Childhood gender-typed behaviour, sexual orientation, childhood abuse and post-traumatic stress disorder: a prospective birth-cohort study.

ALSPAC birth-cohort data were analysed to assess prospective associations between childhood gender nonconformity (CGN), childhood/adolescent abuse, and adulthood PTSD symptoms. Structural equation models assessed whether abuse mediated the relationship between CGN and PTSD. Sex and sexual orientation differences were investigated. For females, higher parent-rated CGN at 30, 42 and 57-months was associated with mother-reported abuse, self-reported physical/psychological abuse, and/or self-reported sexual abuse. Higher CGN at 30-months was associated with more PTSD symptoms at 23 years. Self-rated CGN in males and females, and parent-rated CGN in males, were not associated with abuse or PTSD. Sexual minority identification was associated with higher CGN and abuse and for females, PTSD symptoms. In females, the relationship between greater CGN at 30-months and PTSD symptoms was separately mediated by each abuse variable. Self-reported sexual abuse was no longer a significant mediator after sexual orientation adjustment. Self-reported physical/psychological abuse significantly mediated the association alone when it was entered together with mother-reported abuse, even after sexual orientation adjustment. In conclusion, childhood gender nonconformity in females may increase the risk for adult PTSD symptoms, possibly mediated by childhood abuse. In females, mediation of the relationship between CGN and PTSD by sexual abuse may be particularly relevant for sexual minority individuals.

Childhood gender-typed behavior and emotional or peer problems: a prospective birth-cohort study.

BACKGROUND: Retrospective and cross-sectional studies often report associations between childhood gender nonconformity and greater emotional and peer difficulties. This study used the ALSPAC birth cohort to investigate relationships between childhood gender-typed behavior and peer and emotional problems throughout childhood and adolescence. METHODS: A total of 11,192 participants had at least one measure of parent-rated gender-typed behavior in infancy; 7,049 participants had a measure of child-rated gender-typed behavior at 8.5 years. Separate linear mixed regression models were fitted to assess whether parent-rated and child-rated gender-typed behaviors were associated with emotional and peer problems across childhood and adolescence (6-16 years old). The effect of adding covariates (self-esteem, abuse, bullying, feeling accepted by peers, and feeling different) on these relationships was assessed. RESULTS: For boys, more gender-nonconforming behavior was associated with greater subsequent emotional and peer problems in childhood and adolescence. Adjusting for self-esteem, relational bullying victimization, feeling different, or feeling accepted by peers reduced some of these associations. In contrast, for girls, more gender-nonconforming behavior was associated with fewer emotional problems in childhood and adolescence. In girls, self-reported gender-nonconforming behavior was also associated with fewer parent-rated peer problems but parent-rated gender-nonconforming behavior was associated with more parent-rated peer problems; this latter association was partly explained by self-esteem, bullying, and abuse victimization. These associations were statistically significant but small. CONCLUSIONS: Overall, more female-typical behaviors were generally associated with greater subsequent emotional and peer problems, for both boys and girls. Future studies should investigate factors that reduced these associations, as well as potential negative effects of female-typical behaviors or advantages of male-typical ones. As this was a 14-year longitudinal study, the relationships between gender-role behaviors and emotional/peer problems warrant further research despite the small association sizes.