U.S. transgender teens have high rates of depression, suicidal thoughts, and self-injury, a new study has concluded.

Published in the Journal of the Endocrine Society, the study looked at medical records of 158 transgender teens.

The study included 107 transgender males, 47 females and four teens who identified as non-binary.

A large majority (78.5%) of the teens had a mental health condition, with depression the most common (66.5%). Transgender males had higher incidents of suicidal thoughts (70%) and self-injury (56%) than females, at 49 and 25.5 percent, respectively.

Researchers also found starting hormone treatment significantly improved gender dysphoria in teens.

“Pediatricians need to be able to identify children with gender dysphoria,” said Alejandro Diaz, MD, director of pediatric endocrinology at Nicklaus Children's Hospital in Miami, “This is essential, because early identification and parental support significantly decrease the degree of dysphoria. Among our group of patients, the degree of dysphoria improved significantly after initiating pharmacological treatment and following gender-affirming surgical procedures.”