Objective: To examine health behavior and outcome disparities between transgender, female, and male participants in a national sample of US college students. Participants and Method Summary: Analyses utilized secondary data from 32,964 undergraduate and graduate students responding to the Fall 2013 American College Health Association--National College Health Assessment; 65.8% were female, 0.4% were transgender, 67.9% were white, and 90.4% were heterosexual. Results: Transgender students reported more mental health diagnoses, trauma, and suicidality; experienced more violence and less safety, reported more sex partners and sexually transmitted infections (STIs); higher rates of illicit and nonprescription substance use and binge drinking use while engaging in less harm reduction behavior; and reported more barriers to academic success. Conclusions: There is an established need for college clinicians and health educators to reduce these disparate outcomes once students arrive on campus through professional training and culturally competent campus prevention and intervention efforts to promote health equity.