1
|
Özel F, Stratmann M, Papadopoulos FC, Rüegg J, Bornehag CG. Gender-specific play behavior in relation to autistic traits and behavioral difficulties at the age of seven in the SELMA study. PLoS One 2024; 19:e0308605. [PMID: 39196870 PMCID: PMC11355531 DOI: 10.1371/journal.pone.0308605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 07/24/2024] [Indexed: 08/30/2024] Open
Abstract
BACKGROUND Childhood gender nonconformity is related to psychological distress and behavioral difficulties. Similarly, there is evidence for a link between gender nonconformity, or gender dysphoria in some studies, and autism spectrum disorder and related traits. Our knowledge on those associations mostly originates from clinical populations, which might lead to overestimation. Thus, this study aimed to assess associations between gender nonconformity and behavioral difficulties in a population-based study. METHODS In the Swedish Environmental Longitudinal, Mother and Child, Asthma and Allergy (SELMA) study, cross-sectional associations between gender-specific play behavior and behavioral outcomes and autistic traits were investigated among 718 children at 7-years of age. Play behavior was measured using the Preschool Activities Inventory; behavioral outcomes and autistic traits were measured with the Strengths and Difficulties Questionnaire and the Social Responsiveness Scale, respectively. Linear and logistic regression analyses were performed. RESULTS Higher composite play behavior scores (indicating either increased masculine or decreased feminine play behavior) were associated with increased autistic trait scores in girls (β = 0.13; 95% confidence interval [CI] = 0.00, 0.26). Furthermore, higher composite scores were shown to be associated with behavioral difficulties in both girls (β = 0.11; 95% CI = 0.04, 0.18) and boys (β = 0.10; 95% CI = 0.02, 0.19). Additionally, higher feminine scores were related with increased problems in peer relationships in boys (β = 0.04; 95% CI = 0.00, 0.07). CONCLUSIONS This study suggests a link between gender nonconforming play behavior and autistic traits as well as behavioral difficulties among children in a non-clinical population, which calls attention to the necessity of supporting children with gender nonconformity from early ages.
Collapse
Affiliation(s)
- Fatih Özel
- Department of Organismal Biology, Uppsala University, Uppsala, Sweden
- Centre for Women’s Mental Health during the Reproductive Lifespan–Womher, Uppsala University, Uppsala, Sweden
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Marlene Stratmann
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | | | - Joëlle Rüegg
- Department of Organismal Biology, Uppsala University, Uppsala, Sweden
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| |
Collapse
|
2
|
Ran Q, Chen X, Li X, He L, Zhang K, Tang S. Application of eye and hand interventions in brain magnetic resonance imaging of young children. Heliyon 2024; 10:e35613. [PMID: 39170568 PMCID: PMC11336866 DOI: 10.1016/j.heliyon.2024.e35613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 07/31/2024] [Accepted: 07/31/2024] [Indexed: 08/23/2024] Open
Abstract
Objective To explore the feasibility of eye and hand interventions in young children during brain magnetic resonance imaging (MRI). Methods A total of 414 4- to 6-year-old children who underwent brain MRI at our hospital were randomly divided into 4 groups: the routine posture group (n = 105), eye mask group (n = 102), fixed hand apron group (n = 108), and eye mask and fixed hand apron group (n = 99). All the children underwent brain MRI when they were awake (without using sedatives). The success rate of brain MRI and the quality of brain MR images were compared among the four groups. Results The success rate of brain MRI was the highest in the eye mask and fixed hand apron group (94.9 %), followed by the eye mask group (85.3 %) (P < 0.05). The brain MR image quality was the best for children wearing eye masks and fixed hand aprons (5 points, 69 patients), followed by those wearing eye masks (5 points, 53 patients) (P < 0.05). Conclusion When children undergo brain MRI, simultaneous eye and hand interventions can greatly improve the success rate of the examination and the quality of MR images. This study protocol was registered at the Chinese clinical trial registry (ChiCTR2100050248).
Collapse
Affiliation(s)
- Qiying Ran
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, 400014, China
| | - Xi Chen
- Department of Equipment Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Xiang Li
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, 400014, China
| | - Ling He
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, 400014, China
| | - Ke Zhang
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, 400014, China
| | - Shilong Tang
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, 400014, China
| |
Collapse
|
3
|
Nagata JM, Balasubramanian P, Iyra P, Ganson KT, Testa A, He J, Glidden DV, Baker FC. Screen use in transgender and gender-questioning adolescents: Findings from the Adolescent Brain Cognitive Development (ABCD) Study. Ann Epidemiol 2024; 95:6-11. [PMID: 38719179 DOI: 10.1016/j.annepidem.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/25/2024] [Accepted: 04/30/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVE To assess the association between transgender or gender-questioning identity and screen use (recreational screen time and problematic screen use) in a demographically diverse national sample of early adolescents in the U.S. METHODS We analyzed cross-sectional data from Year 3 of the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®, N = 9859, 2019-2021, mostly 12-13-years-old). Multiple linear regression analyses estimated the associations between transgender or questioning gender identity and screen time, as well as problematic use of video games, social media, and mobile phones, adjusting for confounders. RESULTS In a sample of 9859 adolescents (48.8% female, 47.6% racial/ethnic minority, 1.0% transgender, 1.1% gender-questioning), transgender adolescents reported 4.51 (95% CI 1.17-7.85) more hours of total daily recreational screen time including more time on television/movies, video games, texting, social media, and the internet, compared to cisgender adolescents. Gender-questioning adolescents reported 3.41 (95% CI 1.16-5.67) more hours of total daily recreational screen time compared to cisgender adolescents. Transgender identification and questioning one's gender identity was associated with higher problematic social media, video game, and mobile phone use, compared to cisgender identification. CONCLUSIONS Transgender and gender-questioning adolescents spend a disproportionate amount of time engaging in screen-based activities and have more problematic use across social media, video game, and mobile phone platforms.
Collapse
Affiliation(s)
- Jason M Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
| | - Priyadharshini Balasubramanian
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Puja Iyra
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, TX, USA
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, 2001 Longxiang Boulevard, Longgang District, Shenzhen 518172, China
| | - David V Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, 333 Ravenswood Ave, Menlo Park, CA 94025, USA; School of Physiology, University of the Witwatersrand, 1 Jan Smuts Ave, Braamfontein, Johannesburg 2017, South Africa
| |
Collapse
|
4
|
Ramduny J, Uddin LQ, Vanderwal T, Feczko E, Fair DA, Kelly C, Baskin-Sommers A. Increasing the representation of minoritized youth for inclusive and reproducible brain-behavior associations. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.22.600221. [PMID: 38979302 PMCID: PMC11230295 DOI: 10.1101/2024.06.22.600221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Population neuroscience datasets allow researchers to estimate reliable effect sizes for brain-behavior associations because of their large sample sizes. However, these datasets undergo strict quality control to mitigate sources of noise, such as head motion. This practice often excludes a disproportionate number of minoritized individuals. We employ motion-ordering and motion-ordering+resampling (bagging) to test if these methods preserve functional MRI (fMRI) data in the Adolescent Brain Cognitive Development Study ( N = 5,733 ). Black and Hispanic youth exhibited excess head motion relative to data collected from White youth, and were discarded disproportionately when using conventional approaches. Both methods retained more than 99% of Black and Hispanic youth. They produced reproducible brain-behavior associations across low-/high-motion racial/ethnic groups based on motion-limited fMRI data. The motion-ordering and bagging methods are two feasible approaches that can enhance sample representation for testing brain-behavior associations and fulfill the promise of consortia datasets to produce generalizable effect sizes across diverse populations.
