High school students who view their gender expression as nonconforming to societal expectations for feminine or masculine appearance and behavior may be more likely to experience mental distress and suicidal thoughts/behaviors, according to a study in JAMA Pediatrics. The study also found that among males, gender nonconformity is associated with substance use.
The findings “underscore the importance of implementing school-based programs to prevent substance use and promote mental health that are inclusive of gender-diverse students,” Richard Lowry, M.D., M.S., of the Centers for Disease Control and Prevention and colleagues wrote.
In an accompanying editorial, Ellen Selkie, M.D., M.P.H., a clinical lecturer in adolescent medicine at the University of Michigan, said clinicians should inquire of both patients and parents in a confidential manner about gender identity concerns. “When youth demonstrate gender nonconformity, a careful assessment not only of mental health and substance use, but also of social stressors, is necessary,” she wrote. “Furthermore, knowledge of resources for mental health treatment and safety for gender-nonconforming youth must be in a clinician’s toolkit.”
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