types of approaches. One was providing direct support to individual students by having targeted conversations with classroom teachers and staff who interacted with the student in question on a daily basis. The other was shifting the whole school culture.
“Having one openly trans student is probably just the tip of the iceberg, as the research showed,” she said. “Trans kids are not always visible to us. They might be undisclosed, they might not be sharing their identity, they might be questioning. It’s also about leaders in schools creating an entire culture of openness and acceptance where all kids’ identities can be affirmed.”
After all, experts said, school culture is ultimately the most significant part of addressing health outcomes for trans youth.
When A Queer Endeavor works with educators, Leonardi asks them to take stock of their environment. What’s on the classroom walls? What’s in the curriculum? What’s in the language? What are the assumptions you’re making about students and families?
Leonardi tries to give educators ways to move forward in their own nuanced environment rather than prescribing something specific to do.
“We have to look at the environment that these students are in to understand why they’re having the experiences they’re having. If we do that, the focus is on changing the environment and not on fixing the student, or just supporting the student to ‘have grit, things get better’—coping and problem-solving,” she said. “Those things are important, but essentially, we don’t want our most vulnerable students to cope and problem-solve all the time. We want them to learn and get the education that they are promised in the public system.”