Collapse
Affiliation(s)
- Jivesh Ramduny
- Department of Psychology, Yale University, New Haven, CT, USA
- Kavli Institute for Neuroscience, Yale University, New Haven, CT, USA
| | - Lucina Q. Uddin
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Tamara Vanderwal
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | - Eric Feczko
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, USA
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Damien A. Fair
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, USA
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Clare Kelly
- School of Psychology, Trinity College Dublin, Dublin, Ireland
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Arielle Baskin-Sommers
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| |
Collapse
|
5
|
Fisher E, Wright S, Sargeant C. What do measures of gender identity tell us about gender identity over time? BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2024. [PMID: 38712516 DOI: 10.1111/bjdp.12491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/26/2024] [Accepted: 04/16/2024] [Indexed: 05/08/2024]
Abstract
Gender identity is a multifaceted concept and is represented by a wide range of measures and constructs including both self-report and researcher observations of preferences and behaviours. However, despite their similar theoretical underpinning, gender identity measures are rarely found to correlate with one another, and contrasting patterns and trajectories are often found for each construct (Egan & Perry, Developmental Psychology, 37, 2001, 451). Therefore, this systematic review aimed to present a review of the longitudinal research evidence surrounding gender identity development in the absence of formal intervention. Using a systematic search strategy, 21 studies were identified. Narrative synthesis was used to synthesize the data collected in these studies and trajectories were explored for (1) self-identification measures of gender identity, (2) clothing preferences, (3) peer preferences, and (4) object/activity preferences. Overall, the results of this systematic review are consistent with wider research suggesting that distinct developmental patterns can be observed when using different constructs and measures of gender identity.
Collapse
Affiliation(s)
- Ellena Fisher
- School of Psychology, University of Southampton, Southampton, UK
| | - Sarah Wright
- School of Psychology, University of Southampton, Southampton, UK
| | - Cora Sargeant
- School of Psychology, University of Southampton, Southampton, UK
| |
Collapse
|
6
|
Potter AS. Leveraging Polygenic Scores to Go Beyond Examinations of Pathology Among Gender-Diverse Individuals. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:100311. [PMID: 38800640 PMCID: PMC11116981 DOI: 10.1016/j.bpsgos.2024.100311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 05/29/2024] Open
Affiliation(s)
- Alexandra S. Potter
- Clinical Neuroscience Research Unit, The University of Vermont, Burlington, Vermont
| |
Collapse
|
7
|
Rawee P, Rosmalen JGM, Kalverdijk L, Burke SM. Development of Gender Non-Contentedness During Adolescence and Early Adulthood. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1813-1825. [PMID: 38413534 PMCID: PMC11106144 DOI: 10.1007/s10508-024-02817-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/29/2024]
Abstract
Adolescence is an important period for the development of gender identity. We studied the development of gender non-contentedness, i.e., unhappiness with being the gender aligned with one's sex, from early adolescence to young adulthood, and its association with self-concept, behavioral and emotional problems, and adult sexual orientation. Participants were 2772 adolescents (53% male) from the Tracking Adolescents' Individual Lives Survey population and clinical cohort. Data from six waves were included (ages 11-26). Gender non-contentedness was assessed with the item "I wish to be of the opposite sex" from the Youth and Adult Self-Report at all six waves. Behavioral and emotional problems were measured by total scores of these scales at all six waves. Self-concept was assessed at age 11 using the Global Self-Worth and Physical Appearance subscales of the Self-Perception Profile for Children. Sexual orientation was assessed at age 22 by self-report. In early adolescence, 11% of participants reported gender non-contentedness. The prevalence decreased with age and was 4% at the last follow-up (around age 26). Three developmental trajectories of gender non-contentedness were identified: no gender non-contentedness (78%), decreasing gender non-contentedness (19%), and increasing gender non-contentedness (2%). Individuals with an increasing gender non-contentedness more often were female and both an increasing and decreasing trajectory were associated with a lower global self-worth, more behavioral and emotional problems, and a non-heterosexual sexual orientation. Gender non-contentedness, while being relatively common during early adolescence, in general decreases with age and appears to be associated with a poorer self-concept and mental health throughout development.
Collapse
Affiliation(s)
- Pien Rawee
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Judith G M Rosmalen
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Interdisciplinary Center for Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Luuk Kalverdijk
- Interdisciplinary Center for Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Sarah M Burke
- Interdisciplinary Center for Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| |
Collapse
|
8
|
Torgerson C, Ahmadi H, Choupan J, Fan CC, Blosnich JR, Herting MM. Sex, gender diversity, and brain structure in early adolescence. Hum Brain Mapp 2024; 45:e26671. [PMID: 38590252 PMCID: PMC11002534 DOI: 10.1002/hbm.26671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/27/2024] [Accepted: 03/13/2024] [Indexed: 04/10/2024] Open
Abstract
There remains little consensus about the relationship between sex and brain structure, particularly in early adolescence. Moreover, few pediatric neuroimaging studies have analyzed both sex and gender as variables of interest-many of which included small sample sizes and relied on binary definitions of gender. The current study examined gender diversity with a continuous felt-gender score and categorized sex based on X and Y allele frequency in a large sample of children ages 9-11 years old (N = 7195). Then, a statistical model-building approach was employed to determine whether gender diversity and sex independently or jointly relate to brain morphology, including subcortical volume, cortical thickness, gyrification, and white matter microstructure. Additional sensitivity analyses found that male versus female differences in gyrification and white matter were largely accounted for by total brain volume, rather than sex per se. The model with sex, but not gender diversity, was the best-fitting model in 60.1% of gray matter regions and 61.9% of white matter regions after adjusting for brain volume. The proportion of variance accounted for by sex was negligible to small in all cases. While models including felt-gender explained a greater amount of variance in a few regions, the felt-gender score alone was not a significant predictor on its own for any white or gray matter regions examined. Overall, these findings demonstrate that at ages 9-11 years old, sex accounts for a small proportion of variance in brain structure, while gender diversity is not directly associated with neurostructural diversity.
Collapse
Affiliation(s)
- Carinna Torgerson
- Department of Population and Public Health SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Mark and Mary Stevens Neuroimaging and Informatics InstituteUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Hedyeh Ahmadi
- Department of Population and Public Health SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Jeiran Choupan
- Mark and Mary Stevens Neuroimaging and Informatics InstituteUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Chun Chieh Fan
- Center for Population Neuroscience and GeneticsLaureate Institute for Brain ResearchTulsaOklahomaUSA
- Department of Radiology, School of MedicineUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - John R. Blosnich
- Suzanne Dworak‐Peck School of Social WorkUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Megan M. Herting
- Department of Population and Public Health SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| |
Collapse
|
9
|
Leonard SI, Sharma Y, Hughes TL, Jackman KB, Bruzzese JM. Weight Stigma and Mental and Emotional Health Among Sexual and Gender Minority Individuals: A Scoping Review. LGBT Health 2023. [PMID: 37948558 DOI: 10.1089/lgbt.2023.0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
Purpose: Weight stigma is associated with poor mental and emotional health and may be especially harmful to sexual and gender minority (SGM) individuals due to co-occurring minority stress. The literature on this topic has not been synthesized. We conducted a scoping review of the literature on weight stigma and mental and emotional health among SGM individuals to synthesize findings, highlight gaps, and identify clinical and research implications. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, we searched PubMed, CINAHL, PsycINFO, and Scopus in April 2022. Included studies examined the relationship between weight stigma and mental and emotional health among SGM people of any age. We did not restrict study design or publication date. Results: Of 513 records identified, 23 met inclusion criteria. Most focused on sexual minority individuals; one focused specifically on gender minority individuals. Weight stigma was associated with poorer mental and emotional health in nearly all studies. The most common outcomes examined were self-esteem, maladaptive eating, and depressive symptoms. Five studies, all using the same dataset, focused on adolescents; none focused on older adults. Conclusions: Weight stigma is associated with poorer mental and emotional health among SGM individuals and, through its intersections with minority stress, might impact SGM individuals differently than their cisgender and heterosexual counterparts. There are important gaps regarding weight stigma's effect on SGM adolescents and gender minority individuals and its relationship with a broader range of mental and emotional health outcomes.
