In a new study, 30 percent of transgender youth report a history of at least one suicide attempt, and nearly 42 percent report a history of self-injury, such as cutting.

The Cincinnati Children’s Hospital Medical Center study also discovered a higher frequency of suicide attempts among transgender youth who are dissatisfied with their weight.

“Our study provides further evidence for the at-risk nature of transgender youth and emphasizes that mental health providers and physicians working with this population need to be aware of these challenges,” says Claire Peterson, PhD, a psychologist at Cincinnati Children’s and lead author of the study. “Dissatisfaction with one’s appearance and the drive to look different from one’s sex assigned at birth is central to gender dysphoria – the feeling that your gender identity is different from that at birth.”

More patients transitioning from female to male reported a history of suicide attempts and self-injury than those transitioning from male to female.

The study is published in Suicide and Life-Threatening Behavior, the journal of the American Association of Suicidology.

The researchers analyzed data from the medical records of 96 transgender patients, ages 12 to 22, with gender dysphoria visiting the Transgender Health Clinic at Cincinnati Children’s. The clinic has served nearly 500 patients since it opened in 2013.

Fifty-eight percent had at least one additional psychiatric diagnosis in addition to gender dysphoria. Nearly 63 percent indicated a history of bullying, 23.1 percent a history of school suspension or expulsion, 19.3 percent involvement in physical fights and 17.1 percent repeating a grade in school.

The Cincinnati Children’s researchers hope that additional studies will shed more light on the relations among weight concerns, eating disorders, self-injury and suicidal behaviors.

Cincinnati Children’s started its Transgender Health Clinic to provide an accepting atmosphere and services for patients up to 24 years of age.

Watch “Raising Zay,” a video from the Cincinnati Enquirer to learn more about how one family deals with raising a transgender child and how the medical staff at Cincinnati Children’s Transgender Clinic is helping.