Transgender and nonbinary youth in the U.S. are usually receiving support from their parents or guardians, but they suffer disproportionately from bullying in school, according to a new report from the Human Rights Campaign Foundation.

The findings are from the foundation’s 2024 Report on the Experiences of Parents of Transgender and Non-Binary Children, which highlights the struggles trans youth continue to face despite increased parental support, released Thursday along with its first Supporting Transgender, Non-Binary, and Gender Expansive Children guide, created by the foundation’s Parents for TransgenderEquality National Council. The foundation is the educational arm of HRC.

More than 92 percent of parents surveyed were supportive of their child’s trans identity, notes the report, which features data collected in collaboration with the University of Florida and University of Arizona from nearly 1,500 parents and caregivers of trans and nonbinary youth aged 18 and under.

But the situation was not so good at school. Fifty-five percent of parents said their child had been bullied at school in the past year. Only 26.2 percent had a gender support plan for their child at school. However, of those who did, more than 90 percent said the support plan was very or somewhat helpful. About one in five parents chose their child’s school or district based on policies regarding LGBTQ+ students. But about one in five also reported that their child’s school was not supportive when it came to restroom use, and a third cited lack of support for locker room use.

And despite parental support, many trans and nonbinary children have experienced mental health challenges. Of the parents surveyed, 39.6 percent said their child had been diagnosed with depression, and 49.4 percent said the child was diagnosed with an anxiety disorder. Sixteen percent said their child had been hospitalized for mental health needs, and among those parents, 33 percent said it was related to their gender identity. Parents and caregivers had challenges too, with about 20 percent screening positive for moderate or severe depression.

The parents surveyed are seeking appropriate health care for their trans and nonbinary children, but some are finding barriers here. Ninety-five percent said their child saw at least one doctor in the prior year who knew the child was trans and that the doctor treated them with respect. However, 24 percent said they had to teach a doctor or health care provider about trans people to receive appropriate care; 5.1 percent had a doctor refuse to give their child trans-related and/or gender-affirming care; 21.6 percent had changed providers at some point due to mistreatment, lack of competency, or other reasons related to gender-affirming care; and 25.1 percent experienced at least one barrier to accessing gender-affirming care for their child.

Children are coming out as trans or nonbinary at a young age, the survey notes. On average, parents and caregivers said their child shared their gender identity with them around 11 years old — and over half shared their identity before the age of 13.

The report indicates that parents and children are engaging in advocacy. Half of parents have written to or called their political representatives regarding trans issues, and 17 percent said their child has spoken publicly about these issues.

Still, more than half of parents said they need more resources to help their children, and the new guide is designed to provide those. “This guide is exactly the tool I needed years ago when my daughter was searching for the words to tell us who she was,” Parents for Transgender Equality National Council member Keisha Bell said in a press release. “The guide highlights the nuances of what it means to care for a trans or nonbinary child while also providing guidance to those who are unsure of how to navigate this transition. From helping find an appropriate clinician to providing detailed steps that help support your child’s needs, this guide provides the resources needed to ensure the trans and nonbinary youth in your life feel seen and understood.”

“Parents have made a great deal of progress towards supporting trans youth, while the schools and systems of care around them are often falling short,” added Shoshana Goldberg, director of public education and research at the HRC Foundation. “By taking simple actions like meeting with the school principal and counselor, connecting with trans-affirming local and online communities, and advocating for their child in health care settings, parents can go a long way towards promoting better outcomes for the trans and nonbinary youth in their lives.”