"Some examples of elevated sexual risk emerged among transgender students. More transgender than cisgender students reported first sexual intercourse before age 13 years and having had four or more sex partners, and more transgender students than cisgender female students reported ever having had sexual intercourse and use of alcohol or drugs before last sexual intercourse. Transgender students were more likely than were cisgender students to forego pregnancy prevention at last sexual intercourse and were less likely than were cisgender males to use a condom at last sexual intercourse; however, without further information about the sex and gender identities of these youths and their partners, the risk implications of these results are uncertain and should be interpreted with caution. Transgender students were more likely to have ever received an HIV test, an important protective behavior, given the known higher HIV risk experienced by this population."