Harvard School of Public Health, Boston, MA 02115, USA.
J Am Acad Child Adolesc Psychiatry. 2013 Feb;52(2):143-52. doi: 10.1016/j.jaac.2012.11.006. Epub 2012 Dec 28.
Childhood gender nonconformity has been associated with increased risk of caregiver abuse and bullying victimization outside the home, but it is unknown whether as a consequence children who are nonconforming are at higher risk of depressive symptoms.
Using data from a large national cohort (N = 10,655), we examined differences in depressive symptoms from ages 12 through 30 years by gender nonconformity before age 11 years. We examined the prevalence of bullying victimization by gender nonconformity, then ascertained whether increased exposure to abuse and bullying accounted for possible increased risk of depressive symptoms. We further compared results stratified by sexual orientation.
Participants in the top decile of childhood gender nonconformity were at elevated risk of depressive symptoms at ages 12 through 30 years (for females, 0.19 standard deviations more depressive symptoms than conforming females; for males, 0.34 standard deviations more symptoms than conforming males). By ages 23 to 30 years, 26% of participants in the top decile of childhood nonconformity had probable mild or moderate depression versus 18% of participants who were conforming (p<.001). Abuse and bullying victimization accounted for approximately half the increased prevalence of depressive symptoms in youth who were nonconforming versus conforming. Gender-nonconforming heterosexuals and males were at particularly elevated risk for depressive symptoms.
Gender nonconformity was a strong predictor of depressive symptoms beginning in adolescence, particularly among males and heterosexuals. Physical and emotional bullying and abuse, both inside and outside the home, accounted for much of this increased risk.
儿童时期的性别非一致性与照顾者虐待和家庭以外的欺凌受害风险增加有关,但尚不清楚作为后果,不符合性别规范的儿童是否面临更高的抑郁症状风险。
利用来自大型全国队列的数据(N=10655),我们通过11 岁前的性别非一致性检查了 12 至 30 岁年龄的抑郁症状差异。我们检查了性别非一致性的欺凌受害率,然后确定了是否增加了虐待和欺凌的暴露程度,是否可能增加抑郁症状的风险。我们进一步比较了按性取向分层的结果。
童年性别非一致性最高十分位数的参与者在 12 至 30 岁时患抑郁症状的风险增加(对于女性,比符合性别规范的女性多 0.19 个标准差的抑郁症状;对于男性,比符合性别规范的男性多 0.34 个标准差的症状)。在 23 至 30 岁时,童年非一致性最高十分位数的参与者中,有 26%可能患有轻度或中度抑郁症,而符合性别规范的参与者中则有 18%(p<0.001)。在性别非一致性与符合性别规范的青少年中,约有一半的抑郁症状发生率增加归因于虐待和欺凌受害。异性恋和男性的性别非一致性者尤其面临更高的抑郁症状风险。
性别非一致性是青春期开始出现抑郁症状的一个强有力的预测因素,尤其是在男性和异性恋者中。家庭内外的身体和情感欺凌和虐待,都解释了这一风险的大部分增加。