Collapse
Affiliation(s)
- Sarah I Leonard
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, New York, USA
| | - Yashika Sharma
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, New York, USA
| | - Tonda L Hughes
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, New York, USA
| | - Kasey B Jackman
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, New York, USA
- NewYork-Presbyterian Hospital, New York, New York, USA
| | - Jean-Marie Bruzzese
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, New York, USA
| |
Collapse
|
10
|
Pelham WE, Tapert SF, Zúñiga ML, Thompson WK, Wade NE, Gonzalez MR, Patel H, Baker FC, Dowling GJ, Van Rinsveld AM, Baskin-Sommers A, Kiss O, Brown SA. Pandemic-Related Changes in the Prevalence of Early Adolescent Alcohol and Drug Use, 2020-2021: Data From a Multisite Cohort Study. J Adolesc Health 2023; 73:338-346. [PMID: 37191599 PMCID: PMC10186567 DOI: 10.1016/j.jadohealth.2023.02.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 02/09/2023] [Accepted: 02/26/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE Evaluate changes in early adolescent substance use from May 2020 to May 2021 during the coronavirus disease 2019 pandemic using data from a prospective nationwide cohort: the Adolescent Brain Cognitive Development Study. METHODS In 2018-2019, 9,270 youth aged 11.5-13.0 completed a prepandemic assessment of past-month alcohol and drug use, then up to seven during-pandemic assessments between May 2020 and May 2021. We compared the prevalence of substance use among same-age youth across these eight timepoints. RESULTS Pandemic-related decreases in the past-month prevalence of alcohol use were detectable in May 2020, grew larger over time, and remained substantial in May 2021 (0.3% vs. 3.2% prepandemic, p <.001). Pandemic-related increases in inhalant use (p = .04) and prescription drug misuse (p < .001) were detectable in May 2020, shrunk over time, and were smaller but still detectable in May 2021(0.1%-0.2% vs. 0% pre-pandemic). Pandemic-related increases in nicotine use were detectable between May 2020 and March 2021 and no longer significantly different from prepandemic levels in May 2021 (0.5% vs. 0.2% prepandemic, p = .09). There was significant heterogeneity in pandemic-related change in substance use at some timepoints, with increased rates among youth identified as Black or Hispanic or in lower-income families versus stable or decreased rates among youth identified as White or in higher-income families. DISCUSSION Among youth ages 11.5-13.0 years old, rates of alcohol use remained dramatically reduced in May 2021 relative to prepandemic and rates of prescription drug misuse and inhalant use remained modestly increased. Differences remained despite the partial restoration of prepandemic life, raising questions about whether youth who spent early adolescence under pandemic conditions may exhibit persistently different patterns of substance use.
Collapse
Affiliation(s)
- William E Pelham
- Department of Psychiatry, University of California San Diego, La Jolla, California.
| | - Susan F Tapert
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - María Luisa Zúñiga
- School of Social Work, College of Health and Human Services, San Diego State University, San Diego, California
| | | | - Natasha E Wade
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Marybel R Gonzalez
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Herry Patel
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, California
| | | | | | | | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, California
| | - Sandra A Brown
- Department of Psychology, University of California San Diego, La Jolla, California; Department of Psychiatry, University of California San Diego, La Jolla, California
| |
Collapse
|
11
|
Torgerson C, Ahmadi H, Choupan J, Fan CC, Blosnich JR, Herting MM. Sex, gender diversity, and brain structure in children ages 9 to 11 years old. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.28.551036. [PMID: 37546960 PMCID: PMC10402171 DOI: 10.1101/2023.07.28.551036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
There remains little consensus about the relationship between sex and brain structure, particularly in childhood. Moreover, few pediatric neuroimaging studies have analyzed both sex and gender as variables of interest - many of which included small sample sizes and relied on binary definitions of gender. The current study examined gender diversity with a continuous felt-gender score and categorized sex based on X and Y allele frequency in a large sample of children ages 9-11 years-old (N=7693). Then, a statistical model-building approach was employed to determine whether gender diversity and sex independently or jointly relate to brain morphology, including subcortical volume, cortical thickness, gyrification, and white matter microstructure. The model with sex, but not gender diversity, was the best-fitting model in 75% of gray matter regions and 79% of white matter regions examined. The addition of gender to the sex model explained significantly more variance than sex alone with regard to bilateral cerebellum volume, left precentral cortical thickness, as well as gyrification in the right superior frontal gyrus, right parahippocampal gyrus, and several regions in the left parietal lobe. For mean diffusivity in the left uncinate fasciculus, the model with sex, gender, and their interaction captured the most variance. Nonetheless, the magnitude of variance accounted for by sex was small in all cases and felt-gender score was not a significant predictor on its own for any white or gray matter regions examined. Overall, these findings demonstrate that at ages 9-11 years-old, sex accounts for a small proportion of variance in brain structure, while gender diversity is not directly associated with neurostructural diversity.
Collapse
Affiliation(s)
- Carinna Torgerson
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
- Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Hedyeh Ahmadi
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Jeiran Choupan
- Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Chun Chieh Fan
- Center for Population Neuroscience and Genetics, Laureate Institute for Brain Research, Tulsa, OK, USA
- Department of Radiology, School of Medicine, University of California, San Diego
| | - John R. Blosnich
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Megan M. Herting
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
12
|
van Heesewijk J, Steenwijk MD, Kreukels BPC, Veltman DJ, Bakker J, Burke SM. Alterations in the inferior fronto-occipital fasciculus - a specific neural correlate of gender incongruence? Psychol Med 2023; 53:3461-3470. [PMID: 35301969 PMCID: PMC10277722 DOI: 10.1017/s0033291721005547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 11/06/2021] [Accepted: 12/28/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Increasing numbers of adolescents seek help for gender-identity questions. Consequently, requests for medical treatments, such as puberty suppression, are growing. However, studies investigating the neurobiological substrate of gender incongruence (when birth-assigned sex and gender identity do not align) are scarce, and knowledge about the effects of puberty suppression on the developing brain of transgender youth is limited. METHODS Here we cross-sectionally investigated sex and gender differences in regional fractional anisotropy (FA) as measured by diffusion MR imaging, and the impact of puberty on alterations in the white-matter organization of 35 treatment-naive prepubertal children and 41 adolescents with gender incongruence, receiving puberty suppression. The transgender groups were compared with 79 age-matched, treatment-naive cisgender (when sex and gender align) peers. RESULTS We found that transgender adolescents had lower FA in the bilateral inferior fronto-occipital fasciculus (IFOF), forceps major and corpus callosum than cisgender peers. In addition, average FA values of the right IFOF correlated negatively with adolescents' cumulative dosage of puberty suppressants received. Of note, prepubertal children also showed significant FA group differences in, again, the right IFOF and left cortico-spinal tract, but with the reverse pattern (transgender > cisgender) than was seen in adolescents. CONCLUSIONS Importantly, our results of lower FA (indexing less longitudinal organization, fiber coherence, and myelination) in the IFOF of gender-incongruent adolescents replicate prior findings in transgender adults, suggesting a salient neural correlate of gender incongruence. Findings highlight the complexity with which (pubertal) sex hormones impact white-matter development and add important insight into the neurobiological substrate associated with gender incongruence.
