Swipe om te navigeren naar een ander artikel
Gender nonconformity, that is, transgressing conventionally “masculine” vs. “feminine” characteristics, is often stigmatized. Stigmatization and discrimination are social stressors that raise risk of adverse mental and physical health outcomes and may drive health inequities. However, little is known about the relationship between such social stressors and health-related quality of life (HRQOL). This paper aimed to examine associations between perceived gender nonconformity and HRQOL in a cohort of U.S. adolescents and young adults.
Using data from 8408 participants (18–31 years) in the U.S. Growing Up Today Study (93% white, 88% middle-to-high income), we estimated risk ratios (RRs) for the association of gender nonconformity (three levels: highly gender conforming, moderately conforming, and gender nonconforming) and HRQOL using the EuroQol questionnaire (EQ-5D-5L). Models were adjusted for demographic characteristics, including sexual orientation identity.
Gender nonconformity was independently associated with increased risk of having problems with mobility [RR (95% confidence interval): 1.76 (1.16, 2.68)], usual activities [2.29 (1.67, 3.13)], pain or discomfort [1.59, (1.38, 1.83)], and anxiety or depression [1.72 (1.39, 2.13)], after adjusting for sexual orientation and demographic characteristics. Decrements in health utility by gender nonconformity were observed: compared to persons who were highly gender conforming, mean health utility was lower for the moderately gender conforming [beta (SE): −0.011 (.002)] and lowest for the most gender nonconforming [−0.034 (.005)].
In our study, HRQOL exhibited inequities by gender nonconformity. Future studies, including in more diverse populations, should measure the effect of gender-related harassment, discrimination, and violence victimization on health and HRQOL.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
Kosciw, J. G., Greytak, E. A., Palmer, N. A., & Boesen, M. J. (2014). The 2013 National School Climate Survey: The experiences of lesbian, gay, bisexual and transgender youth in our nation’s schools. New York: GLSEN. Retrieved from http://www.glsen.org/article/2013-national-school-climate-survey.
Grant, J. M., Mottet, L. A., Tanis, J., Harrison, J., Herman, J., & Keisling, M. (2011). Injustice at every turn: A report of the National Transgender Discrimination Survey. Washington, D.C.: National Center for Transgender Equality and National Gay and Lesbian Task Force; National Gay and Lesbian Task Force. Retrieved from http://endtransdiscrimination.org/report.html.
Roberts, A. L., Rosario, M., Slopen, N., Calzo, J. P., & Austin, S. B. (2013). Childhood gender nonconformity, bullying victimization, and depressive symptoms across adolescence and early adulthood: an 11-year longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry, 52(2), 143–152. doi: 10.1016/j.jaac.2012.11.006. CrossRefPubMed
Bontempo, D. E., & D’Augelli, A. R. (2002). Effects of at-school victimization and sexual orientation on lesbian, gay, or bisexual youths’ health risk behavior. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 30(5), 364–374. CrossRef
Borrell, L. N., Jacobs, D. R. Jr., Williams, D. R., Pletcher, M. J., Houston, T. K., & Kiefe, C. I. (2007). Self-reported racial discrimination and substance use in the Coronary Artery Risk Development in Adults Study. American Journal of Epidemiology, 166(9), 1068–1079. doi: 10.1093/aje/kwm180. CrossRefPubMed
Krieger, N. (2014). Discrimination and health inequities. In Social epidemiology (2nd ed., pp. 63–125). Oxford: Oxford University Press.
Beatty, D. L., Matthews, K. A., Bromberger, J. T., & Brown, C. (2014). Everyday discrimination prospectively predicts inflammation across 7-years in racially diverse midlife women: Study of Women’s Health Across the Nation. The Journal of Social Issues, 70(2), 298–314. doi: 10.1111/josi.12061. CrossRefPubMedPubMedCentral
Lepore, S. J., Revenson, T. A., Weinberger, S. L., Weston, P., Frisina, P. G., Robertson, R., … Cross, W. (2006). Effects of social stressors on cardiovascular reactivity in Black and White women. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 31(2), 120–127. doi: 10.1207/s15324796abm3102_3. CrossRef
Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding (consensus report). Washington, D.C.: Institute of Medicine: committee on lesbian, gay, bisexual, and transgender health issues and research gaps and opportunities. Retrieved from http://www.iom.edu/Reports/2011/The-Health-of-Lesbian-Gay-Bisexual-and-Transgender-People.aspx.
