Post submitted by Alison Gill, Esq.

We have long known that youth whose gender expression does not fit traditional roles based on their sex assigned at birth – who are often referred to as gender non-conforming or gender expansive youth -- are at increased risk for a variety of negative health issues. They are more likely to be victimized by bullying, abuse, and sexual harassment, and to experience negative behavioral health outcomes including drug use, depression and suicide.

However, there has been little population-based research to provide us with data quantifying the sobering issues facing gender expansive youth --until now. It’s appropriate that as we mark Mental Health Month, we have a new report to highlight. For the first time we have data on the behavioral health of gender-expansive students.

The report, Health Risk Behaviors among Gender Expansive Students, was published recently by Advocates for Youth and the All Students Count Coalition, a group of organizations -- including the Human Rights Campaign -- that promotes better data collection for LGBTQ youth. Using federal data from the Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Surveillance System (YRBSS), the report shows that gender nonconformity is associated with a wide variety of health disparities and risk behaviors. It also indicates that gender expression is associated with risk behaviors independent of sexual orientation.

Just a few of the findings relating to behavioral health include:

Compared to males who describe themselves as masculine, feminine males are:

  • Three times more likely to miss school because they feel unsafe
  • Three times more likely to attempt suicide
  • Four times more likely to have used amphetamines

Compared to females who describe themselves as feminine, masculine females are:

  • Four times more likely to have used heroin
  • Four times more likely to have smoked at school
  • Two times more likely to make a plan about how they would attempt suicide

Compared to females who describe themselves as feminine, androgynous females are:

  • One-and-a-half times more likely to seriously consider attempting suicide
  • One-and-a-half times more likely to engage in self harm
  • Two times more likely to be cyber bullied

These findings make clear that a young person’s gender expression—in addition to their gender identity or sexual orientation—is an important factor in their health and safety. Because the YRBSS does not offer a CDC-approved question that identifies transgender participants, it is unknown whether any of these gender expansive students identify as transgender. As researchers and advocates call for improved data on gender minority youth, this research demonstrates that there is need for data collection pertaining to both gender identity and gender expression.  

The new data about gender expansive youth will help educators, policymakers, advocates, and public health practitioners develop a greater understanding of gender expression and gender nonconformity and how they relate to mental health risks among youth. This will allow them to create or modify programs and policies to meet gender expansive students’ particular needs, and to improve their behavioral health outcomes and academic success.

This Mental Health Month, please help spread awareness of this new report and data on the behavioral health disparities facing gender expansive youth. Learn more about how you can support LGBTQ youth here.

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