Students responded to questions about violence, victimization, substance use, suicide risk, sexual risk behaviors. The survey also included an optional question regarding transgender identity.
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"This study is the first time this question was asked," Caitlin Clark of GLSEN, a national nonprofit aimed at ensuring school safety for LGBTQ students, told NBC News. The CDC and GLSEN worked together "to figure out the best way to assess gender identity in a way that youth understand." She hopes the YRBS question won't remain optional for long.
Across the 19 sites, 94.4 percent of respondents said, “No, I am not transgender” while 1.8 percent responded, “Yes, I am transgender.” Another 1.6 percent said, “I am not sure if I am transgender” and 2.1 percent chose “I do not know what this question is asking.”
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Compared to their cisgender peers, the nearly 2 percent who identified as transgender faced higher rates of victimization, substance abuse and suicidal thoughts, according to the CDC.
The report, which reflects similar findings from previous but smaller studies, showed 27 percent of trans high schoolers feel unsafe at or when en route or leaving school, 35 percent are bullied at school and, as aforementioned, 35 percent attempt suicide.
Amit Paley, who heads the Trevor Project, a suicide prevention and crisis intervention group for LGBTQ youth, called the findings "groundbreaking" and said in a recent interview with the Washington Post that the figures reveal "the very real health risks" plaguing trans students.
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“This is the first time we’ve had a federal government report of this magnitude showing that transgender youth exist in this country and in larger numbers than researchers had previously estimated,” Paley said.
In 2017, The Atlanta Journal-Constitution reported on the trend of violence against trans people. Based on data from the Human Rights Campaign, more than 60 percent of transgender deaths occurred in the South that year.
"Georgia is one of five states nationally that does not have a hate crime statute on the books. Fifteen other states have hate crime laws, but do not address sexual orientation or gender identity," AJC's Nelson Helm wrote.
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FBI reports revealed an increase in hate crimes against the LGBT community in 2016 compared to the previous year. Crimes motivated by an anti-transgender bias also increased to 111 incidents in 2016; up from 76 a year prior.
In light of the recent YRBS report, CDC experts call for coordinated intervention efforts in schools to create and enforce anti-bullying policy and implement training to ensure supportive school staff.
The agency's move comes just days after the United States Supreme Court revived President Donald Trump's transgender military ban, which blocks most trans people from serving in the military as cases challenging the policy make their way through lower courts.
Read the full CDC report at cdc.gov.
A previous version of this story stated the YRBS survey was nationally representative, which it is. However, to clarify, only the 19 sites in the new study responded to the pilot question on transgender identity.