(WASHINGTON) — A first-of-its-kind survey has found that 3.3% of U.S. high school students identified as transgender in 2023, with another 2.2% identified as questioning.

The first nationally representative survey from the U.S. Centers for Disease Control and Prevention also highlights the multiple health disparities faced by transgender students who may experience gender dysphoria, stigma, discrimination, social marginalization or violence because they do not conform to social expectations of gender, the CDC reports.

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These stressors increase the likelihood transgender youth and those who are questioning may experience mental health challenges, leading to disparities in health and well-being, according to the health agency.

Here are some of the findings:

More than a quarter (26%) of transgender and questioning students attempted suicide in the past year, compared to 5% of cisgender male and 11% of cisgender female students. The CDC urged schools to “create safer and more supportive environments for transgender and questioning students” to address these disparities, including inclusive activities, mental health and other health service referrals, and implementing policies that are LGBTQ-inclusive.

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About 7 in 10 questioning students (69%) and transgender students (72%) experienced persistent feelings of sadness or hopelessness, which the CDC states is a marker of depressive symptoms.

The CDC estimates 40% of transgender and questioning students have experienced bullying at school. About a quarter of transgender students (25.3%) and more than a quarter of questioning students (26.4%) skipped school because they felt unsafe, compared with 8.5% of cisgender male students.

Trans students were more likely to experience unstable housing in the last month than cisgender students. The CDC found 10.7% of trans students and 10% of questioning students said they experienced unstable housing, compared to 2.1% of cisgender males and 1.8% of cisgender females.

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The CDC noted this disparity is likely caused of discrimination, such as family rejection.

Additionally, “transgender students might experience discrimination, harassment, and assault among foster, shelter, and other social service providers that make this population less likely to be sheltered when experiencing unstable housing, compounding their vulnerability to experiences of violence, poor mental health, and suicidal thoughts and behaviors,” the report states.

The Youth Risk Behavior Surveillance System regularly surveys more than 20,000 high school students in both public and private schools nationwide to monitor adolescent behavior over time to identify key issues and health needs.

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If you are struggling with thoughts of suicide or worried about a friend or loved one, call or text the Suicide & Crisis Lifeline at 988 for free, confidential emotional support 24 hours a day, seven days a week.

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