Collapse
Affiliation(s)
- Jason van Heesewijk
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, De Boelelaan 1131, Amsterdam, Noord-Holland, Netherlands
| | - Martijn D. Steenwijk
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, De Boelelaan 1131, Amsterdam, Noord-Holland, Netherlands
| | - Baudewijntje P. C. Kreukels
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, De Boelelaan 1131, Amsterdam, Noord-Holland, Netherlands
| | - Dick J. Veltman
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, De Boelelaan 1131, Amsterdam, Noord-Holland, Netherlands
| | - Julie Bakker
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, De Boelelaan 1131, Amsterdam, Noord-Holland, Netherlands
| | - Sarah M. Burke
- Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, location VUmc, De Boelelaan 1131, Amsterdam, Noord-Holland, Netherlands
| |
Collapse
|
13
|
Loso HM, Locke Dube S, Chaarani B, Ivanova M, Garavan H, Johns MM, Potter AS. Associations Between Gender Nonconformity, School Environments, Family Conflict, and Emotional and Behavioral Health Among Children Ages 10-11. J Adolesc Health 2023; 72:869-876. [PMID: 37032213 PMCID: PMC10503520 DOI: 10.1016/j.jadohealth.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 01/21/2023] [Accepted: 02/01/2023] [Indexed: 04/11/2023]
Abstract
PURPOSE In youth, gender nonconformity (GNC; gender expression that differs from stereotypes based on assigned sex at birth) is associated with a higher likelihood of peer and caregiver victimization and rejection. However, few studies have examined the relationship between GNC, overall family conflict, perceptions of school environment, and emotional and behavioral health problems among children ages 10-11. METHODS The Adolescent Brain Cognitive Development Study data release 3.0 was used (n = 11,068; 47.9% female). A path analysis was used to examine whether school environment and family conflict, mediated the relationship between GNC and behavioral and emotional health outcomes. RESULTS We found significant mediation of the relationship between GNC and behavioral and emotional health by school environment a2b2 = .20, 95% CI [0.13, 0.27] and family conflict a1b1 = 0.34, 95% CI [0.25, 0.42]. DISCUSSION Our results suggest that youth who present as gender nonconforming experience elevated family conflict, poorer perceptions of their school environment and elevated behavioral and emotional health problems. Further, the relationship between GNC and elevated emotional and behavioral health problems was mediated by perceptions of school environment and family conflict. Clinical and policy suggestions to improve environments and outcomes for youth who present as gender nonconforming are discussed.
Collapse
Affiliation(s)
- Hannah M Loso
- Department of Psychiatry, University of Vermont, Burlington Vermont; Department of Psychological Science, University of Vermont, Burlington Vermont.
| | | | - Bader Chaarani
- Department of Psychiatry, University of Vermont, Burlington Vermont
| | - Masha Ivanova
- Department of Psychiatry, University of Vermont, Burlington Vermont; Department of Psychological Science, University of Vermont, Burlington Vermont
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont, Burlington Vermont; Department of Psychological Science, University of Vermont, Burlington Vermont
| | - Michelle M Johns
- Academic Research Centers, NORC at University of Chicago, Chicago Illinois
| | - Alexandra S Potter
- Department of Psychiatry, University of Vermont, Burlington Vermont; Department of Psychological Science, University of Vermont, Burlington Vermont
| |
Collapse
|
14
|
Abstract
Transgender and gender diverse (TGD) children and adolescents are an increasingly visible yet highly stigmatized group. These youth experience more psychological distress than not only their cisgender, heterosexual peers but also their cisgender, sexual minority peers. In this review, we document these mental health disparities and discuss potential explanations for them using a minority stress framework. We also discuss factors that may increase and decrease TGD youth's vulnerability to psychological distress. Further, we review interventions, including gender-affirming medical care, that may improve mental health in TGD youth. We conclude by discussing limitations of current research and suggestions for the future.
Collapse
Affiliation(s)
- Natalie M Wittlin
- Department of Psychology, Princeton University, Princeton, New Jersey, USA;
| | - Laura E Kuper
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Endocrinology, Children's Health Systems of Texas, Dallas, Texas, USA
| | - Kristina R Olson
- Department of Psychology, Princeton University, Princeton, New Jersey, USA;
| |
Collapse
|
15
|
Thoman JM, DeLisi LE. Editorial: The association of gender dysphoria with psychosis. Curr Opin Psychiatry 2023; 36:147-149. [PMID: 37017143 DOI: 10.1097/yco.0000000000000863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Affiliation(s)
| | - Lynn E DeLisi
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts, USA
| |
Collapse
|
16
|
Ballering AV, Burke SM, Maeckelberghe ELM, Rosmalen JGM. How to Ensure Inclusivity in Large-Scale General Population Cohort Studies? Lessons Learned with Regard to Including and Assessing Sex, Gender, and Sexual Orientation. ARCHIVES OF SEXUAL BEHAVIOR 2023:10.1007/s10508-023-02600-y. [PMID: 37186037 DOI: 10.1007/s10508-023-02600-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 05/17/2023]
Abstract
Despite recent advances in the measurement of sex, gender, and sexual orientation in large-scale cohort studies, the three concepts are still gaining relatively little attention, may be mistakenly equated, or non-informatively operationalized. The resulting imprecise or lacking information hereon in studies is problematic, as sex, gender, and sexual orientation are important health-related factors. Omission of these concepts from general population cohort studies might dismiss participants' identity and experiences and pushes research on sexual or gender minority populations toward purposive sampling, potentially introducing selection bias. It also reinforces the unintentional notion of irrelevance of these concepts to health research, ultimately disadvantaging sexual and gender minority populations. Similarly, a lack of uniform measures on sex, gender, and sexual orientation hampers multi-cohort studies in which data from multiple studies are combined, facilitating increased statistical power. This paper discusses the encountered pitfalls and lessons learned on including and assessing sex, gender, and sexual orientation in large-scale general population cohort studies, exemplified by the Dutch Lifelines Cohort Study. Additionally, we propose hands-on strategies on how to operationalize these concepts in an inclusive manner that is useful for large-scale general population cohort studies.
