discussion
This study builds on previous research conducted among states and local urban school districts that have included transgender identity items in the YRBS since 2017 to estimate the nationally representative prevalence of transgender identity among U.S. high school students. For the first time, we present estimates and questions about transgender identity (1). An analysis of 2021 YRBS data from 18 states found similar prevalence of transgender identity and similar distribution across demographic characteristics of transgender and questioning students (7).
This study found that transgender and self-identifying students experience higher rates of violence, poor mental health, suicidal ideation and behavior, unstable housing, and school compared to cisgender students. It was found that the proportion of connections with Approximately 40% of transgender and questioning students have experienced bullying at school. About 26% of transgender and questioning students attempted suicide in the past year, compared with about 5% of cisgender men. Prevalence of unstable housing was highest among transgender students (10.7%) and lowest among cisgender women (1.8%). The differences identified in this study are consistent with those found in previous studies using state YRBS, clinical samples, and convenience samples (1,8). Previous research using state YRBS data from 2017 and 2019 found that transgender and questioning students combined had a more than seven times higher prevalence of unstable housing, and were also found to be on the “street” (i.e. It has been demonstrated that people are three times more likely to be living in their car (in their car). , parks, campgrounds, or other public places) compared to cisgender students if their housing is unstable (9).
Minority stress theory and the gender minority stress framework (10) can be applied to understand the factors that perpetuate these disparities. Transgender and questioning people experience prejudice, discrimination, and social exclusion related to their gender as a result of institutionalized social norms that privilege cisgender people. people. Accumulating stressors such as internalizing prejudiced attitudes, expectations of rejection, and experiences of discrimination and violence contribute to poor mental health among transgender and questioning people, leading to disparities in health and well-being. The possibility increases. Transgender and self-identifying students are often affected by family life (e.g., adverse childhood experiences, parental rejection, gender dysphoria) and school life (e.g., bullying, violence, misgendering by peers or teachers, gender identity). may face stressors (e.g., denial of access to activities tailored to their needs). identity) can increase the risk of poor mental health (8). Additionally, transgender students of color may face additional marginalization related to their race and ethnicity. According to the GLSEN 2021 National School Climate Survey, approximately 80% of lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) students (K-12) are exposed to verbal, physical, or sexual harassment at school. half of LGBTQ+ students of color have experienced racial/ethnic-related victimization (11).
The structural and interpersonal discrimination faced by transgender students, including family rejection, puts this population at increased risk of experiencing housing instability (9). Transgender students may experience discrimination, harassment, and assault among foster parents, shelters, and other social service providers, and therefore may be less likely to be protected while experiencing housing instability. This further exacerbates their vulnerability to experiences such as violence, poor mental health, and suicidal thoughts. Action (9).
The report’s findings show that transgender-identifying students experience more violence, less connectedness to school, more unstable housing, and poorer mental health than cisgender students. , indicate that they are experiencing more suicidal thoughts and behaviors, highlighting the need for interventions to create a safe and supportive environment for them. A student who has questions about being transgender. Having a supportive family and peers, feeling connected to family and school, having a positive name and pronouns that others use consistently, and being proud of their identity. is a protective factor for transgender students that buffers the effects of minority stressors and promotes better mental health ( 8 ).
Opportunity for intervention
Schools are in a unique position to create safe and supportive environments free of violence and bullying for all students, including transgender and questioning students. Violence, poor mental health and suicide are not caused by a single factor, nor can prevention be achieved through a single strategy. However, strategies that create safe, supportive environments that include transgender students and foster connectedness to school can improve the health and well-being of transgender students across a range of outcomes. The CDC’s What Works in Schools (WWIS) approach (https://www.cdc.gov/healthyyouth/whatworks/what-works-overview.htm) has been shown to reduce experiences of violence, poor mental health, and suicide. Evidence has been shown to support the association. Thoughts and Behaviors of High School Students (12) WWIS helps school districts and schools deliver quality comprehensive health education, connect students to health services, and foster safe and supportive school environments. Specifically, school connectedness and activities that promote a safe and supportive environment are associated with decreased odds of experiencing violence, poor mental health, and suicidal thoughts and behaviors among high school students ( 13). Activities in which LGBTQ+ students participate are associated with lower odds of having these experiences for all students, regardless of sexual identity (14). Inclusive activities include implementing Gender and Sexuality Alliances (student-led clubs that provide an avenue for students with LGBTQ+ identities and their allies to come together and provide support); This may include providing professional development to educators and school staff, providing mental health services, etc. Referrals to other health services that include students with LGBTQ+ identities and implementation of policies that include students with LGBTQ+ identities. To date, the WWIS approach has not been specifically evaluated among transgender and questioning students. Further research is needed. However, the potential for school support to promote health for transgender and questioning students is promising.
CDC’s Dating Matters (https://www.cdc.gov/intimate-partner-violence/php/datingmatters/index.html) is an evidence-based teen dating violence prevention model that Educate youth about types of healthy relationships. Working with family and friends can be effective in reducing the risk of experiencing and perpetrating violence and drug use. Dating Matters creates a guide to healthy and safe relationships for LGBTQ+ youth (https://vetoviolence.cdc.gov/apps/dating-matters-toolkit/static/media/Dating_Matters_LGTBQ%20Guide_Youth_v5a_508.fde67eab.pdf has been adjusted for. Customized resources that provide information about healthy relationships specific to the unique needs and experiences of students with LGBTQ+ identities. CDC’s Suicide Prevention Resources for Action (https://www.cdc.gov/suicide/resources/prevention.html) provides a comprehensive approach to suicide prevention that addresses multiple factors associated with suicide risk. Strategies have been identified. The implementation of school-based strategies and community-based supports can serve as the foundation for effective youth suicide prevention. Schools create safe, supportive environments and foster connections by teaching coping and problem-solving, providing gatekeeper training to school colleagues, teachers, and other adults, and implementing mental health supports. (the term ‘gatekeeper’ refers to people trained to identify people in schools) by reducing the risk of suicide and facilitating referrals to treatment and support services. Respond effectively (https://www.cdc.gov/suicide/pdf/preventionresource.pdf). CDC’s Comprehensive Suicide Prevention Program (https://www.cdc.gov/suicide/programs/csp.html) provides a comprehensive approach to suicide prevention with a special focus on those disproportionately affected by suicide. It funds 24 programs that implement and evaluate public health approaches. , including transgender and questioning students.
The McKinney-Bent Homeless Assistance Act† (MVA) is a federal law that authorizes services that enable precariously housed students to enroll, attend, and succeed in school. Certain MVA programs include family counseling, school and community-based programs for youth health and mental health care, and referrals to LGBTQ+ programs supported by student-led groups, including the Gender and Sexuality Alliance. Provide training and support (15). Schools can help support transgender and troubled students facing housing instability by connecting them with MVA-funded programs tailored to these transgender needs. can play a vital role.
