Evidence of Differences in Gender-Affirming School Experiences in a Sample of Transgender and Gender-Diverse Youth

Past and current research has often utilized a binary (ie, man/woman) category to measure gender and/or has combined multiple transgender identities into singular groups (eg, transgender girls and nonbinary youth as one category). However, transgender communities are heterogeneous and encompass much more than commonly recognized labels such as only transgender boys/girls and nonbinary youth. Furthermore, the small body of research that has investigated differences within transgender communities based on gender identity has found important health and behavioral differences. Using a large, national sample of transgender youth (N = 3,570), we investigated differences in health-relevant gender-affirming school experiences (ie, being referred to by the correct pronouns or name, authentic gender expression through clothing, and access to restrooms/locker rooms) among diverse transgender youth. Adjusted models (for outness, sexual identity, age, and caregiver education) indicated that transgender boys and transgender girls reported significantly worse gender-specific experiences in schools related to pronoun and chosen name use as well as access to restrooms/locker rooms compared with youth with nonbinary gender-diverse identities (eg, demigender and nonbinary), with some exceptions. Furthermore, transgender boys reported greater authentic gender expression through clothing relative to most other youth with nonbinary gender-diverse identities (eg, gender nonconforming and multiother). These findings have implications for how we might develop targeted interventions given that we pinpoint several disparities in health-relevant gender-affirming school experiences among transgender youth based on their specific gender identity. Finally, this provides stakeholders with a greater understanding of the extent of heterogeneity within transgender communities.