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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
Open accessAbstract
) 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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“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“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]
Experimental — accuracy not yet measured
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“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]
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Metadata
- 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
- Published
- 2019-01-25
- Volume
- 68
- Issue
- 3
- Pages
- 67-71
- ISSN
- 0149-2195 (ISSN-L)
- 1545-861X
- 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
- diamond
- doi.org
- 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 › Medicine › Public Health, Environmental and Occupational Health › 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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