Abstract
Importance: Gender minority adults experience higher rates of sexual violence (SV) than
cisgender adults. How this disparity extends to youths, including perpetration rates, is unknown.
Objective: To compare rates of experience and perpetration of SV by gender identity and
investigate characteristics associated with odds of perpetration within gender identity categories.
Design, Setting, and Participants: This cross-sectional study used baseline data from a
national online longitudinal survey collected in 2018 to 2020. Eligible participants were youths ages
14 to 16 years who read English and had internet access. Data were analyzed in November 2021 and
March 2022.
Exposures: Youth characteristics included stressors associated with being marginalized (eg,
internalized transphobia), general stressors (eg, trauma not associated with experiencing SV), other
marginalized statuses (eg, identifying as a girl), factors associated with protection (eg, social
support), environmental characteristics (eg, community violence exposure), and risk factors
associated with SV (eg, consumption of violent pornography).
Main Outcomes and Measures: Self-reported rates of experiencing and perpetrating SV,
defined as sexual assault, rape, attempted rape, and coercive sex, among cisgender, transgender, and
nonbinary youths.
Results: Among 4193 youths in the sample (mean [SD] age, 14.8 [0.7] years), 3282 participants (78.3%) were cisgender, 329 participants (7.9%) were transgender, and 582 participants (13.9%) were nonbinary. The odds of SV perpetration were not statistically significantly different for transgender boys and girls (odds ratio [OR], 0.90; 95% CI, 0.57-1.41; P = .64) or nonbinary youths (OR, 0.78; 95% CI, 0.54-1.12; P = .18) compared with cisgender boys and girls. By contrast, transgender boys and girls (OR, 2.31; 95% CI, 1.83-2.91; P < .001) and nonbinary youths (OR, 2.37; 95% CI, 1.98-2.83; P < .001) were more than 2-fold as likely as cisgender boys and girls to report experiencing SV. Aggressive behavior was associated with higher odds of SV perpetration for transgender boys and girls (adjusted OR [aOR], 1.87; 95% CI, 0.75-4.65; P = .18) and nonbinary youths (aOR, 1.61; 95% CI, 0.78-3.32; P = .20). Indications of hostile masculinity were associated with higher odds of SV perpetration among cisgender youths (ie, positive attitudes for boys to engage in rape behaviors: aOR per unit increase in score, 1.15; 95% CI, 1.07-1.25; P < .001; sexual dominance: aOR per unit increase in score, 1.03; 95% CI, 1.01-1.04; P < .001) but not among transgender or nonbinary youths.
Conclusion and Relevance: These findings may suggest an important foundation for the development of inclusive, research-based SV prevention programs and methods for incorporating gender identity effectively into SV research.
