Category: Gay / Lesbian / Bisexual / Transgender Issues

PS14- #C77 - Adolescent Gender Nonconformity Associated With Longitudinal Declines in Health

Saturday, Nov 18
4:00 PM – 5:00 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Gender | LGBTQ+ | Adolescents

Previous research suggests that, similar to sexual minority youth, gender nonconforming adolescents experience minority stress related to their gender identity or expression. Gender nonconformity refers to gender expressions that diverge from what is expected based on one’s sex assigned at birth (i.e., displaying a more masculine/feminine appearance or mannerisms compared to other girls/boys). The minority stress experiences that gender nonconforming adolescents encounter, such as peer victimization or expectations of rejection, may negatively impact their health and psychological functioning. Although the health consequences of minority stress has been recognized for sexual minority youth, less research has explored the unique association between gender nonconformity and health above and beyond sexual orientation. This study sought to examine the association between adolescent gender nonconformity and prospective changes in health after accounting for other factors that may impact adolescents’ overall wellbeing.
A total of 714 high school students (384 girls; M age = 16.01 years, SD = .76) participated in a longitudinal, school-based study in the Southern US. Participants completed self-report measures of their gender identity, gender nonconformity, sexual minority identity label (lesbian, gay, bisexual, queer, etc.), current depressive symptoms, and current overall health (Time 1). Participant’s socioeconomic status was estimated using public records of median household income. Overt and relational peer victimization were assessed using sociometric peer-report. Participants’ self-reported health was assessed again one year later (Time 2). Hierarchical linear regressions examined the effect of gender nonconformity on health at Time 2, after controlling for gender, sexual minority identity label, SES, Time 1 health, depressive symptoms, and peer victimization. In the first model, health at Time 1, depressive symptoms, and sexual minority identity label emerged as significant main effects—all other predictors were nonsignificant. The addition of gender nonconformity significantly improved the model (< .05)After accounting for the effects of previous health, depression symptoms, sexual minority status, SES, and peer victimization, gender nonconformity predicted a significant decrease in self-reported health at Time 2. 


Results from this study build on previous literature that demonstrates health disparities among gender nonconforming individuals, and suggest that gender nonconformity is associated with declines in health in mid-adolescence. Moreover, this effect was observed above and beyond the negative health effects associated with using a LGBQ sexual orientation label. Although this study did not address potential mediators of this association, it is important to note that this effect was observed after accounting for the effects of other factors known to be associated with both gender nonconformity and health outcomes (sexual orientation, depression, peer victimization). Future research should examine other factors that may mediate this association, and could explore for possible differences across subjective and objective measures of health.

Leigh Spivey

Graduate Student
UNC Chapel Hill

Mitch Prinstein

Professor and Director of Clinical Psychology
UNC Chapel Hill
Chapel Hill, North Carolina