In a groundbreaking survey, the U.S. Centers for Disease Control and Prevention (CDC) revealed that 3.3% of U.S. high school students now identify as transgender, while an additional 2.2% are questioning their gender identity. This first-of-its-kind national survey marks a pivotal moment for understanding the experiences of transgender youth and highlights a range of health disparities that they face, including elevated risks for mental health challenges, violence, and discrimination.
The findings come from the CDC’s Youth Risk Behavior Surveillance System, a national survey that monitors the health behaviors of over 20,000 students in grades 9 through 12. The 2023 survey marks the first time transgender and gender-questioning identities have been explicitly included. The results are both eye-opening and alarming: transgender and questioning teens experience significantly higher rates of bullying, persistent sadness, and suicidal thoughts or behaviors compared to their cisgender peers.
Staggering Mental Health Disparities
Among the most distressing revelations from the survey is the heightened rate of suicidal thoughts and attempts among transgender and questioning students. Over a quarter (26%) of transgender and questioning students reported attempting suicide in the past year, compared to 5% of cisgender male and 11% of cisgender female students. The CDC attributes this to the compounded stressors transgender youth face—gender dysphoria, stigma, social marginalization, and frequent discrimination.
“We have 5% of young people in the country who, because of their gender identity, are stigmatized, bullied, made to feel unsafe, and disconnected at school,” said Kathleen Ethier, the CDC’s director of adolescent and school health. “Consequently, they experience poorer mental health and are at a higher risk for suicide than their cisgender peers. That’s just heartbreaking.”
For many of these students, the lack of support from school communities further exacerbates these challenges. Only 37% of transgender students reported feeling close to others at school, a sharp contrast to 62% of cisgender male students. The lack of connection and safety within the school environment makes it harder for transgender youth to navigate their mental health challenges and reach out for the help they desperately need.
Bullying and Violence Intensify Vulnerability
The survey also shines a light on the heightened levels of bullying and violence faced by transgender and gender-questioning teens. About 40% of these students reported being bullied, a rate twice as high as their cisgender peers, with 20% of cisgender girls and 15% of cisgender boys experiencing bullying. This frequent harassment, coupled with feelings of isolation, leaves many transgender students vulnerable to long-term mental health struggles.
Schools have a pivotal role in shaping the environments that these students experience. The CDC has urged schools to implement measures that foster inclusivity and support, including policies that affirm LGBTQ identities, referrals to mental health services, and the promotion of LGBTQ-inclusive activities. However, the report suggests that many institutions have not yet taken these steps, leaving transgender youth at the mercy of hostile or indifferent environments.
“Transgender students face discrimination not only from peers but often from teachers and administrators, making schools one of the most challenging places for them to feel safe,” the report states. “This impacts their mental health and increases the risk of violence and suicidal behaviors.”
Impact of Unstable Housing and Homelessness
Another contributing factor to the mental health crisis among transgender youth is housing instability. According to the CDC report, transgender and questioning students are significantly more likely to experience unstable housing than their cisgender counterparts. Approximately 10% of transgender students reported facing housing instability in the past month, compared to just 2% of cisgender male students and 1.8% of cisgender female students.
This instability often stems from family rejection, a situation that leaves many transgender teens vulnerable to homelessness and further violence. Once displaced, transgender youth are also less likely to be placed in stable housing due to discrimination in foster systems and shelters.
“Transgender students might experience discrimination, harassment, and assault among foster, shelter, and other social service providers,” the CDC report explains, “which compounds their vulnerability to experiences of violence, poor mental health, and suicidal thoughts and behaviors.”
Political Context and Policy Implications
The timing of this report is especially notable, as the survey data was collected amidst a surge of legislative activity across the U.S. regarding transgender rights. In 2023, dozens of states proposed or passed laws restricting access to gender-affirming healthcare, regulating which bathrooms transgender youth can use, and banning their participation in school sports.
Research has shown that these political attacks exacerbate mental health issues among transgender youth. According to a study by the LGBTQ suicide prevention organization The Trevor Project, transgender and nonbinary teens reported higher rates of suicidal thoughts and behaviors in states with stricter laws than those who lived in more supportive environments.
Ethier emphasized that safe and supportive environments are essential to improving outcomes for transgender youth. “What we’re finding is that when you don’t create safe and supportive school environments for the most vulnerable youth, it has an impact on their mental health and their suicidal thoughts and behaviors.”
The Importance of School Connectedness
School connectedness—defined as students feeling cared for and supported by adults and peers at their school—has been shown to significantly reduce the risk of mental health issues, violence, and suicidal behavior. The CDC report stresses the importance of fostering a sense of belonging and inclusion for transgender students, particularly through gender-affirming policies, inclusive curricula, and LGBTQ support groups like Gender and Sexuality Alliances (GSAs).
“Activities that are inclusive of LGBTQ+ students are associated with decreases in the odds of these experiences among all students, regardless of sexual identity,” the CDC report noted.
Research indicates that even small efforts, like using students’ preferred pronouns and offering safe spaces within schools, can dramatically improve the mental health outcomes of transgender youth. But without these supports, the mental health crisis among transgender youth will likely continue to escalate.
Supporting Transgender Teens: Resources for Parents and Allies
Parents, teachers, and allies can play a crucial role in helping transgender and questioning teens navigate these challenges. Dr. Christine Moutier, the chief medical officer of the American Foundation for Suicide Prevention, suggests several strategies for supporting struggling teens:
- Look for changes: Pay attention to shifts in eating, sleeping, or social habits, as well as changes in school performance.
- Keep the lines of communication open: Encourage conversations about their feelings and offer support, even if the teen is reluctant to talk.
- Seek professional support: If a teen expresses suicidal thoughts, professional mental health intervention may be necessary. Pediatricians or mental health specialists can offer guidance.
- In emergencies: If a teen is in immediate danger, do not leave them alone. Reach out to crisis support hotlines and remove potentially harmful objects from their environment.
For anyone experiencing suicidal thoughts or concerned about a friend or loved one, the Suicide & Crisis Lifeline is available at 988. This confidential support line is free and accessible 24 hours a day, seven days a week.
The Bottom Line
The CDC’s survey offers a rare and necessary glimpse into the lived experiences of transgender and gender-questioning high school students. As the data reveals, these young people are facing severe mental health disparities, often without adequate support from their schools or communities.
Addressing these issues requires a concerted effort from schools, lawmakers, and society as a whole to create environments that affirm transgender identities and provide the necessary mental health resources. While the report highlights significant challenges, it also offers a roadmap for creating safer, more supportive spaces that can help improve the mental health and well-being of transgender youth across the country.
As the conversation around transgender rights continues to evolve, the well-being of young people at the heart of this debate must remain the central focus.
