Research ArticleViolence Victimization, Substance Use Disparities, and Gender-Nonconforming Youth
Section snippets
INTRODUCTION
Gender-nonconforming adolescents, that is, those whose appearance or behaviors do not align with the societal expectations of their gender,1,2 may experience higher risk for substance use than gender-conforming youth.3, 4, 5 Given the well-documented negative effects of adolescent substance use on developmental, social, and health outcomes,6 disproportionate rates of substance use raise important questions about what factors may be driving this trend. One potential explanatory mechanism may be
Study Sample
As part of the Youth Risk Behavior Surveillance System, conducted by the Centers for Disease Control and Prevention (CDC), approximately 20 large urban school districts conduct the Youth Risk Behavior Survey (YRBS) biennially using a 2-stage cluster sample design to produce a representative sample of public high school students in Grades 9–12 within each jurisdiction. In 2015, three of these large urban school districts included an optional question on their YRBS questionnaire for assessing
RESULTS
Among the total student population, 76.8% of male and 82.5% of female students were gender conforming; 10.2% of male and 13.5% of female students were equally feminine/masculine; and 13.0% of male and 4.0% of female students were gender nonconforming (Table 1). Both male and female students experienced violence victimization, with some variation in the types of violence victimizations experienced. The prevalence of violence victimization categories ranged from 6.5% to 12.8% among male students,
DISCUSSION
Gender nonconformity may have implications for a substantial segment of this population, with approximately 1 in 5 (23.2% of male and 17.5% of female) high school students reported having an equally feminine/masculine or a gender-nonconforming expression. The present findings are consistent with previous research that has shown gender-nonconforming youth experience high rates of harassment and victimization, as well as increased substance use, compared to their gender-conforming peers.4,5,16, 17
CONCLUSIONS
The findings suggest that some substance use among gender-nonconforming male students may occur in response to the greater prevalence of violence victimizations they experience. Developing support systems within schools and linking school and community resources for gender-nonconforming students may be an important avenue to improve mental health and reduce substance use in this population. Possible interventions include providing safe spaces and school staff contacts who are knowledgeable and
ACKNOWLEDGMENTS
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
No financial disclosures were reported by the authors of this paper.
REFERENCES (37)
- et al.
Social stress and substance use disparities by sexual orientation among high school students
Am J Prev Med
(2017) - et al.
Stigma and its public health implications
Lancet
(2006) - et al.
Poly-victimization: a neglected component in child victimization
Child Abuse Negl
(2007) - et al.
Poly-victimization and risk of posttraumatic, depressive, and substance use disorders and involvement in delinquency in a national sample of adolescents
J Adolesc Health
(2010) - et al.
Nonconforming gender expression is a predictor of bullying and violence victimization among high school students in four U.S. school districts
J Adolesc Health
(2016) - et al.
Childhood gender nonconformity, bullying victimization, and depressive symptoms across adolescence and early adulthood: an 11-year longitudinal study
J Am Acad Child Adolesc Psychiatry
(2013) Constructions of masculinity and their influence on men's well-being: a theory of gender and health
Soc Sci Med
(2000)- et al.
The effects of gender- and sexuality-based harassment on lesbian, gay, bisexual, and transgender substance use disparities
J Adolesc Health
(2018) - et al.
Transgender youth substance use disparities: results from a population-based sample
J Adolesc Health
(2017) - et al.
School absenteeism and mental health among sexual minority youth and heterosexual youth
J Sch Psychol
(2014)