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Cited by 749LGBTQ Health, Identity, and PolicyGender, Sexuality, and EducationAdolescent Sexual and Reproductive Health

Transgender Identity and Experiences of Violence Victimization, Substance Use, Suicide Risk, and Sexual Risk Behaviors Among High School Students—19 States and Large Urban School Districts, 2017

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Johns, Michelle M., Lowry, Richard, Andrzejewski, Jack, Barrios, Lisa C., Demissie, Zewditu, McManus, Timothy, Rasberry, Catherine N., Robin, Leah +1 more·2019·MMWR Morbidity and Mortality Weekly Report
DOI 10.15585/mmwr.mm6803a3PMC PMC6348759
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Abstract

) experience disparities in violence victimization, substance use, suicide risk, and sexual risk compared with their cisgender peers (those whose gender identity does align with their sex) (1-3). Yet few large-scale assessments of these disparities among high school students exist. The Youth Risk Behavior Survey (YRBS) is conducted biennially among local, state, and nationally representative samples of U.S. high school students in grades 9-12. In 2017, 10 states (Colorado, Delaware, Hawaii, Maine, Maryland, Massachusetts, Michigan, Rhode Island, Vermont, Wisconsin) and nine large urban school districts (Boston, Broward County, Cleveland, Detroit, District of Columbia, Los Angeles, New York City, San Diego, San Francisco) piloted a measure of transgender identity. Using pooled data from these 19 sites, the prevalence of transgender identity was assessed, and relationships between transgender identity and violence victimization, substance use, suicide risk, and sexual risk behaviors were evaluated using logistic regression. Compared with cisgender males and cisgender females, transgender students were more likely to report violence victimization, substance use, and suicide risk, and, although more likely to report some sexual risk behaviors, were also more likely to be tested for human immunodeficiency virus (HIV) infection. These findings indicate a need for intervention efforts to improve health outcomes among transgender youths.

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  • 53% of transgender young people felt sad or hopeless almost every day for at least 2 weeks in the past year, compared to 30% of cisgender young people.

    “Regarding gender identity, 53% of transgender young people felt sad or hopeless almost every day for at least 2 weeks in the past year, compared to 30% of cisgender young people [4].”

    From Findings from a feasibility study of an adapted cognitive behavioral therapy group intervention to reduce depression among lgbtq (Lesbian, gay, bisexual, transgender, or queer) young people (2019) · cites this paper as [4]

    Table 2 reports 53.1% for transgender students, matching the cited 53% after rounding. It reports 20.7% for cisgender males and 39.3% for cisgender females, not a combined 30% estimate. The table’s definition also specifies that sadness or hopelessness led students to stop some usual activities, a condition omitted from the claim. (LLM, conf=0.85)

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  • LGB young people are about three times more likely than heterosexual peers to have made a plan for suicide.

    “Compared to their heterosexual peers, LGB young people are about three times more likely to have thought about suicide (15% vs. 43%, respectively), three times more likely to have made a plan for suicide (12% vs. 38%), and five times more likely to have attempted suicide (7% vs. 35%) [4].”

    From Findings from a feasibility study of an adapted cognitive behavioral therapy group intervention to reduce depression among lgbtq (Lesbian, gay, bisexual, transgender, or queer) young people (2019) · cites this paper as [4]

    The suicide-risk table reports that 39.3% of transgender students made a suicide plan, compared with 10.4% of cisgender males and 16.0% of cisgender females. It supports an elevated rate of suicide planning, but the comparison is by gender identity, not LGB versus heterosexual identity, and it does not report the cited 38% versus 12% figures. (LLM, conf=0.84)

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  • National prevalence data show that over half of LGBTQ young people experienced depressive symptoms at significantly higher rates compared to cisgender heterosexual young people.

    “This is unsurprising given the national prevalence data showing over half of LGBTQ young people experienced depressive symptoms at significantly higher rates compared to cisgender heterosexual young people [3,4].”

    From Findings from a feasibility study of an adapted cognitive behavioral therapy group intervention to reduce depression among lgbtq (Lesbian, gay, bisexual, transgender, or queer) young people (2019) · cites this paper as [4]

    Table 2 reports that 53.1% of transgender students felt sad or hopeless for at least two weeks, a significantly higher rate than among cisgender male and female students. But the study pools data from 10 states and nine urban school districts; it does not establish national prevalence for LGBTQ young people generally or compare them specifically with cisgender heterosexual young people. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Depression disproportionately affects young people who identify as LGBTQ.

    “Depression is a debilitating and burdensome mental health disorder that disproportionately affects young people who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) [1,2,3,4].”

    From Findings from a feasibility study of an adapted cognitive behavioral therapy group intervention to reduce depression among lgbtq (Lesbian, gay, bisexual, transgender, or queer) young people (2019) · cites this paper as [4]

    The Discussion reports higher suicide risk among transgender high school students, but does not report depression rates. Searches for depression and depressive symptoms found no passage establishing that depression disproportionately affects LGBTQ young people. (LLM, conf=0.77)

    Experimental — accuracy not yet measured

  • LGB young people are about five times more likely than heterosexual peers to have attempted suicide.

    “Compared to their heterosexual peers, LGB young people are about three times more likely to have thought about suicide (15% vs. 43%, respectively), three times more likely to have made a plan for suicide (12% vs. 38%), and five times more likely to have attempted suicide (7% vs. 35%) [4].”

    From Findings from a feasibility study of an adapted cognitive behavioral therapy group intervention to reduce depression among lgbtq (Lesbian, gay, bisexual, transgender, or queer) young people (2019) · cites this paper as [4]

    The suicide-risk table (page not provided) reports attempts among transgender students compared with cisgender students, not LGB students compared with heterosexual peers. Searches for the LGB–heterosexual comparison and the cited percentages found no passage addressing that claim. (LLM, conf=0.76)

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Authors
Johns, M. M., Lowry, R., Andrzejewski, J., Barrios, L. C., Demissie, Z., McManus, T., Rasberry, C. N., Robin, L., & Underwood, J. M.
Affiliations
Centers for Disease Control and Prevention (US)
Corresponding author
Johns, Michelle M.
ORCID
Venue
MMWR Morbidity and Mortality Weekly Report
Publisher
Centers for Disease Control MMWR Office
Published
2019-01-25
Volume
68
Issue
3
Pages
67-71
ISSN
  • 0149-2195 (ISSN-L)
  • 1545-861X
DOI
10.15585/mmwr.mm6803a3
PMC
PMC6348759
OpenAlex
W2911994102
Cited by
746
References
6
Citations by year
2026: 38 · 2025: 77 · 2024: 126 · 2023: 123 · 2022: 136 · 2021: 116 · 2020: 99 · 2019: 29
FWCI
119.37
Type
journal article
Language
en
Open access
Locations
  • MMWR Morbidity and Mortality Weekly Report (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
National Institute on Drug Abuse (T32DA023356)
Topics
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
  • Social Sciences › Gender Studies › Gender, Sexuality, and Education
  • Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
Keywords
transgender identity, transgender youth, violent victimization, substance use, suicide risk, sexual risk behavior, HIV testing, high school students, Youth Risk Behavior Survey, urban school districts
MeSH terms
Adolescent, Female, Humans, Male, Risk, Risk-Taking, Schools, Sexual Behavior, Students, Suicide, United States, Urban Population, Violence, Crime Victims, Substance-Related Disorders, Transgender Persons

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