Introduction: Emerging data suggests transgender youth disproportionately experiencing sexual violence. We investigate differences in sexual violence victimization by gender identity in a nationally representative sample of US high school students.

Methods: We analyzed data from n=15,073 US high school students via the 2023 Youth Risk Behavior Surveillance Survey (YRBSS). Multivariable logistic regressions compared three measures of sexual victimization (lifetime forced sexual intercourse [FSI]; past 12-month sexual violence; and past 12-month dating sexual violence) by gender identity. We also conducted these analyses stratified by sex. Models controlled for grade, race, ethnicity, and alcohol use.

Results: Transgender youth had greater odds of lifetime FSI (aOR: 3.29; 95%CI: 2.10–5.14) and past 12-month sexual violence (aOR: 2.47; 95%CI: 1.56–3.92) and past 12-month dating violence (aOR: 2.01), relative to cisgender youth. Interaction models were significant for lifetime FSI (p<0.001) and past 12-month sexual violence (p<0.001) but not past 12-month sexual dating violence (p=0.707). Among those who identified their sex as male, transgender identity corresponded with greater odds of reporting lifetime FSI (aOR:13.17), past 12-month sexual violence (aOR: 9.24), and past 12-month dating violence (aOR: 9.56). . Conversely, odds of any sexual violence victimization outcome were equivalent by gender identity among those who identified their sex as female.

Conclusion: Transgender youth, particularly those who identified their sex as male, had significantly higher odds of experiencing sexual violence in their lifetime and within the past year. Prevention measures as well as trauma-informed treatment are needed to reduce the incidence and impact of sexual violence among youth.