Nearly two-thirds of transgender youth in Canada say they’ve harmed themselves in the last year, and more than one in three have attempted suicide, according to a new national study.

The survey, Being Safe, Being Me, interviewed 923 trans youth aged 14-25 from across Canada, including 268 from Ontario.

It found that many struggle with mental health issues and discrimination; 70 per cent say they’ve been sexually harassed and two-thirds say they’ve experienced discrimination based on their gender identity. More than one in three teens aged 14-18 say they’ve been threatened or physically injured.

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“That’s not a small number, especially when we know bullying, discrimination, rejection, violence toward people have a profound impact on their health,” says study author Elizabeth Saewyc, a professor in nursing and adolescent medicine at the University of British Columbia.

Saewyc said the high rates of self-harming amongst trans youth “stand out” when comparing against general youth surveys, in which 5-15 per cent of participants report suicide attempts.

The study also found a disconnect between trans youth and their health care providers; just 15 per cent of those with family doctors say they’re comfortable discussing health concerns with their physicians.

“Clearly, health care providers and clinics need training to ensure they provide the appropriate gender affirming care to trans youth,” says Saewyc.

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Support from adults makes a big difference, the study found. Though one in three participants say they didn’t have an adult role model to confide in, those that did reported better overall health.

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Participants also say their mental health is better when living in their “felt gender” — 83 per cent do so some of the time, and half all of the time. This usually requires support from the community, says Saewyc

“We really need to be able to help support young people in being able to express their gender identity.”

Chris Veldhoven, an education and training specialist at Toronto-based LGBTQ charity The 519, says the report confirms what those working on the ground have known for a long time.

“This is a useful tool for motivating discussion and bridge building where people may not understand other people’s experiences,” he says.

Parents, schools and policy-makers have to come together to build safer spaces for trans youth, he says.

Funded by the Canadian Institutes of Health Research, Being Safe, Being Me is the first and largest study of its kind.