Recent studies suggest that one group of students struggles with mental health issues more than others: transgender students.

While research shows big increases in reported depression, anxiety or other mental health issues among college students in recent years, one study examined problems transgender students face. The findings were published in September's American Journal of Preventative Medicine.

Researchers looked at an internet-based Healthy Minds Study that polled 65,000 students at 71 U.S. colleges and universities between 2015 and 2017. Of those students, about 1,200 reported having "an alternate gender identity, meaning they do not identify with the gender that matches their birth sex."

Researchers found that almost 80% of those students reported at least one mental health issue. That compared with 45% of cisgender students — those identifying as their birth sex — who reported having a mental health issue.

Multiple issues

Sarah Ketchen Lipson, an assistant professor at the Boston University School of Public Health and lead author of the study, said transgender students were more likely to face every mental health issue raised in the study, especially thoughts of suicide and attempting suicide.

Transgender people identify with a sexuality that is different than their birth gender. Most identify with the opposite sex, but there are other orientations, as well. Many change their name and appearance, and some seek medical treatment to align with their new identity.

In 2016, about 1.4 million (0.6%) Americans identified themselves as transgender, according to the Williams Institute at the University of California-Los Angeles School of Law.

Some mental health problems, such as those stemming from family abandonment and homelessness, affect students long before they enter college, Lipson said. Many U.S. colleges and universities have shown support for gay and lesbian students, she said, but barriers remain to transgender students feeling fully accepted. These issues may not be as clear to cisgender people, she said.

Many schools require students to use their birth name or gender pronoun on school records, and changing this information can be difficult. At many schools, restrooms are segregated by gender. And while schools may have policies to prevent discrimination against gay or lesbian students, their policies often fail to identify transgender individuals.

Lipson said all these seemingly minor issues can intensify existing mental health problems.

'Not even visible'

The report's findings did not surprise Shane Windmeyer, executive director of Campus Pride, one of the largest organizations supporting lesbian, gay and transgender college students in the United States.

Windmeyer said that while most colleges and universities employ trained specialists to support different minority groups, that is not the case for trans students.

"Trans folks are not even visible on many college campuses," he said. "They are not seen as a population to serve, still, on many campuses."

Windmeyer said dealing with mental health issues can make college and university life harder for young people. Worse, most schools do not give students the choice to report their chosen sexual identity on official documents. So administrators have no way of knowing how well or how poorly they are serving transgender students, he said.

Windmeyer said schools must be open to understand their needs in order to serve them better, including a willingness to make changes.

Lipson echoed that comment in the Boston University publication The Brink: "There has never been a more important time for colleges and universities to take action to protect and support trans, genderqueer and nonbinary students on campus."