Does Gender Nonconforming Behavior in Early Childhood Predict Adolescents’ Depressive Symptoms?

Abstract

Gender nonconforming behavior (GNB) is a risk factor for poorer psychological adjustment, but little is known about whether preschool-age children displaying GNB are at risk for depressive symptoms during adolescence. We examined maternal report of GNB at age 4–5 years-old as a predictor of adolescents’ depressive symptoms at age 16–17 years-old in a longitudinal study of U.S. children from a predominantly low SES (61% received Aid to Families with Dependent Children) and African American (90%) sample. Youth with GNB in early childhood (n = 10) reported more depressive symptoms during adolescence than did their peers without GNB (n = 115), and this relationship remained after controlling for covariates (environmental risk, prenatal exposure, and neonatal medical problems). Our findings suggest that early GNB may be a risk factor for the development of depressive symptoms in adolescence. Further research is needed to replicate the current findings with a larger sample and to identify the underlying mechanisms by which GNB may increase risk for depressive symptoms. If replicated, the findings further highlight the need for both professionals and parents to become aware of the potential challenges that children with GNB face and to become knowledgeable about ways to facilitate healthy adjustment among gender nonconforming youth.

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References

  1. Achenbach, T. M. (1991). Manual for the child behavior checklist/4–18 and 1991 profile. Burlington: University of Vermont, Dept. of Psychiatry.

    Google Scholar 

  2. Alanko, K., Santtila, P., Witting, K., Varjonen, M., Jern, P., Johansson, A., . . . Kenneth Sandnabba, N. (2009). Psychiatric symptoms and same-sex sexual attraction and behavior in light of childhood gender atypical behavior and parental relationships. Journal of Sex Research, 46, 494–504. https://doi.org/10.1080/00224490902846487

    Article  PubMed  Google Scholar 

  3. Aspenlieder, L., Buchanan, C. M., McDougall, P., & Sippola, L. K. (2009). Gender nonconformity and peer victimization in pre- and early adolescence. International Journal of Developmental Science, 3, 3–16. https://doi.org/10.3233/DEV-2009-3103.

    Article  Google Scholar 

  4. Atzaba-Poria, N., Pike, A., & Deater-Deckard, K. (2004). Do risk factors for problem behaviour act in a cumulative manner? An examination of ethnic minority and majority children through an ecological perspective. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 45, 707–718. https://doi.org/10.1111/j.1469-7610.2004.00265.x.

    Article  PubMed  Google Scholar 

  5. Avenevoli, S., Swendsen, J., He, J. P., Burstein, M., & Merikangas, K. R. (2015). Major depression in the national comorbidity survey-adolescent supplement: Prevalence, correlates, and treatment. Journal of the American Academy of Child & Adolescent Psychiatry, 54, 37–44 e32. https://doi.org/10.1016/j.jaac.2014.10.010.

    Article  Google Scholar 

  6. Baams, L., Beek, T., Hille, H., Zevenbergen, F. C., & Bos, H. M. (2013). Gender nonconformity, perceived stigmatization, and psychological well-being in Dutch sexual minority youth and young adults: A mediation analysis. Archives of Sexual Behavior, 42, 765–773. https://doi.org/10.1007/s10508-012-0055-z.

    Article  PubMed  Google Scholar 

  7. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck depression inventory-II. San Antonio: Psychological Corporation.

    Google Scholar 

  8. Bendersky, M., & Lewis, M. (1994). Environmental risk, biological risk and developmental outcome. Developmental Psychology, 30, 484–494.

    Article  Google Scholar 

  9. Bennett, D., Ambrosini, P., Bianchi, M., Barnett, D., Metz, C., & Rabinovich, H. (1997). Relationship of Beck depression inventory factors to depression among adolescents. Journal of Affective Disorders, 45, 127–134.

    Article  PubMed  Google Scholar 

  10. Bennett, D., Sullivan, M., & Lewis, M. (2010). Neglected children, shame-proneness, and depressive symptoms. Child Maltreatment, 15, 305–314. https://doi.org/10.1177/1077559510379634.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Borgogna, N. C., McDermott, R. C., Aita, S. L., & Kridel, M. M. (2018). Anxiety and depression across gender and sexual minorities: Implications for transgender, gender nonconforming, pansexual, demisexual, asexual, queer, and questioning individuals. Psychology of Sexual Orientation and Gender Diversity. https://doi.org/10.1037/sgd0000306.

