Transgender and nonbinary young people are more likely to experience sexual assault if they go to a school that doesn’t allow them to access bathrooms corresponding to their gender, according to a new study published Monday in the journal Pediatrics.

Harvard T. H. Chan School of Public Health researchers analyzed 2017 data from more than 3,600 trans and nonbinary youth in grades 7 through 12. Researchers found that 26.5% of transgender boys, 18.5% of transgender girls, and 17.6% of nonbinary teens assigned male at birth reported having been sexually assaulted in the last year.

The risk for sexual assault increased when restroom and locker room access was restricted. There is a 26% greater risk of sexual assault for transgender boys, a 42% greater risk for nonbinary people assigned female at birth, and a 149% greater risk for transgender girls. They did not find a significant difference in risk for nonbinary people assigned male at birth, as the study did not have enough of those students.

Lead study author Gabriel Murchison said in a video presenting the study that researchers can’t be certain that bathroom restrictions for trans and nonbinary youth cause sexual assault.

“However, our results make clear that sexual assault is a serious health concern for transgender and nonbinary youth and that the school environment may play a role,” Murchison said in the video.

The study concluded that pediatricians should be aware that sexual assault is highly prevalent among trans and nonbinary teens. Researchers added that pediatricians should also be aware that these kinds of restrictive policies may be associated with risk for sexual assault and harassment of transgender youth.

The study results reinforce what transgender people and LGBTQ health advocates have been saying for some time about their safety in bathrooms that don’t correspond with their gender.

Elisabeth B. Flynn, senior communications director at the Mazzoni Center for LGBT Health and Wellbeing, told SELF in 2016 that policies forcing transgender people and nonbinary people to use bathrooms that don’t correspond with their gender gives people a cover for harassment.

“Gender policing in restrooms actually invites people to try to determine someone else’s gender, giving someone with ulterior motives an excuse for spying on other occupants as ‘detective work,'” Flynn said. “The people who’ve been confronted under these laws include trans and cisgender people. But because cisgender people are more likely to have ID that matches their gender identity, they are able to respond more easily.”

This fear for safety includes transgender adults trying to use public restrooms of their gender. A 2013 Williams Institute at UCLA School of Law survey found that 70% of transgender responders said they were denied entrance, harassed, or assaulted when trying to use a public bathroom corresponding with their gender.

That hasn’t stopped interest groups form pushing anti-trans ballot initiatives. A ballot committee called Keep Massachusetts Safe, pushed a ballot initiative last fall, Question 3, to overturn a 2016 state anti-discrimination law. One television ad from the group showed a man in a bathroom stall near a teenager girl undressing and a voice says, “It means any man who says he’s a woman can enter a woman’s locker room, dressing room or bathroom at any time — even convicted sex offenders.” One of the committee’s major donors supported the anti-LGBTQ Family Research Council. Massachusetts voters ultimately decided to keep the legislation in place. Anchorage, Alaska voters also defeated Proposition 1 last year, which would have required Anchorage residents to use bathrooms and other facilities according to gender assigned at birth.

Schools have also pushed policies that are harmful to transgender students. The Eastern Lancaster County School District in Pennsylvania recently ended the practice of letting transgender students use bathrooms according to their gender and would institute a policy that says students have to use facilities based on biological sex or use bathrooms designed for only one occupant. During a school board meeting in April, Superintendent Robert Hollister said, “I think a lawsuit potential certainly exists.”

Although some conservatives have long claimed that transgender people’s unrestricted use of bathrooms and other facilities endanger cisgender people, research makes it clear that it’s the other way around.

There isn’t sufficient evidence to show that cisgender people are harmed by transgender people who use bathrooms corresponding with their gender. A 2018 Williams Institute study looked at localities in Massachusetts with and without gender identity inclusive public accommodation nondiscrimination ordinances. It found that there was no evidence that the passage of laws protecting transgender people’s rights was related to the number or frequency of criminal incidents in bathrooms.