While analyzing the 2021 National Youth Tobacco Survey results, I discovered fascinating participant data that are not specific to tobacco use. In particular, the survey poses these two questions on sexual orientation and gender identity:
Question 155: Which of the following best describes you?
- Heterosexual (straight);
- Gay or Lesbian;
- Bisexual;
- Not Sure.
Question 156: Some people describe themselves as transgender when their sex at birth does not match the way they think or feel about their gender. Are you transgender?
- No, I am not transgender;
- Yes, I am transgender;
- I am not sure if I am transgender;
- I do not know what this question is asking.
The 2021 NYTS may have been the first federal survey to simultaneously pose both of these questions to this population. The responses enable researchers to estimate the national prevalence of gender identity according to sexual orientation, which to my knowledge hasn’t been accomplished before.
There are some caveats to consider in reviewing the results. First, 20,400 students age 9 to 19+ years old participated in the 2021 NYTS. For all surveys like this, the CDC has developed a complex weighting system in order to generate estimates for the nation’s 28.7 million youth. I employ that weighting system here.
While 23 of 38 survey participants who were 9 or 10 years old were asked the above questions, those numbers were so small that I chose not to include their responses in my analysis. Furthermore, because 11- and12-year-olds were almost twice as likely to respond that they did not know what the transgender question was asking, I evaluated only results for teens 13 years and older. The final participant number for my analysis was 13,800, which represents 19.3 million nationally.
| Prevalence (%)* of Sexual Orientation and Gender Identity of Participants 13+ Years in the 2021 National Youth Tobacco Survey | |||||
|---|---|---|---|---|---|
| Sexual | Gender Identity | ||||
| Orientation | (Transgender) | ||||
| No | Yes | Unsure | Don’t Know | All | |
| Heterosexual (straight) | 74.9% | 0.3% | 0.3% | 1.9% | 77.4% |
| Gay or Lesbian | 2.3 | 0.6 | 0.4 | 0.1 | 3.4 |
| Bisexual | 9.1 | 0.8 | 1.2 | 0.3 | 11.4 |
| Not Sure | 5.9 | 0.2 | 0.7 | 1.0 | 7.8 |
| All | 92.3 | 1.9 | 2.5 | 3.3 | 100% |
*Percentages may not add up due to rounding.
Extrapolating as noted above, of the 19.3 million teens,
3.4% (648,500) reported being gay or lesbian, and 11.4% (2.2 million) being bisexual.
The combined total is slightly higher than that reported in an analysis of the
2019 Youth Risk Behavior Survey (here). An additional 7.8% (1.5 million) of teens
were unsure about their sexual orientation.
About 1.9% (368,000) of teens described themselves as transgender, a
figure which is consistent with a CDC analysis of the 2017 YRBS (here). The majority of teens identifying as
transgender in the NYTS were gay/lesbian or bisexual. Almost a half-million teens said they were
unsure about their gender identity, and over 600,000 did not know what the
question was asking.
It is my hope that this survey analysis will inform the discussion around teen sexual orientation and gender identity.
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