Transgender, gender-questioning teens have worse health outcomes

Compared with cisgender youth, transgender and gender-questioning youth have increased risk factors and worse outcomes in five health domains, according to a study published in the April 19 issue of the Journal of the American Medical Association.

Gilbert Gonzales, Ph.D., and Cameron Deal, from Vanderbilt University in Nashville, Tennessee, used state data sets from the 2017 and 2019 Youth Risk Behavior Surveys to examine risk factors and health outcomes in a population-based sample of gender minority adolescents. Several domains of health were examined: bullying, sexual and dating violence, mental health and suicidality, sexual risk behaviors, and substance use. Data were included from 4,092 transgender respondents, 3,661 gender-questioning respondents, and 189,396 cisgender participants (1.8, 1.6, and 96.6 percent, respectively).

The researchers found that an estimated 10.2, 53.2, and 49.3 percent of cisgender adolescents, transgender adolescents, and gender-questioning adolescents, respectively, identified as lesbian, gay, or bisexual. On most measures in all five domains, transgender adolescents reported differences from cisgender adolescents, and differences were reported for gender-questioning adolescents in all domains except sexual risk behaviors. For example, transgender adolescents were more likely to report bullying at school (adjusted prevalence ratio [aPR], 1.88) and considering, planning, and attempting suicide (aPRs, 1.69, 1.94, and 2.65, respectively) than cisgender youth; gender-questioning adolescents were also more likely to report bullying at school, and considering, planning, and attempting suicide than cisgender youth (aPRs, 1.62, 1.54, 1.60, and 2.26, respectively).

"This analysis extends prior research to gender-questioning youths and reports the demographic characteristics and health status of gender minority adolescents," the authors write.

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