Collapse
Affiliation(s)
- Aranka V Ballering
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
| | - Sarah M Burke
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Els L M Maeckelberghe
- University Medical Center Groningen, Wenckebach Institute for Training and Education, University of Groningen, Groningen, The Netherlands
| | - Judith G M Rosmalen
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
- Department of Internal Medicine, University Medical Center of Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
17
|
Loso H, Chaarani B, Dube SL, Albaugh MD, Cheaito A, Garavan H, Potter A. Gender diversity associated with patterns of brain activation seen in populations that experience childhood stress. Front Integr Neurosci 2023; 17:1084748. [PMID: 36969492 PMCID: PMC10033574 DOI: 10.3389/fnint.2023.1084748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 02/06/2023] [Indexed: 03/12/2023] Open
Abstract
Introduction Stressful childhood experiences are associated with unique brain activity patterns during emotional processing. Specifically, pediatric stress is linked to activation in the insulae, superior temporal and parahippocampal gyri, and the amygdalae, as well as differential activation in the dorsal anterior cingulate cortex when viewing emotional faces. Gender diversity is broadly associated with higher victimization and mental health disparities in children aged 9/10, but whether it is associated with stress-like alterations in brain function (BOLD signal during task-based fMRI) remains unknown. We investigate the functional brain correlates of this relationship to determine if gender-diverse youth show patterns of functional activity during an emotional task consistent with those of other populations that experience heightened stress. Methods We used data from the Adolescent Brain Cognitive Development (ABCD)® study. First, we identified a subset of 4,385 participants aged 10/11 years with gender diversity data and quality-controlled fMRI data from the EN-Back (emotional n-back) task. The EN-Back is a working memory task that presents emotion faces as well as pictures of places as control stimuli. We regressed BOLD signal associated with emotion faces (faces minus places contrast) on gender diversity. Next, we tested if parental acceptance or youth perceptions of their school environment moderated the relationship between gender diversity and activation in the insulae or fusiform gyrus. Finally, we used structural equation modeling to investigate gender diversity's association with parental acceptance, perceptions of school environments, internalizing and externalizing problems. Results Gender diversity was associated with widespread increases in BOLD signal during the faces condition of the EN-Back task. Youth's report of parental acceptance and school environment did not moderate the relationship between gender diversity and BOLD signal in the insula or fusiform gyrus. Gender diversity was related to greater parent and school-related stress, which was associated with elevated mental health problems. Conclusion Patterns of functional activity were consistent with those reported in prior literature on childhood stress. Gender diversity was associated with increased emotional and behavioral problems, as well as parent and school-related stress. These findings indicate the importance of the home and school environments for supporting the wellbeing of gender diverse youth.
Collapse
Affiliation(s)
- Hannah Loso
- Department of Psychological Science, The University of Vermont, Burlington, VT, United States
- Department of Psychiatry, The University of Vermont, Burlington, VT, United States
| | - Bader Chaarani
- Department of Psychological Science, The University of Vermont, Burlington, VT, United States
| | - Sarahjane Locke Dube
- Department of Psychological Science, The University of Vermont, Burlington, VT, United States
| | - Matthew D. Albaugh
- Department of Psychological Science, The University of Vermont, Burlington, VT, United States
- Department of Psychiatry, The University of Vermont, Burlington, VT, United States
| | - Aya Cheaito
- Department of Psychological Science, The University of Vermont, Burlington, VT, United States
- Department of Psychiatry, The University of Vermont, Burlington, VT, United States
| | - Hugh Garavan
- Department of Psychological Science, The University of Vermont, Burlington, VT, United States
- Department of Psychiatry, The University of Vermont, Burlington, VT, United States
| | - Alexandra Potter
- Department of Psychological Science, The University of Vermont, Burlington, VT, United States
- Department of Psychiatry, The University of Vermont, Burlington, VT, United States
| |
Collapse
|
18
|
Randall AB, van der Star A, Pennesi JL, Siegel JA, Blashill AJ. Gender identity-based disparities in self-injurious thoughts and behaviors among pre-teens in the United States. Suicide Life Threat Behav 2022; 53:241-249. [PMID: 36562588 DOI: 10.1111/sltb.12937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/26/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Transgender individuals are at heightened risk for self-injurious thoughts and behaviors (SITBs). Evidence suggests that middle childhood-aged transgender individuals experience elevated rates of non-suicidal self-injury (NSSI) and passive suicidal ideation (SI), compared to cisgender children. Little is known about gender identity-based disparities in SI more broadly and suicidal behavior (SB) in children aged 9 and 10. The aim of this study was to examine gender identity-based disparities in SITBs among children in middle childhood (pre-teens) in a US-based sample. METHODS Using data from the 3.0 baseline release of the Adolescent Brain Cognitive Development (ABCD) study, logistic regression models, unadjusted and adjusted for covariates, were performed to examine gender identity-based disparities in SITBs. RESULTS In a model adjusted for birth sex, race/ethnicity, and household income, transgender children were at significantly higher odds for current (adjusted odds ratio [AOR] = 6.34) but not lifetime NSSI compared with cisgender children. Transgender children were at significantly higher odds for current and lifetime SI (AOR = 13.03; AOR = 5.39, respectively) and SB (AOR = 14.21; AOR = 12.64, respectively) compared with cisgender children. CONCLUSIONS Gender identity-based disparities in SITBs may be present as early as age 9 and 10, demonstrating the need for SITB prevention and intervention efforts specific to transgender children.
Collapse
Affiliation(s)
- Alyson B Randall
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Arjan van der Star
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Jamie-Lee Pennesi
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Jaclyn A Siegel
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Aaron J Blashill
- Department of Psychology, San Diego State University, San Diego, California, USA.,San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| |
Collapse
|
19
|
Ghassabian A, Suleri A, Blok E, Franch B, Hillegers MHJ, White T. Adolescent gender diversity: sociodemographic correlates and mental health outcomes in the general population. J Child Psychol Psychiatry 2022; 63:1415-1422. [PMID: 35147218 DOI: 10.1111/jcpp.13588] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Gender diversity in young adolescents is understudied outside of referral clinics. We investigated gender diversity in an urban, ethnically diverse sample of adolescents from the general population and examined predictors and associated mental health outcomes. METHODS The study was embedded in Generation R, a population-based cohort of children born between 2002 and 2006 in Rotterdam, the Netherlands (n = 5727). At ages 9-11 and 13-15 years, adolescents and/or their parents responded to two questions addressing children's contentedness with their assigned gender, whether they (a) 'wished to be the opposite sex' and (b) 'would rather be treated as someone from the opposite sex'. We defined 'gender-variant experience' when either the parent or child responded with 'somewhat or sometimes true' or 'very or often true'. Mental health was assessed at 13-15 years, using the Achenbach System of Empirically Based Assessment. RESULTS Less than 1% of the parents reported that their child had gender-variant experience, with poor stability between 9-11 and 13-15 years. In contrast, 4% of children reported gender-variant experience at 13-15 years. Adolescents who were assigned female at birth reported more gender-variant experience than those assigned male. Parents with low/medium educational levels reported more gender-variant experience in their children than those with higher education. There were positive associations between gender-variant experience and symptoms of anxiety, depression, somatic complaints, rule-breaking, and aggressive behavior as well as attention, social, and thought problems. Similar associations were observed for autistic traits, independent of other mental difficulties. These associations did not differ by assigned sex at birth. CONCLUSIONS Within this population-based study, adolescents assigned females were more likely to have gender-variant experience than males. Our data suggest that parents may not be aware of gender diversity feelings in their adolescents. Associations between gender diversity and mental health symptoms were present in adolescents.
