Gender Nonconformity and Common Mental Health Problems: A Meta-Analysis

Yin Xu; Jinghao Feng; Qazi Rahman

doi:10.1016/j.cpr.2024.102500

Gender Nonconformity and Common Mental Health Problems: A Meta-Analysis

Yin Xu^*, Jinghao Feng, Qazi Rahman

^*Corresponding author for this work

Sichuan University

Research output: Contribution to journal › Review article › peer-review

Abstract

We tested the association between gender nonconformity and common mental health outcomes, including generalized anxiety symptoms, depressive symptoms, self-esteem, self-harm attempts, and suicide attempts using an exhaustive meta-analysis. PsycInfo, ProQuest Central, EBSCOhost, and PubMed were searched for eligible articles using either cross-sectional or longitudinal designs on 11th July 2024. A total number of 1975 articles were identified and selected following PRISMA. Twenty-five, 48, 32, seven, and nine studies were included on generalized anxiety symptoms, depressive symptoms, self-esteem, self-harm attempts, and suicide attempts, reaching a total sample size of 142,069, 188,681, 27,488, 47,523, and 25,573, respectively. Meta-analyses were performed using a random-effects model stratified by mental health outcomes. We found that higher levels of gender nonconformity were associated with higher levels of generalized anxiety (r = 0.06) and depressive symptoms (r = 0.11), lower levels of self-esteem (r = 0.18), and increased risk of self-harm (r = 0.17) and suicide attempts (r = 0.14). Gender nonconformity had stronger links to generalized anxiety symptoms, depressive symptoms, and self-esteem in men than in women. Behaviors-based gender nonconformity showed stronger links to depressive symptoms and self-esteem compared to traits-based gender nonconformity. The effect size for the association between gender nonconformity and depressive symptoms was significantly larger in adolescent samples than in childhood samples. There was no significant moderation by sexual orientation. While gender nonconformity is robustly associated with a range of common mental health problems, the magnitude of this association varies depending on the specific mental health outcomes considered and sex. Interventions to mitigate mental health differences and improve overall well-being among individuals who display greater gender nonconformity are needed.

Original language	English
Article number	102500
Journal	Clinical Psychology Review
Volume	114
DOIs	https://doi.org/10.1016/j.cpr.2024.102500
Publication status	Published - Dec 2024

Keywords

Gender nonconformity
Sexual orientation
LGBTQ+
Homosexuality
Lesbian, gay, bisexual
Meta-analysis
Mental health
Depressive symptoms
Suicide attempts
Self-esteem
Self-harm

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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title = "Gender Nonconformity and Common Mental Health Problems: A Meta-Analysis",

abstract = "We tested the association between gender nonconformity and common mental health outcomes, including generalized anxiety symptoms, depressive symptoms, self-esteem, self-harm attempts, and suicide attempts using an exhaustive meta-analysis. PsycInfo, ProQuest Central, EBSCOhost, and PubMed were searched for eligible articles using either cross-sectional or longitudinal designs on 11th July 2024. A total number of 1975 articles were identified and selected following PRISMA. Twenty-five, 48, 32, seven, and nine studies were included on generalized anxiety symptoms, depressive symptoms, self-esteem, self-harm attempts, and suicide attempts, reaching a total sample size of 142,069, 188,681, 27,488, 47,523, and 25,573, respectively. Meta-analyses were performed using a random-effects model stratified by mental health outcomes. We found that higher levels of gender nonconformity were associated with higher levels of generalized anxiety (r = 0.06) and depressive symptoms (r = 0.11), lower levels of self-esteem (r = 0.18), and increased risk of self-harm (r = 0.17) and suicide attempts (r = 0.14). Gender nonconformity had stronger links to generalized anxiety symptoms, depressive symptoms, and self-esteem in men than in women. Behaviors-based gender nonconformity showed stronger links to depressive symptoms and self-esteem compared to traits-based gender nonconformity. The effect size for the association between gender nonconformity and depressive symptoms was significantly larger in adolescent samples than in childhood samples. There was no significant moderation by sexual orientation. While gender nonconformity is robustly associated with a range of common mental health problems, the magnitude of this association varies depending on the specific mental health outcomes considered and sex. Interventions to mitigate mental health differences and improve overall well-being among individuals who display greater gender nonconformity are needed.",

keywords = "Gender nonconformity, Sexual orientation, LGBTQ+, Homosexuality, Lesbian, gay, bisexual, Meta-analysis, Mental health, Depressive symptoms, Suicide attempts, Self-esteem, Self-harm",

author = "Yin Xu and Jinghao Feng and Qazi Rahman",

note = "Publisher Copyright: {\textcopyright} 2024 Elsevier Ltd",

year = "2024",

month = dec,

doi = "10.1016/j.cpr.2024.102500",

language = "English",

volume = "114",

journal = "Clinical Psychology Review",

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AB - We tested the association between gender nonconformity and common mental health outcomes, including generalized anxiety symptoms, depressive symptoms, self-esteem, self-harm attempts, and suicide attempts using an exhaustive meta-analysis. PsycInfo, ProQuest Central, EBSCOhost, and PubMed were searched for eligible articles using either cross-sectional or longitudinal designs on 11th July 2024. A total number of 1975 articles were identified and selected following PRISMA. Twenty-five, 48, 32, seven, and nine studies were included on generalized anxiety symptoms, depressive symptoms, self-esteem, self-harm attempts, and suicide attempts, reaching a total sample size of 142,069, 188,681, 27,488, 47,523, and 25,573, respectively. Meta-analyses were performed using a random-effects model stratified by mental health outcomes. We found that higher levels of gender nonconformity were associated with higher levels of generalized anxiety (r = 0.06) and depressive symptoms (r = 0.11), lower levels of self-esteem (r = 0.18), and increased risk of self-harm (r = 0.17) and suicide attempts (r = 0.14). Gender nonconformity had stronger links to generalized anxiety symptoms, depressive symptoms, and self-esteem in men than in women. Behaviors-based gender nonconformity showed stronger links to depressive symptoms and self-esteem compared to traits-based gender nonconformity. The effect size for the association between gender nonconformity and depressive symptoms was significantly larger in adolescent samples than in childhood samples. There was no significant moderation by sexual orientation. While gender nonconformity is robustly associated with a range of common mental health problems, the magnitude of this association varies depending on the specific mental health outcomes considered and sex. Interventions to mitigate mental health differences and improve overall well-being among individuals who display greater gender nonconformity are needed.

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KW - Homosexuality

KW - Lesbian, gay, bisexual

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KW - Suicide attempts

KW - Self-esteem

KW - Self-harm

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U2 - 10.1016/j.cpr.2024.102500

DO - 10.1016/j.cpr.2024.102500

M3 - Review article

SN - 0272-7358

VL - 114

JO - Clinical Psychology Review

JF - Clinical Psychology Review

M1 - 102500

ER -

Gender Nonconformity and Common Mental Health Problems: A Meta-Analysis

Abstract

Keywords

UN SDGs

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