  12. Deater-Deckard, K., Dodge, K. A., Bates, J. E., & Pettit, G. S. (1998). Multiple risk factors in the development of externalizing behavior problems: Group and individual differences. Development and Psychopathology, 10, 469–493.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Egan, S. K., & Perry, D. G. (2001). Gender identity: A multidimensional analysis with implications for psychosocial adjustment. Developmental Psychology, 37, 451–463. https://doi.org/10.1037/0012-1649.37.4.451.

    Article  PubMed  Google Scholar 

  14. Forcier, M., & Johnson, M. (2013). Screening, identification, and support of gender non-conforming children and families. Journal of Pediatric Nursing, 28, 100–102. https://doi.org/10.1016/j.pedn.2012.11.001.

    Article  PubMed  Google Scholar 

  15. Gordon, A. R., Krieger, N., Okechukwu, C. A., Haneuse, S., Samnaliev, M., Charlton, B. M., & Austin, S. B. (2017). Decrements in health-related quality of life associated with gender nonconformity among U.S. adolescents and young adults. Quality of Life Research, 26, 2129–2138. https://doi.org/10.1007/s11136-017-1545-1.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Haas, A. P., Eliason, M., Mays, V. M., Mathy, R. M., Cochran, S. D., D’Augelli, A. R., . . . Clayton, P. J. (2011). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: Review and recommendations. Journal of Homosexuality, 58, 10–51. https://doi.org/10.1080/00918369.2011.534038.

  17. Halim, M. L., Ruble, D., Tamis-LeMonda, C., & Shrout, P. E. (2013). Rigidity in gender-typed behaviors in early childhood: A longitudinal study of ethnic minority children. Child Development, 84, 1269–1284. https://doi.org/10.1111/cdev.12057.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Hendricks, M. L., & Testa, R. J. (2012). A conceptual framework for clinical work with transgender and gender nonconforming clients: An adaptation of the minority stress model. Professional Psychology: Research and Practice, 43, 460–467. https://doi.org/10.1037/a0029597.

    Article  Google Scholar 

  19. Hobel, C. J., Hyvarinen, M. A., Okada, D. M., & Oh, W. (1973). Prenatal and intrapartum high-risk screening. American Journal of Obstetrics and Gynecology, 117(1), 1–9. https://doi.org/10.1016/0002-9378(73)90720-5.

    Article  PubMed  Google Scholar 

  20. IBM. (2016). IBM SPSS statistics for windows (version 24.0). Armonk: IBM Corp.

    Google Scholar 

  21. Kane, E. W. (2006). “No way my boys are going to be like that!” Parents' responses to children's gender nonconformity. Gender & Society, 20, 149–176. https://doi.org/10.1177/0891243205284276.

    Article  Google Scholar 

  22. Kim, S., Thibodeau, R., & Jorgensen, R. S. (2011). Shame, guilt, and depressive symptoms: A meta-analytic review. Psychological Bulletin, 137, 68–96.

    Article  PubMed  Google Scholar 

  23. Krefetz, D. G., Steer, R. A., Gulab, N. A., & Beck, A. T. (2002). Convergent validity of the Beck depression inventory-II with the Reynolds adolescent depression scale in psychiatric inpatients. Journal of Personality Assessment, 78, 451–460. https://doi.org/10.1207/S15327752JPA7803_05.

    Article  PubMed  Google Scholar 

  24. Kuvalanka, K. A., Weiner, J. L., Munroe, C., Goldberg, A. E., & Gardner, M. (2017). Trans and gender-nonconforming children and their caregivers: Gender presentations, peer relations, and well-being at baseline. Journal of Family Psychology, 31, 889–899.

    Article  PubMed  Google Scholar 

  25. Landolt, M. A., Bartholomew, K., Saffrey, C., Oram, D., & Perlman, D. (2004). Gender nonconformity, childhood rejection, and adult attachment: A study of gay men. Archives of Sexual Behavior, 33, 117–128.

    Article  PubMed  Google Scholar 

  26. Lewis, M. (1987). Early sex role behavior and school age adjustment. In J. M. Reinisch, L. A. Rosenblum, & S. A. Sanders (Eds.), Masculinity/femininity: Basic perspectives (pp. 202–226). New York: Oxford University Press.

    Google Scholar 

  27. Lewis, M. (1995). Shame: The exposed self. New York: Simon and Schuster.

    Google Scholar 

  28. Li, G., Kung, K. T., & Hines, M. (2017). Childhood gender-typed behavior and adolescent sexual orientation: A longitudinal population-based study. Developmental Psychology, 53, 764–777. https://doi.org/10.1037/dev0000281.