Collapse
Affiliation(s)
- Akhgar Ghassabian
- Departments of Pediatrics, Population Health, and Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Anna Suleri
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Elisabet Blok
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Berta Franch
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Tonya White
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
20
|
Gavidia R, Whitney DG, Hershner S, Selkie EM, Tauman R, Dunietz GL. Gender identity and transition: relationships with sleep disorders in US youth. J Clin Sleep Med 2022; 18:2553-2559. [PMID: 35912700 PMCID: PMC9622987 DOI: 10.5664/jcsm.10158] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Transgender or gender-nonconforming (TGNC) identity is associated with higher burden of sleep disorders relative to cisgender identity. However, the role of gender-affirming therapy (GAT) in sleep disorders is poorly understood. This study examined relationships between TGNC identity, transition, and sleep disorders among TGNC and cisgender youth. METHODS This retrospective cross-sectional study utilized a large US-based administrative claims database (deidentified Optum Clinformatics Data Mart Database) to identify youth aged 12-25 years who obtained a diagnosis of TGNC identity and those who pursued GAT. Descriptive statistics estimated distributions of demographic and health characteristics by gender identity. Unadjusted and age-adjusted logistic regression models were used to examine associations between TGNC identity, GAT, and sleep disorders. RESULTS This study included 1,216,044 youth, of which 2,603 (0.2%) were identified as TGNC. Among the 1,387 TGNC who pursued GAT, 868 and 519 were identified as transmasculine and transfeminine, respectively. Adjusted analysis showed increased odds of insomnia (odds ratio = 5.4, 95% confidence interval 4.7, 6.2), sleep apnea (odds ratio = 3.0, 95% confidence interval 2.3, 4.0), and other sleep disorders (odds ratio = 3.1, 95% confidence interval 2.5, 3.9) in TGNC relative to cisgender youth. Decreased odds of any sleep disorder were observed in the TGNC youth on GAT (odds ratio = 0.5, 95% confidence interval 0.4, 0.7) relative to those not on GAT. CONCLUSIONS This study demonstrated a high burden of sleep disorders in TGNC youth in comparison to cisgender. However, GAT may confer a protective effect on sleep disorders among TGNC youth. Longitudinal assessments of sleep disorders prior to and post-GAT are needed to uncover their temporal relationships. CITATION Gavidia R, Whitney DG, Hershner S, Selkie EM, Tauman R, Dunietz GL. Gender identity and transition: relationships with sleep disorders in US youth. J Clin Sleep Med. 2022;18(11):2553-2559.
Collapse
Affiliation(s)
- Ronald Gavidia
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan
| | - Daniel G. Whitney
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor Michigan
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Shelley Hershner
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan
| | - Ellen M. Selkie
- Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, University of Wisconsin–Madison, Madison, Wisconsin
| | - Riva Tauman
- Sleep Disorders Center, Tel Aviv Souraski Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Galit Levi Dunietz
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, Michigan
| |
Collapse
|
21
|
Zhao X, Zhang A, Liu W, Tao F, Sun Y. Childhood Separation from Parents with Cognitive and Psychopathological Outcomes in Adolescence. Dev Sci 2022; 26:e13324. [PMID: 36065157 DOI: 10.1111/desc.13324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 07/22/2022] [Accepted: 08/28/2022] [Indexed: 11/30/2022]
Abstract
To examine the effects of childhood parent-child separation with varying duration and form on later cognitive performance and psychopathological problems over a 6-year period, we use data from the China Family Panel Study, which is an ongoing, prospective nationally representative study across 25 provinces in China. Of the 4033 children aged 4-10 years followed in 2012, 3522 children with complete data on separation from fathers and mothers were included. In 2018, 2560 participants were followed and interviewed to assess cognitive performance, behavioral problems as well as depressive symptoms at age 10-16 years. A total of 3522 children (mean [SD] age at baseline, 6.9 [2.0] years) were included. About 17.9% and 13.3% had separated from father and mother over 11 months or more in the year prior to the survey. Prolonged separation from parents was associated with lower scores in vocabulary (maternal: adjusted β = -1.64, P = 0.002; paternal: adjusted β = -1.58, P<0.001) and mathematics performance (maternal: adjusted β = -1.10, P = 0.009; paternal: adjusted β = -0.94, P = 0.004) over a 6-year period. Prolonged maternal separation was associated with 0.34-point higher internalizing behaviors (P<0.001) and 0.21-point higher externalizing behaviors (P = 0.009), as well as 0.89-point higher depressive symptoms (P = 0.018), while prolonged paternal separation was associated with 0.23-point higher internalizing behaviors (P = 0.005) and 0.76-point higher depressive symptoms (P = 0.011). The finding demonstrates substantial negative impacts of childhood paternal and maternal separations on cognitive and mental well-being during adolescence, which might be dependent on the "stress-dose" (duration of separation) and urban-rural residence. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Xudong Zhao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, Anhui, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Anhui Zhang
- Wuhu Maternity & Child Health Care Center, Wuhu, Anhui, 230001, China
| | - Wanxu Liu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, Anhui, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, Anhui, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Ying Sun
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, Anhui, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, Anhui, 230032, China
| |
Collapse
|
22
|
Goodwin SR, Moskal D, Marks RM, Clark AE, Squeglia LM, Roche DJO. A Scoping Review of Gender, Sex and Sexuality Differences in Polysubstance Use in Adolescents and Adults. Alcohol Alcohol 2022; 57:292-321. [PMID: 35284931 DOI: 10.1093/alcalc/agac006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/25/2022] [Accepted: 01/29/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Polysubstance use is a common, problematic behavior that increases risk of harm to self and others. Research suggests that rates may vary based on gender, sex and sexuality. Understanding the current state of this literature may inform prevention and treatment of polysubstance use, leading to reduced public health burden. OBJECTIVES This review aimed to synthesize research on gender, sex and sexuality differences in polysubstance use in adults and adolescents. METHODS A scoping review was conducted using all EBSCO databases, PubMed and Google Scholar to identify articles examining the effects of gender, sex and sexuality on polysubstance use. Polysubstance use was defined broadly as the use of any combination of substances over any time period and included licit (alcohol, tobacco) and illicit substances, concurrent and simultaneous use, from lifetime to daily use and use at any frequency. Studies were considered if they were published in peer-reviewed journals between January 1990 and October 2020 and were written in English. Publicly available data sources were also utilized to fully capture prevalence data that has not been published elsewhere. RESULTS Findings were mostly inconsistent and often conflicting. Only two findings were generally consistent: adult men were overall more likely to report polysubstance use than adult women, and sexual and gender minorities report more frequent polysubstance use than non-minorities. CONCLUSIONS Research has been unable to clearly elucidate differences in polysubstance use prevalence and patterns according to gender, sex and sexuality. Several recommendations are offered to advance future research and address limitations of current research.
