Rider GN, McMorris BJ, Gower AL, Coleman E, Eisenberg ME. Health and Care Utilization of Transgender and Gender Nonconforming Youth: a Population-Based Study. Pediatrics. 2018;141(3):e20171683.
In prior small studies, youth who are transgender and gender nonconforming (TGNC) are at elevated risk for mental health disparities and negative health outcomes. In this study of over 80,000 9th- and 11th-grade students in public schools in Minnesota in 2016, 2.7% of students self-identified as TGNC. TGNC youth were nearly twice as likely to report their overall health as "poor," "fair" or "good" (instead of "very good" or "excellent") as their same-age peers. TGNC youth were also more than 3 times as likely to report long-term mental health problems.
Important terms to know: transgender youth have a gender identity and/or expression differing from societal expectations based on birth-assigned sex. Gender nonconforming youth have gender expression that does not follow stereotypical conventions of femininity and masculinity and who may or may not identify as transgender. Cisgender youth have a gender identity aligning with their birth-assigned sex. In this population-based study, thought to be the largest focused on health and health care of TGNC youth compared with cisgender youth, TGNC adolescents had significantly lower rates of preventive medical and dental checkups, and higher rates of nurse's office visits at school, than cisgender peers. Among TGNC youth, regardless of sex assigned at birth, the most commonly perceived gender expression was "equally feminine and masculine", and health and health care differed substantially across gender expression. For adolescents assigned male at birth, TGNC youth who self-perceived as "equally feminine and masculine" or "somewhat masculine" were more likely to report poorer general health than those who self-perceived as "very masculine". For adolescents assigned female at birth, TGNC youth who self-perceived as "somewhat feminine," "equally feminine and masculine" or "somewhat masculine" were significantly more likely to report poorer general health than those who self-perceived as "very feminine".