    Article  PubMed  Google Scholar 

  29. Lucassen, M. F., Stasiak, K., Samra, R., Frampton, C. M., & Merry, S. N. (2017). Sexual minority youth and depressive symptoms or depressive disorder: A systematic review and meta-analysis of population-based studies. Australian and New Zealand Journal of Psychiatry, 51, 774–787. https://doi.org/10.1177/0004867417713664.

    Article  PubMed  Google Scholar 

  30. Martin, C. L., & Ruble, D. N. (2010). Patterns of gender development. Annual Review of Psychology, 61, 353–381. https://doi.org/10.1146/annurev.psych.093008.100511.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Martin-Storey, A., & August, E. G. (2016). Harassment due to gender nonconformity mediates the association between sexual minority identity and depressive symptoms. Journal of Sex Research, 53(1), 85–97. https://doi.org/10.1080/00224499.2014.980497.

    Article  PubMed  Google Scholar 

  32. Maughan, B., Collishaw, S., & Stringaris, A. (2013). Depression in childhood and adolescence. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 22, 35–40.

    PubMed  PubMed Central  Google Scholar 

  33. Mereish, E. H., Peters, J. R., & Yen, S. (2018). Minority stress and relational mechanisms of suicide among sexual minorities: Subgroup differences in the associations between heterosexist victimization, shame, rejection sensitivity, and suicide risk. Suicide & Life-Threatening Behavior. https://doi.org/10.1111/sltb.12458.

  34. Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Meyer, E. J. (2009). Gender, bullying, and harassment: Strategies to end sexism and homophobia in schools. New York: Teachers College Press.

    Google Scholar 

  36. Naicker, K., Galambos, N. L., Zeng, Y., Senthilselvan, A., & Colman, I. (2013). Social, demographic, and health outcomes in the 10 years following adolescent depression. Journal of Adolescent Health, 52, 533–538. https://doi.org/10.1016/j.jadohealth.2012.12.016.

    Article  PubMed  Google Scholar 

  37. Norbeck, J. S., Lindsey, A. M., & Carrieri, V. L. (1981). The development of an instrument to measure social support. Nursing Research, 30, 264-269.

    Google Scholar 

  38. Olson, K. R., Key, A. C., & Eaton, N. R. (2015). Gender cognition in transgender children. Psychological Science, 26, 467–474. https://doi.org/10.1177/0956797614568156.

    Article  PubMed  Google Scholar 

  39. Orr, S. T., James, S. A., & Casper, R. (1992). Psychosocial stressors and low birth weight: Development of a questionnaire. Journal of Developmental and Behavioral Pediatrics, 13, 343-347.

    Article  Google Scholar 

  40. Pyne, J. (2014). Gender independent kids: A paradigm shift in approaches to gender non-conforming children. The Canadian Journal of Human Sexuality, 23(1), 1–8. https://doi.org/10.3138/cjhs.23.1.CO1.

    Article  Google Scholar 

  41. Rieger, G., & Savin-Williams, R. C. (2012). Gender nonconformity, sexual orientation, and psychological well-being. Archives of Sexual Behavior, 41, 611–621. https://doi.org/10.1007/s10508-011-9738-0.

    Article  PubMed  Google Scholar 

  42. Rieger, G., Linsenmeier, J. A., Gygax, L., & Bailey, J. M. (2008). Sexual orientation and childhood gender nonconformity: Evidence from home videos. Developmental Psychology, 44, 46–58. https://doi.org/10.1037/0012-1649.44.1.46.

    Article  PubMed  Google Scholar 

  43. Roberts, A. L., Rosario, M., Slopen, N., Calzo, J. P., & Austin, S. B. (2013). Childhood gender nonconformity, bullying victimization, and depressive symptoms across adolescence and early adulthood: An 11-year longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry, 52, 143–152. https://doi.org/10.1016/j.jaac.2012.11.006.

    Article  PubMed  Google Scholar 

  44. Ruble, D. N., Martin, C. L., & Berenbaum, S. A. (2006). Gender development. In N. Eisenberg (Ed.), Handbook of child psychology (Vol. 3, 6th ed., pp. 858–932). Hoboken: Wiley.

    Google Scholar 

  45. Sameroff, A. J., Seifer, R., Baldwin, A., & Baldwin, C. (1993). Stability of intelligence from preschool to adolescence: The influence of social and family risk factors. Child Development, 64, 80–97. https://doi.org/10.2307/1131438.

    Article  PubMed  Google Scholar 

  46. Signorella, M. L., Bigler, R. S., & Liben, L. S. (1993). Developmental differences in children's gender schemata about others: A meta-analytic review. Developmental Review, 13, 147–183. https://doi.org/10.1006/drev.1993.1007.