Collapse
Affiliation(s)
- Shelby R Goodwin
- Department of Psychiatry, University of Maryland, Baltimore, MD 21201, USA
| | - Dezarie Moskal
- VA Center for Integrated Healthcare, VA Western New York Healthcare System, Buffalo, NY 14215, USA.,Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14215, USA
| | - Russell M Marks
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI 02903, United States
| | - Ashton E Clark
- Department of Psychiatry, University of Maryland, Baltimore, MD 21201, USA
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Daniel J O Roche
- Department of Psychiatry, University of Maryland, Baltimore, MD 21201, USA
| |
Collapse
|
23
|
Graham P. Letter to the Editor: Transgender and mental health. J Child Psychol Psychiatry 2022; 63:245. [PMID: 34008869 DOI: 10.1111/jcpp.13437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Philip Graham
- Institute of Child Health, University College, London, UK
| |
Collapse
|
24
|
Potter AS, Dube SL, Barrios LC, Bookheimer S, Espinoza A, Feldstein Ewing SW, Freedman EG, Hoffman EA, Ivanova M, Jefferys H, McGlade EC, Tapert SF, Johns MM. Measurement of gender and sexuality in the Adolescent Brain Cognitive Development (ABCD) study. Dev Cogn Neurosci 2022; 53:101057. [PMID: 35026661 PMCID: PMC8759998 DOI: 10.1016/j.dcn.2022.101057] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 12/13/2021] [Accepted: 01/03/2022] [Indexed: 11/28/2022] Open
Abstract
The Adolescent Brain Cognitive DevelopmentSM (ABCD) study is a longitudinal study of adolescent brain development and health that includes over 11,800 youth in the United States. The ABCD study includes broad developmental domains, and gender and sexuality are two of these with noted changes across late childhood and early adolescence. The Gender Identity and Sexual Health (GISH) workgroup recommends measures of gender and sexuality for the ABCD study, prioritizing those that are developmentally sensitive, capture individual differences in the experience of gender and sexuality, and minimize participant burden. This manuscript describes the gender and sexuality measures used in ABCD and provides guidance for researchers using these data. Data showing the utility of these measures and longitudinal trends are presented. Including assessment of gender and sexuality in ABCD allows for characterization of developmental trajectories of gender and sexuality, and the broad scope of ABCD data collection allows examination of identity development in an intersectional manner.
Collapse
Affiliation(s)
- Alexandra S Potter
- Department of Psychiatry, Larner College of Medicine, University of Vermont, 1 S Prospect St, UHC Arnold 6, Burlington, VT 05401, USA.
| | - Sarahjane L Dube
- Department of Psychiatry, Larner College of Medicine, University of Vermont, 1 S Prospect St, UHC Arnold 6, Burlington, VT 05401, USA.
| | - Lisa C Barrios
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, 1600 Clifton Rd., NE MS US 8-1, Atlanta, GA 30329, USA.
| | - Susan Bookheimer
- Joaquin Fuster Professor of Cognitive Neuroscience, UCLA School of Medicine, 916 Camino Colibri, Calabasas, CA 91302, USA.
| | - Abigail Espinoza
- Adolescent Brain Cognitive Development (ABCD) Study, Developmental Brain Imaging Lab (DBIL), Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, Portland, OR 97239-3098, USA.
| | - Sarah W Feldstein Ewing
- Prochaska Endowed Professor of Psychology and Interdisciplinary Neuroscience, University of Rhode Island, Kingston, 130 Flagg Ave., Kingston, RI, USA.
| | - Edward G Freedman
- Dept. Neuroscience, Del Monte Institute for Neuroscience, University of Rochester Medical Center, 430 Elmwood Ave, Rochester NY 14620, USA.
| | - Elizabeth A Hoffman
- Division of Extramural Research, National Institute on Drug Abuse, National Institutes of Health, 301 North Stonestreet Ave, Rockville, MD 20850, USA.
| | - Masha Ivanova
- Department of Psychiatry, Larner College of Medicine, University of Vermont, 1 S Prospect St, Burlington, VT 05401, USA.
| | - Hailee Jefferys
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO 63110 USA.
| | - Erin C McGlade
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Dr, Box 1, Salt Lake City, UT 84108, USA.
| | - Susan F Tapert
- Department of Psychiatry, UC San Diego, 9500 Gilman Drive, San Diego, CA 92093-0603, USA.
| | - Michelle M Johns
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, 1600 Clifton Rd., NE MS US 8-1, Atlanta, GA 30329, USA.
| |
Collapse
|
25
|
Potter A. Commentary: Reply to 'Transgender and mental health' by Philip Graham. J Child Psychol Psychiatry 2022; 63:246-247. [PMID: 34008881 PMCID: PMC9196274 DOI: 10.1111/jcpp.13441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 04/07/2021] [Indexed: 11/29/2022]
Abstract
The letter to the editor from Philip Graham regarding the manuscript 'Early adolescent gender diversity and mental health in the Adolescent Brain Cognitive Development study' (Potter et al., 2021) raises several points that highlight the complexity of the conversation around gender development in youth. While there is an agreement between the original manuscript and much of the letter, some of the issues raised warrant further discussion and clarification.
Collapse
Affiliation(s)
- Alexandra Potter
- Department of Psychiatry University of Vermont Burlington VT USA
| |
Collapse
|
26
|
Martin J, Hadwin JA. The roles of sex and gender in child and adolescent mental health. JCPP ADVANCES 2022. [DOI: 10.1002/jcv2.12059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Joanna Martin
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics Cardiff University Cardiff UK
| | | |
Collapse
|
27
|
Examining the Relationship between Gender Contentedness and Sex-Related Experiences among Taiwanese Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010635. [PMID: 34682381 PMCID: PMC8536183 DOI: 10.3390/ijerph182010635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 09/28/2021] [Accepted: 10/08/2021] [Indexed: 12/02/2022]
Abstract
Little is known about how gender contentedness is related to sex-related experiences among Taiwanese adolescents. Secondary analysis of data (n = 2624, Mage = 13.3 ± 0.47 years and 51% males) on a longitudinal youth cohort was used to track the evolving development of sex-related experiences such as exposure to sexually explicit media, romantic experiences, and sexual behaviors. Hierarchical multinomial logistic regression analyses were applied to study the effects of gender contentedness on sex-related outcome variables. The results showed that nearly 10% of the subjects were not contented with their gender. As compared to peers, gender-discontented adolescents had a higher likelihood of exposures to sexually explicit media (odds ratio [OR]. = 1.70, 95% confidence interval [CI]. = 1.18–2.46) and risky sex behaviors (OR = 2.22, 95% CI = 1.03–4.81). These results shed light on the impact of self-perceived gender contentedness on sex-related experiences in Taiwanese adolescents. Our findings are helpful for the development of practical guidance on sexual health issues, particularly for those who are discontented with their gender.
