study recently published in Pediatrics contains some familiar and new findings that have important implications for families, mental health and health care professionals, educators, and everyone who interacts with youth.

First, the familiar findings: transgender or gender nonconforming (TGNC) youth reported poorer mental health and physical health outcomes than their cisgender (gender-conforming) counterparts. Over 60 percent reported a health status other than “very good” or “excellent,” compared to 33 percent of cisgender students. Mental health issues were commonly reported as well, with 59 percent of TGNC reporting long-term mental health concerns. Less than 20 percent of cisgender students reported the same. TGNC youth were also less likely to seek help for their mental or physical health problems.

What is new is that the study, which followed 80,000 youth in the 9th-11thgrades in Minnesota, found more youth were identifying as TGNC than has been previously observed. This increase in self-identification may be due to changing attitudes and greater societal openness to gender fluidity and diversity. In this study, nearly 3% of the population self-defined as TGNC, compared with a previous comparable study that estimated this population at closer .7%. As one of the study’s authors, Daniel Shumer, noted, this finding “should serve to inform school administrators, mental health professionals, and medical professionals that they will see youth with diverse gender identities and expressions in their schools and offices.”

Second, the majority of TGNC respondents perceived their gender expression as “equally feminine and masculine.” As noted by Shumer, “this is in stark contrast to the way that current medical guidance has focused almost exclusively on the treatment of transgender people with binary views of gender. Youth are rejecting this binary thinking and are asking adults to keep up.”

Another important finding from this study was that youth of color were more likely to identify as TGNC. This discovery is especially significant given the elevated risks related to the intersecting effects of gender- and race-based discrimination.

Finally, the authors of this study want readers to know that being TGNC does not in and of itself cause mental health challenges and suicide. Studies from the Netherlands and elsewhere show that when TGNC youth have supportive families and are exposed to open, respectful environments, they thrive nearly as well as their cisgender counterparts. This should give all advocates hope that by providing respectful, caring, gender-sensitive support, the health outcomes for TGNC can change for the better.

Resources for further exploration: