Content area
Full text
Gender non-conformity (GNC) describes the extent to which a person's behaviour, appearance and/or identity do not conform to culturally defined gender norms based on their sex presumed at birth (Turban & Ehrensaft, 2018). Individuals may identify as transgender (trans) when their gender identity does not align with their sex presumed at birth. Worldwide, mental health disparities are a consistent empirical finding amongst GNC and trans groups, including child and adolescent groups (Eisenberg et al., 2017; Macmullin, Aitken, Nabbijohn, & Vanderlaan, 2019; Van Der Miesen, Nabbijohn, Santarossa, & Vanderlaan, 2018; Wang et al., 2020). These findings are well-documented amongst clinic-referred trans young people seeking supportive interventions at specialist gender clinics (Aitken, Vanderlaan, Wasserman, Stojanovski, & Zucker, 2016; De Graaf et al., 2020; De Vries, Steensma, Cohen-Kettenis, Vanderlaan, & Zucker, 2016; Drummond, Bradley, Peterson-Badali, Vanderlaan, & Zucker, 2018; Olson, Schrager, Belzer, Simons, & Clark, 2015; Peterson, Matthews, Copps-Smith, & Conard, 2017), and also for GNC and trans young people from the general population (Becerra-Culqui et al., 2018; Van Der Miesen et al., 2018). Suicidal ideation (SI) and attempts (Macmullin et al., 2019; Mak et al., 2020; Spivey & Prinstein, 2018; Strauss et al., 2020), and generalised anxiety disorders (Chodzen, Hidalgo, Chen, & Garofalo, 2019), for example, are much more prevalent in GNC and trans young people compared to their age-matched, gender-conforming (GC) peers. Reasons for poor mental health outcomes in these groups are multifactorial but stem from a combination of body dysphoria and minority-related stressors, which often include societal and family non-acceptance, victimisation, and internalised prejudices (Chodzen et al., 2019; Rabasco & Andover, 2020; Reisner et al., 2016; Roberts, Rosario, Slopen, Calzo, & Austin, 2013; Robles et al., 2016; Strauss et al., 2020; Zucker, Wood, & VanderLaan, 2014).
To date, there is a paucity of population-based longitudinal studies examining associations between GNC in childhood and adolescence and mental health outcomes later in life (Reisner et al., 2016). The majority of studies have used cross-sectional designs using non-probability samples, particularly convenience samples, many of which are clinically derived and are not representative of the broader population.(Henderson, Blosnich, Herman, & Meyer, 2019; Reisner et al., 2016) However, collective data from the extant literature provide preliminary support for the conjecture that a history of GNC in childhood is a...