Collapse
|
28
|
Silveri MM, Schuttenberg EM, Schmandt K, Stein ER, Rieselbach MM, Sternberg A, Cohen-Gilbert JE, Katz-Wise SL, Blackford JU, Potter AS, Potter MP, Sarvey DB, McWhinnie CM, Feinberg JE, Boger KD. Clinical Outcomes Following Acute Residential Psychiatric Treatment in Transgender and Gender Diverse Adolescents. JAMA Netw Open 2021; 4:e2113637. [PMID: 34152417 PMCID: PMC8218077 DOI: 10.1001/jamanetworkopen.2021.13637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
IMPORTANCE Transgender and gender diverse (TGD) individuals, who have a gender identity that differs from their sex assigned at birth, are at increased risk of mental health problems, including depression, anxiety, self-injurious behavior, and suicidality, relative to cisgender peers. OBJECTIVE To examine mental health outcomes among TGD vs cisgender adolescents in residential treatment. DESIGN, SETTING, AND PARTICIPANTS This cohort study's longitudinal design was used to compare groups at treatment entry and discharge, and 1-month postdischarge follow-up. The setting was an adolescent acute residential treatment program for psychiatric disorders. Participants were TGD or cisgender adolescents enrolled in the treatment program. Statistical analysis was performed October 2019 to March 2021. EXPOSURE Adolescents participated in a 2-week acute residential treatment program for psychiatric disorders. MAIN OUTCOMES AND MEASURES Primary outcomes were depressive (the Center for Epidemiologic Studies Depression Scale [CES-D]) and anxiety (the Multidimensional Anxiety Scale for Children [MASC]) symptoms, and emotional dysregulation (the Difficulties in Emotion Regulation Scale [DERS]), measured at treatment entry and discharge, and postdischarge follow-up. Age of depression onset, suicidality, self-injury, and childhood trauma also were assessed at treatment entry. RESULTS Of 200 adolescent participants who completed treatment entry and discharge assessments, the mean (SD) age was 16.2 (1.5) years; 109 reported being assigned female at birth (54.5%), 35 were TGD (17.5%), and 66 (49.3%) completed 1-month follow-up. TGD participants had an earlier mean (SD) age of depression onset (TGD: 10.8 [2.4] years vs cisgender: 11.9 [2.3] years; difference: 1.07 years; 95% CI, 0.14-2.01 years; P = .02), higher mean (SD) suicidality scores (TGD: 44.4 [23.1] vs cisgender: 28.5 [25.4]; difference: 16.0; 95% CI, 6.4-25.5; P = .001), more self-injurious behavior (mean [SD] RBQ-A score for TGD: 3.1 [2.5] vs cisgender: 1.7 [1.9]; difference: 1.42; 95% CI, 0.69-2.21; P = .001) and more childhood trauma (eg, mean [SD] CTQ-SF score for emotional abuse in TGD: 12.7 [5.4] vs cisgender: 9.8 [4.7]; difference: 2.85; 95% CI, 1.06-4.64; P = .002). The TGD group also had higher symptom scores (CES-D mean difference: 7.69; 95% CI, 3.30 to 12.08; P < .001; MASC mean difference: 7.56; 95% CI, 0.46 to 14.66; P = .04; and DERS mean difference: 18.43; 95% CI, 8.39 to 28.47; P < .001). Symptom scores were significantly higher at entry vs discharge (CES-D mean difference, -12.16; 95% CI, -14.50 to -9.80; P < .001; MASC mean difference: -3.79; 95% CI, -6.16 to -1.42; P = .02; and DERS mean difference: -6.37; 95% CI, -10.80 to -1.94; P = .05) and follow-up (CES-D mean difference: -9.69; 95% CI, -13.0 to -6.42; P < .001; MASC mean difference: -6.92; 95% CI, -10.25 to -3.59; P < .001; and DERS mean difference: -12.47; 95% CI, -18.68 to -6.26; P < .001). CONCLUSIONS AND RELEVANCE This cohort study found mental health disparities in TGD youth relative to cisgender youth, with worse scores observed across assessment time points. For all participants, primary clinical outcome measures were significantly lower at treatment discharge than at entry, with no significant differences between discharge and 1-month follow-up. Given the substantial degree of mental health disparities reported in TGD individuals, these findings warrant focused clinical attention to optimize treatment outcomes in gender minority populations.
Collapse
Affiliation(s)
- Marisa M. Silveri
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Eleanor M. Schuttenberg
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, Massachusetts
- Adolescent Acute Residential Treatment Program, McLean Hospital, Belmont, Massachusetts
| | - Kaya Schmandt
- Adolescent Acute Residential Treatment Program, McLean Hospital, Belmont, Massachusetts
| | - Elena R. Stein
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, Massachusetts
- Adolescent Acute Residential Treatment Program, McLean Hospital, Belmont, Massachusetts
| | - Maya M. Rieselbach
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, Massachusetts
- Adolescent Acute Residential Treatment Program, McLean Hospital, Belmont, Massachusetts
| | - Ariel Sternberg
- Adolescent Acute Residential Treatment Program, McLean Hospital, Belmont, Massachusetts
| | - Julia E. Cohen-Gilbert
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Sabra L. Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Jennifer Urbano Blackford
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Mona P. Potter
- McLean Anxiety Mastery Program, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Dana B. Sarvey
- Adolescent Acute Residential Treatment Program, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Chad M. McWhinnie
- Adolescent Acute Residential Treatment Program, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Jessica E. Feinberg
- Adolescent Acute Residential Treatment Program, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Kathryn D. Boger
- McLean Anxiety Mastery Program, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
29
|
Dube S, Ivanova M, Potter A. "I Don't Understand": Who Is Missed When We Ask Early Adolescents, "Are You Transgender"? ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:741-745. [PMID: 33821375 PMCID: PMC8212690 DOI: 10.1007/s10508-021-01986-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Sarahjane Dube
- Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington Vermont
| | - Masha Ivanova
- Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington Vermont
| | - Alexandra Potter
- Department of Psychiatry, University of Vermont Larner College of Medicine, Burlington Vermont
| |
Collapse
|
30
|
Burke SM. Commentary: Gender diversity and adolescent mental health - a reflection on Potter et al. (2020). J Child Psychol Psychiatry 2021; 62:180-183. [PMID: 32865228 DOI: 10.1111/jcpp.13309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/10/2020] [Accepted: 07/15/2020] [Indexed: 12/31/2022]
Abstract
Using a multidimensional measure of gender identity for youths, Potter and colleagues elegantly investigated the prevalence of gender diversity and associated mental health problems in a large sample of young adolescents. The authors address an important need of studies within the behavioral and medical sciences to consider more carefully variations in a person's subjective experience of gender. Their study shows that individual differences in gender identity significantly relate to adolescent mental health problems. Moreover, findings of the current study, and future follow-up assessments of the ABCD cohort, will, hopefully, add important quantitative, empirical data to the controversial discussions on gender identity development and gender diversity in childhood and adolescence (Journal of Child Psychology and Psychiatry, 59, 2018, 1244; Pediatric gender identity, 2020, Cham, Switzerland: Springer International; International Journal of Transgenderism, 19, 2018, 225).
Collapse
|
31
|
Peper JS, Burke SM, Wierenga LM. Sex differences and brain development during puberty and adolescence. HANDBOOK OF CLINICAL NEUROLOGY 2020; 175:25-54. [PMID: 33008529 DOI: 10.1016/b978-0-444-64123-6.00003-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Sex differences in behavior, and whether these behavioral differences are related to sex differences in brain development, has been a longstanding topic of debate. Presumably, sex differences can provide critically important leads for explaining the etiology of various illnesses that show (i) large sex differences in prevalence and (ii) have an origin before or during adolescence. The general aim of this chapter is to provide an overview of scientific studies on sex differences in normative brain and behavioral development across puberty and adolescence, including the (sex) hormone-driven transition phase of puberty. Moreover, we describe the literature on brain and behavioral development in gender dysphoria, a severe and persistent incongruence between the self-identified gender and the assigned sex at birth. From the literature it becomes clear there is evidence for a specific link between pubertal maturation and developmental changes in arousal, motivation, and emotion. However, this link is rather similar between boys and girls. Moreover, although there is substantial evidence for sex differences in mean brain structure, these have not always been linked to sex differences in behavior, cognition, or psychopathology. Furthermore, there is little evidence for sex differences in brain development and thus, studies so far have been unable to explain sex differences in cognition. Suggestions for future research and methodologic considerations are provided.
Collapse
Affiliation(s)
- Jiska S Peper
- Department of Psychology, Leiden University, Leiden, The Netherlands.
| | - Sarah M Burke
- Department of Psychology, Leiden University, Leiden, The Netherlands
| | - Lara M Wierenga
- Department of Psychology, Leiden University, Leiden, The Netherlands
| |
Collapse
|