People who identify as transgender or gender non-conforming are less healthy on average than their cisgender counterparts, according to a Tuesday study.

The study, published in JAMA Internal Medicine, used data from the Behavioral Risk Factor Surveillance System, a health survey administered annually by the Centers for Disease Control and Prevention (CDC).

The CDC formulated a series of questions regarding gender identity in 2013, the questions had been adopted by 28 states and territories at the time of the study.

Researchers from Brigham & Women’s Hospital and Beth Israel Deaconess Medical Center, both affiliated with Harvard Medical School in Boston, examined responses from 314,450 cisgender and 1,443 transgender interviewees collected in 2014 and 2015.

The study’s lead author Dr. Carl Streed Jr. emphasized the importance of collecting health data on the transgender population.

“There is little research on this population, because people haven’t been asking them to identify themselves,” Screed told Reuters. “These are patients and individuals and communities that need our attention at this point and we should be working with them to better identify what’s going on in their lives,” Streed said.

Transgender respondents were disproportionately younger, poorer, less white and more likely to be unemployed. In addition to these demographic trends, researchers identified numerous health disparities between transgender adults and the cisgender adult population.

Transgender interviewees were less likely to describe themselves as healthy relative to the general population, 29 percent of transgender individuals reported their health as fair or poor compared to 17 percent of cisgendered respondents.

More specifically, transgender people were more likely to be overweight and depressed. They were also more likely to be uninsured and more likely to let a health problem go untreated.

The health disparities between the transgender and cisgender population also extended to cognitive functioning. When asked whether they had any problems with “concentrating, remembering or making decisions,” 10 percent of cisgender and 18 percent of transgender adults answered yes.

While the study’s authors make no claim of causation between an individual’s identification as transgender and negative health outcomes, the magnitude of the disparities across a broad range of health areas rules out mere coincidence as the explanatory factor.

The authors noted that the study does not reflect the entire U.S. transgender community because the data was confined to the states that adopted the CDC’s gender identity survey questions. Despite this qualification, they did assert that “This study confirms that gender minority adults in the United States experience health disparities compared with their cisgender peers.”

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