School Bathroom Policies Associated with Sexual Assault

Transgender youth are young people whose gender assigned at birth does not match their gender identity. A recent study by the Center for Disease Control showed that nearly 2% of high school students in the United States identify as transgender.

Some transgender youth identify as such in a binary fashion. For instance, a child may be assigned a male sex at birth but identify as female. Other transgender youth identify as non-binary, meaning that they do not identify as strictly male or female.

Using a data set of 3,673 transgender students grades 7 through 12, a new study from the Harvard School of Public Health in the journal Pediatrics revealed alarming rates of sexual assault victimization among these young people.

The survey asked students the following question:

During the past 12 months, how many times did anyone force you to do sexual things that you did not want to do? (Count such things as kissing, touching, or being physically forced to have sexual intercourse.)

The results were shocking and warrant significant public health concern. Among transgender boys (those with a female sex assigned at birth who identify as male), 26.5% answered yes to this question. Among transgender girls, 18.5%. 27.0% of non-binary birth-assigned females and 17.6% of birth-assigned males reported victimization in the past year. The question only asks about the past year, and lifetime prevalence is likely even higher. In a 2015 survey of transgender adults, 47% reported a lifetime history of sexual assault victimization.

The researchers also examined whether school policies that required transgender youth to use the restrooms and locker rooms of their sex assigned at birth was associated with sexual assault victimization. It is the first study to examine this question.

After adjusting for a list of potential confounding variables (including teacher attitudes toward LGBTQ students as a measure of how accepting a school is), they found that these policies were associated with sexual assault victimization. The increased risk ranged from 1.26 to 2.49 times the risk of those in schools without these policies.

Given that the study is cross-sectional, it is difficult to say that these policies caused the sexual assaults rather than the other way around. Reverse causation seems implausible. I doubt that sexual assaults resulted in the policies. As with any cross-sectional study, however, it’s always possible that there is an unmeasured confounding variable.

If these policies are causal, however, and it seems likely they are, these results warrant serious public health consideration. With 2% of high schools students identifying as transgender, these increased risks would mean that these policies are responsible for tens of thousands of sexual assaults each year.

The authors point out that pediatricians should be concerned and that they should screen and counsel their patients. Policymakers, however, should be just as concerned. If we have school policies that are resulting in thousands of new sexual assaults each year, we need to consider legislation that makes such policies illegal. Each year we wait means thousands of more victims.