263670 Health risk behavior among transgender youth: Data from the 2011 Youth Risk Behavior Survey in San Francisco's public middle and high schools

Tuesday, October 30, 2012

John P. Shields, PhD, MSW , Research Department, Education, Training & Research Associates (ETR), San Francisco, CA
Kelly Whitaker, MPA , Research Department & School of Social Welfare, Education, Training & Research Associates (ETR) & University of California, Berkeley, San Francisco, CA
Kevin Gogin, MFT , Student Support Services Department, San Francisco Unified School District, San Francisco, CA
Heather Franks, MA , Research Department, Education, Training & Research Associates (ETR), Scotts Valley, CA
Francisco Buchting, PhD , Program Services Division, ETR Associates, Scotts Valley, CA
Background. The derivation of reliable statistics describing the prevalence of health risk behavior within the transgender youth population is fraught with conceptual and operational challenges. These challenges limit public health responses to the needs of this population, which emerging evidence suggests may be very high. The San Francisco Unified School District is the only public district in the nation to include a survey item about gender identity on their middle and high school surveys. Purpose. The purpose of this study was to conduct analyses the 2011 administration of the Youth Risk Behavior Survey in San Francisco's public 22 middle and 20 high schools that focused on describing the health and wellness of transgender youth. Methods. Using a stratified random sampling design, the YRBS was administered to 2,730 middle school and 2,220 high school students, yielding a 74% survey completion rate at both levels. YRBS results are representative of all SFUSD students in grades 6 through 12. Study analysts applied complex samples analysis procedures to derive weighted estimates of risk behavior among self-identified transgender youth. Results. Results show transgender youth report significantly disproportional rates of victimization at school (e.g., harassment, bullying, and other violence) compared to students who reported traditional gender identity (i.e., male sex male gender identity, female sex female gender identity). Results also show a consistent pattern of increased engagement in health risk behavior across nearly all survey indicators. Discussion. Emerging data suggest that transgender youth may be at high risk for a myriad of negative outcomes, yet additional data are needed to confirm these results. However, few communities across the nation have included items on gender identity and/or gender expression on their youth health surveys, undermining the ability of policy makers and practitioners to appropriately address the health needs of transgender youth.

Learning Areas:
Epidemiology
Public health or related research

Learning Objectives:
1. Identify the challenges associated with developing reliable and valid questions about gender identity and gender expression. 2. Identify statistical methods used to estimate low-prevalence risk behavior in population sub-groups. 3. Describe the current landscape of public health data on the transgender youth population.

Keywords: Underserved Populations, Gender

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have served as principal investigator and co-investigator on federally-funded research projects to evaluate school-based behavioral health programs and services for children exposed to domestic violence. For 13 years, I have led the implementation of myriad program evaluation projects focused on programs serving children and adolescents in partnership with local, state, and federal stakeholders. Among my scientific interests has been to study the health of lesbian, gay, bisexual, and transgender youth.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.