Fredriksen-Goldsen, K. I., Kim, H.-J., Barkan, S. E., Muraco, A., & Hoy-Ellis, C. P. (2013). Health disparities among lesbian, gay, and bisexual older adults: results from a population-based study. American Journal of Public Health, 103(10), 1802–1809. doi: 10.2105/AJPH.2012.301110. CrossRefPubMedPubMedCentral
Holzemer, W. L., Human, S., Arudo, J., Rosa, M. E., Hamilton, M. J., Corless, I., … Maryland, M. (2009). Exploring HIV stigma and quality of life for persons living with HIV infection. Journal of the Association of Nurses in AIDS Care, 20(3), 161–168. doi: 10.1016/j.jana.2009.02.002. CrossRefPubMed
Goffman, E. (1963). Stigma; notes on the management of spoiled identity. Englewood Cliffs, NJ, Prentice-Hall
Iwamoto, D. K., Cheng, A., Lee, C. S., Takamatsu, S., & Gordon, D. (2011). “Man-ing” up and getting drunk: the role of masculine norms, alcohol intoxication and alcohol-related problems among college men. Addictive Behaviors, 36(9), 906–911. doi: 10.1016/j.addbeh.2011.04.005. CrossRefPubMedPubMedCentral
Halkitis, P. N., Moeller, R. W., Siconolfi, D. E., Jerome, R. C., Rogers, M., & Schillinger, J. (2008). Methamphetamine and poly-substance use among gym-attending men who have sex with men in New York City. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 35(1), 41–48. doi: 10.1007/s12160-007-9005-8. CrossRef
Calzo, J. P., Roberts, A. L., Corliss, H. L., Blood, E. A., Kroshus, E., & Austin, S. B. (2014). Physical activity disparities in heterosexual and sexual minority youth ages 12–22 years old: roles of childhood gender nonconformity and athletic self-esteem. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 47(1), 17–27. doi: 10.1007/s12160-013-9570-y. CrossRef
Roberts, A. L., Rosario, M., Calzo, J. P., Corliss, H. L., Frazier, L., & Austin, S. B. (2014). Masculine boys, feminine girls, and cancer risk behaviors: An 11-year longitudinal study. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine. doi: 10.1016/j.jadohealth.2014.02.020.
Greytak, E. A., Gill, A., Conron, K. J., Matthews, P. A., Scout Reisner, S. L., … Tamar-Mattis, A. (2014). Identifying transgender and other gender minority respondents on population-based surveys: Special considerations for adolescents, race/ethnicity, socioeconomic status, and intersex status. In J. L. Herman (Ed.), Best Practices for Asking Questions to Identify Transgender and Other Gender Minority Respondents on Population-Based Surveys (pp. 29–43). Los Angeles, CA: The Williams Institute. Retrieved from http://williamsinstitute.law.ucla.edu/wp-content/uploads/geniuss-report-sep-2014.pdf.
Agency for Healthcare Research and Quality. (2012). U.S. valuation of the EuroQol EQ-5D(TM) health states (text). Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from http://www.ahrq.gov/rice/EQ5Dproj.htm.
van Hout, B., Janssen, M. F., Feng, Y.-S., Kohlmann, T., Busschbach, J., Golicki, D., … Pickard, A. S. (2012). Interim scoring for the EQ-5D-5L: Mapping the EQ-5D-5L to EQ-5D-3L value sets. Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 15(5), 708–715. doi: 10.1016/j.jval.2012.02.008. CrossRef
Lubetkin, E. I., Jia, H., Franks, P., & Gold, M. R. (2005). Relationship among sociodemographic factors, clinical conditions, and health-related quality of life: Examining the EQ-5D in the U.S. general population. Quality of Life Research, 14(10), 2187–2196. doi: 10.1007/s11136-005-8028-5. CrossRefPubMed
Liang, K.-Y., & Zeger, S. L. (1986). Longitudinal data analysis using generalized linear models. Biometrika, 73(1), 13–22. CrossRef
Yuan, Y. (2011). Multiple imputation using SAS software. Journal of Statistical Software, 45(6), 1–25. CrossRef
Goldsmith, K. A., Dyer, M. T., Schofield, P. M., Buxton, M. J., & Sharples, L. D. (2009). Relationship between the EQ-5D index and measures of clinical outcomes in selected studies of cardiovascular interventions. Health and Quality of Life Outcomes, 7(1), 96. doi: 10.1186/1477-7525-7-96. CrossRefPubMedPubMedCentral
Friedman, M. S., Koeske, G. F., Silvestre, A. J., Korr, W. S., & Sites, E. W. (2006). The impact of gender-role nonconforming behavior, bullying, and social support on suicidality among gay male youth. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 38(5), 621–623. doi: 10.1016/j.jadohealth.2005.04.014. CrossRef
Remafedi, G., Farrow, J. A., & Deisher, R. W. (1991). Risk factors for attempted suicide in gay and bisexual youth. Pediatrics, 87(6), 869–875. PubMed
Hendricks, M. L., & Testa, R. J. (2012). A conceptual framework for clinical work with transgender and gender nonconforming clients: An adaptation of the minority stress model. Professional Psychology: Research and Practice, 43(5), 460. CrossRef
Corliss, H. L., Rosario, M., Wypij, D., Fisher, L. B., & Austin, S. B. (2008). Sexual orientation disparities in longitudinal alcohol use patterns among adolescents: Findings from the Growing Up Today Study. Archives of Pediatrics & Adolescent Medicine, 162(11), 1071–1078. doi: 10.1001/archpedi.162.11.1071. CrossRef
Sønderlund, A. L., O’Brien, K., Kremer, P., Rowland, B., De Groot, F., Staiger, P., … Miller, P. G. (2014). The association between sports participation, alcohol use and aggression and violence: a systematic review. Journal of Science and Medicine in Sport / Sports Medicine Australia, 17(1), 2–7. doi: 10.1016/j.jsams.2013.03.011. CrossRef
- Decrements in health-related quality of life associated with gender nonconformity among U.S. adolescents and young adults
Allegra R. Gordon
Cassandra A. Okechukwu
Brittany M. Charlton
S. Bryn Austin
- Springer International Publishing