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More teenagers are identifying as trans and gender non-conforming than previously thought, according to new research.

A new study published in Pediatrics analyzed a 2016 survey of almost 81,000 Minnesota teens, focusing on students in the 9th and 11th grade. The Associated Press reports that the study found that nearly 3 percent of the students surveyed identify as trans or gender non-conforming and don’t identify with the sex they were assigned at birth.

The study also found that these teenagers reported more mental and physical health issues than other teens. A study published in the same journal last year found that teenagers whose families support their transition and allow kids to present their gender identity have better mental health than those whose families do not. There are also high suicide and self harm rates among trans youth.

That states are continuing to survey their teen populations to take note of how many identify as trans or non-conforming is important, considering the CDC does not ask about trans status on its youth surveys, the AP points out. A study from December of last year found that 27 percent of California teenagers reported that they were viewed as gender-nonconforming. And taking note of how vast this population is, and the ways in which teens identify themselves, is crucial—especially in the medical profession where trans patients so often get dismissive or uneducated care.