    Article  Google Scholar 

  47. Steensma, T. D., Zucker, K. J., Kreukels, B. P., Vanderlaan, D. P., Wood, H., Fuentes, A., & Cohen-Kettenis, P. T. (2014). Behavioral and emotional problems on the Teacher's report form: A cross-national, cross-clinic comparative analysis of gender dysphoric children and adolescents. Journal of Abnormal Child Psychology, 42, 635–647. https://doi.org/10.1007/s10802-013-9804-2.

    Article  PubMed  Google Scholar 

  48. Stirling, K., Toumbourou, J. W., & Rowland, B. (2015). Community factors influencing child and adolescent depression: A systematic review and meta-analysis. Australian and New Zealand Journal of Psychiatry, 49, 869–886. https://doi.org/10.1177/0004867415603129.

    Article  PubMed  Google Scholar 

  49. Straub, K. T., McConnell, A. A., & Messman-Moore, T. L. (2018). Internalized heterosexism and posttraumatic stress disorder symptoms: The mediating role of shame proneness among trauma-exposed sexual minority women. Psychology of Sexual Orientation and Gender Diversity, 5, 99–108.

    Article  Google Scholar 

  50. Thapar, A., Collishaw, S., Pine, D. S., & Thapar, A. K. (2012). Depression in adolescence. The Lancet, 379(9820), 1056–1067. https://doi.org/10.1016/s0140-6736(11)60871-4.

    Article  Google Scholar 

  51. Toomey, R. B., Ryan, C., Diaz, R. M., Card, N. A., & Russell, S. T. (2010). Gender-nonconforming lesbian, gay, bisexual, and transgender youth: School victimization and young adult psychosocial adjustment. Developmental Psychology, 46, 1580–1589. https://doi.org/10.1037/a0020705.

    Article  Google Scholar 

  52. Turban, J., Ferraiolo, T., Martin, A., & Olezeski, C. (2017). Ten things transgender and gender nonconforming youth want their doctors to know. Journal of the American Academy of Child and Adolescent Psychiatry, 56, 275–277. https://doi.org/10.1016/j.jaac.2016.12.015.

    Article  PubMed  Google Scholar 

  53. van Beijsterveldt, C. E., Hudziak, J. J., & Boomsma, D. I. (2006). Genetic and environmental influences on cross-gender behavior and relation to behavior problems: A study of Dutch twins at ages 7 and 10 years. Archives of Sexual Behavior, 35, 647–658. https://doi.org/10.1007/s10508-006-9072-0.

    Article  PubMed  Google Scholar 

  54. Wallace, R., & Russell, H. (2013). Attachment and shame in gender-nonconforming children and their families: Toward a theoretical framework for evaluating clinical interventions. International Journal of Transgenderism, 14(3), 113–126. https://doi.org/10.1080/15532739.2013.824845.

    Article  Google Scholar 

  55. Yunger, J. L., Carver, P. R., & Perry, D. G. (2004). Does gender identity influence children's psychological well-being? Developmental Psychology, 40, 572–582. https://doi.org/10.1037/0012-1649.40.4.572.

    Article  PubMed  Google Scholar 

  56. Zosuls, K. M., Andrews, N. C. Z., Martin, C. L., England, D. E., & Field, R. D. (2016). Developmental changes in the link between gender typicality and peer victimization and exclusion. Sex Roles, 75, 243–256. https://doi.org/10.1007/s11199-016-0608-z.

    Article  Google Scholar 

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Acknowledgements

The authors gratefully acknowledge the assistance of Jennifer Birnkrant with preliminary data analyses and Patrick Oczkos with the literature review. The present study was supported by Grant DA07109 to Michael Lewis, David S. Bennett, & Dennis P. Carmody from the National Institute on Drug Abuse.

Funding

The current study was funded in part by the United States’ National Institutes of Drug Abuse.

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Correspondence to David S. Bennett.

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In addition, as stated in the manuscript, the study was approved by the Institutional Review Boards of Drexel University and Rutgers University, and informed consent was obtained from participants’ mothers while assent was obtained from the adolescents.

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Bennett, D.S., Borczon, E. & Lewis, M. Does Gender Nonconforming Behavior in Early Childhood Predict Adolescents’ Depressive Symptoms?. Sex Roles 81, 521–528 (2019). https://doi.org/10.1007/s11199-019-1010-4

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Keywords

  • Sex roles
  • Depression
  • Adolescent psychopathology
  • Longitudinal studies